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Antoniazzi L, Miranda RC, Rauber F, Afonso C, Santos C, Lopes C, Rodrigues S, Levy RB. Inadequate intakes of fatty acids attributed to the ultra-processed foods consumed by Portuguese population: The upper project. Nutr Metab Cardiovasc Dis 2024; 34:2546-2554. [PMID: 39174431 DOI: 10.1016/j.numecd.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND AND AIMS Population-based studies suggest an inverse relationship between the dietary share of ultra-processed foods (UPF), as defined by NOVA classification, and the overall dietary nutritional quality. However, few studies have evaluated the impact of ultra-processed foods on the fatty acid profile of the diet. The aim of this study was to assess the association between consumption of UPF and the fatty acids profile of the diet in Portugal. METHODS AND RESULTS Cross-sectional data from IAN-AF 2015-2016 were used for this study. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. For both adults and elderly, the contents of total fatty acids (TFA), saturated fatty acids (SFA) and trans fatty (TRFA) were higher in the fraction of UPF, compared to the other three NOVA groups, while [monounsaturated fatty acids (MUFA)+, polyunsaturated fatty acids (PUFA)/SFA] ratio was lower. The UPF population attributable fraction (PAF) demonstrated that if the dietary contribution of UPF was reduced to levels observed in the first quintile, statistically significant reductions in the prevalence of inadequate intakes of fatty acids would be observed for adults [TRFA (PAF 98.37%, 95% CI 87.27-99.79) and SFA (PAF 37.26%, 95% CI 25.46-47.19)] and for elderly [TRFA (PAF 94.61%, 95% CI 77.59-98.71) and PUFA (PAF 98.28, 95% CI 48.22-99.94)]. CONCLUSIONS In this study the consumption of UPF was associated with a worse fatty acids profile in the Portuguese diet, adding evidence regarding the negative impact of UPF on diet quality.
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Affiliation(s)
- Luiza Antoniazzi
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Renata C Miranda
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil; Department of Nutrition, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Cristina Santos
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Associate Laboratory RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Carla Lopes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Renata B Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Zhao L, Zhang X, Yu D, Wang L, Shrubsole MJ, Zheng W, Sudenga SL, Zhang X. Ultra-processed products and risk of liver cancer: A prospective cohort study. Clin Nutr 2024; 43:2298-2304. [PMID: 39226717 DOI: 10.1016/j.clnu.2024.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 08/01/2024] [Accepted: 08/12/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND & AIMS Several studies have shown positive associations between ultra-processed foods and drinks and cancer risk. However, evidence remains limited for liver cancer. We aimed to evaluate the associations between ultra-processed foods and drinks and liver cancer risk. METHODS We included 73,119 participants (22,431 Whites, 47,837 Blacks, 2851 other race) from the Southern Community Cohort Study. Ultra-processed products were defined based on the Nova classification using data from a validated food frequency questionnaire and calculated as percentage of daily foods by weight. Incident liver cancer and vital status were ascertained via linkages to state cancer registries and the National Death Index as of December 31, 2019. RESULTS With a median of 13.9 year's follow-up, we documented 453 incident liver cancer cases. Participants with higher intake of ultra-processed foods had an elevated risk of liver cancer (hazard ratios [HR] Tertile 3 vs. tertile 1 1.69, 95% confidence intervals [CI]: 1.28-2.22; Ptrend<0.001). The subclasses of ultra-processed foods, such as ultra-processed grains and fried potatoes (HR T3 vs. T1 1.29, 95% CI: 1.01-1.65; Ptrend = 0.03), processed protein foods (HR T3 vs. T1 1.49, 95% CI: 1.14-1.94; Ptrend = 0.007) and mixed dishes (HR T3 vs. T1 1.39, 95% CI: 1.09-1.77; Ptrend = 0.01), were positively associated with liver cancer risk. No significant association was found for ultra-processed drinks (HR T3 vs. T1 0.85, 95% CI: 0.67-1.07; Ptrend = 0.16). DISCUSSION In a prospective cohort with predominantly low-income Southern US adults, we found certain ultra-processed foods were associated with a higher risk of liver cancer. Further studies are needed to confirm our findings.
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Affiliation(s)
- Longgang Zhao
- School of Nursing, Yale University, Orange, CT, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lei Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Martha J Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Staci L Sudenga
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xuehong Zhang
- School of Nursing, Yale University, Orange, CT, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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3
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Mackenbach JD, Pinho MGM, Stuber JM, van der Roest J, Lakerveld J, Beulens JWJ. The effects of nudging and pricing strategies on the availability and purchases of ultra-processed foods: A secondary analysis of the Supreme Nudge trial. Appetite 2024; 201:107599. [PMID: 38992569 DOI: 10.1016/j.appet.2024.107599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
Regular consumption of ultra-processed foods (UPF) is a risk factor for morbidity and mortality. UPF are widely available in supermarkets. Nudging and pricing strategies are promising strategies to promote healthier supermarket purchases and may reduce UPF purchases. We investigated whether supermarket nudging and pricing strategies targeting healthy foods, but not specifically discouraging UPF, would change UPF availability, price, promotion and placement (UPF-APPP) in supermarkets and customer UPF purchases. We used data from the Supreme Nudge parallel cluster-randomized controlled trial, testing the effect of a combined nudging and pricing intervention promoting healthy products. The Dutch Consumer Food Environment Score (D-CFES) was used to audit 12 participating supermarkets in terms of UPF-APPP. We used customer loyalty card data of the first twelve intervention weeks from 321 participants to calculate the proportion of UPF purchases. Descriptive statistics were used to assess differences in D-CFES between supermarkets. Mixed model analyses were used to assess the association between the D-CFES and UPF purchases and the effect of the intervention on UPF purchases. No difference in the D-CFES between intervention and control supermarkets were found. No statistically significant association between the D-CFES and UPF purchases (β = -0.00, 95%CI: -0.02, 0.01) and no significant effect of the intervention on UPF purchases (β = 0.02, 95%CI: -0.07, 0.12) was observed. Given the significant proportion of unhealthy and UPF products in Dutch supermarkets, nudging and pricing strategies aimed at promoting healthy food purchases are not sufficient for reducing UPF-APPP nor purchases, and nationwide regulation may be needed.Trial registration number: Dutch Trial Register ID NL7064, May 30, 2018, https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7302.
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Affiliation(s)
- J D Mackenbach
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, De Boelelaan 1117, Amsterdam, Netherlands.
| | - M G M Pinho
- Upstream Team, Amsterdam UMC, De Boelelaan 1117, Amsterdam, Netherlands; Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3584 CB, Utrecht, Netherlands
| | - J M Stuber
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, De Boelelaan 1117, Amsterdam, Netherlands
| | - J van der Roest
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health, Amsterdam, Netherlands
| | - J Lakerveld
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, De Boelelaan 1117, Amsterdam, Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Netherlands
| | - J W J Beulens
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, De Boelelaan 1117, Amsterdam, Netherlands
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Ilori T, Christofides N, Baldwin-Ragaven L. The relationship between food insecurity, purchasing patterns and perceptions of the food environment in urban slums in Ibadan, Nigeria. BMC Nutr 2024; 10:122. [PMID: 39294824 PMCID: PMC11409710 DOI: 10.1186/s40795-024-00929-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 09/05/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Rapid urbanisation without concomitant infrastructure development has led to the creation of urban slums throughout sub-Saharan Africa. People living in urban slums are particularly vulnerable to food insecurity due to the lack of physical and economic accessibility to food. Hence, it is important to explore how vulnerable groups living in slums interact with the food environment. This study assessed the relationships between food insecurity, including restrictive coping strategies, food purchasing patterns and perceptions about the food environment among dwellers of selected urban slums in Ibadan, Nigeria. METHODS This community-based cross-sectional study was conducted with people responsible for food procurement from 590 randomly selected households in two urban slums in Ibadan. Food insecurity and restrictive coping strategies were assessed using the Household Food Insecurity Access Scale and the Coping Strategy Index, respectively. We examined purchasing patterns of participants by assessing the procurement of household foodstuffs in different categories, as well as by vendor type. Participants' perceptions of the food environment were derived through a five-item composite score measuring food availability, affordability and quality. Chi-square tests and logistic regression models analysed associations between food insecurity, purchasing patterns and perceptions of the food environment. RESULTS The prevalence of food insecurity in the sample was 88%, with 40.2% of the households experiencing severe food insecurity. Nearly a third (32.5%) of the households used restrictive coping strategies such as limiting the size of food portions at mealtimes, while 28.8% reduced the frequency of their daily meals. Participants purchased food multiple times a week, primarily from formal and informal food markets rather than from wholesalers and supermarkets. Only a few households grew food or had livestock (3.2%). Food insecure households had a lower perceived access to the food environment, with an approximate 10% increase in access score per one-unit decrease in food insecurity (AOR = 0.90, 95% CI: 0.84, 0.96). The most procured foods among all households were fish (72.5%), bread (60.3%), rice (56.3%), yam and cassava flours (50.2%). Food-secure households procured fruit, dairy and vegetable proteins more frequently. CONCLUSION Food insecurity remains a serious public health challenge in the urban slums of Ibadan. Perceptions of greater access to the food environment was associated with increasing food security. Interventions should focus on creating more robust social and financial protections, with efforts to improve livelihoods to ensure food security among urban slum-dwellers.
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Affiliation(s)
- Temitope Ilori
- Family Medicine Unit, Department of Community Medicine, Faculty of Clinical Sciences, Ibadan, Nigeria.
- Department of Family Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Laurel Baldwin-Ragaven
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Morais R, Rodrigues M, Ferreira F, Barros R, Padrão P, Ortigão M, Tavares M, Moreira P. Ultra-Processed Foods and Nutritional Intake of Children and Adolescents from Cantagalo, São Tomé and Príncipe. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1089. [PMID: 39334622 PMCID: PMC11430853 DOI: 10.3390/children11091089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Globally, dietary patterns are shifting toward an increased consumption of ultra-processed foods, raising the risk of some metabolic and nutritional diseases from a young age. This trend is now also affecting low- and middle-income countries. Considering this, we aimed to assess the contribution of ultra-processed foods to total energy intake and their association with the nutritional intake of children and adolescents in Cantagalo, São Tomé and Príncipe. METHODS We conducted a cross-sectional study with a sample of 546 households. Data were collected on anthropometrics, sociodemographic characteristics, and lifestyle, including 24 h food recall questionnaires for children and adolescents. The reported foods were nutritionally assessed and categorized according to the NOVA classification to estimate the contribution of ultra-processed foods. Logistic regression models were used to estimate the magnitude of the associations between higher consumption of ultra-processed foods and nutritional intake, adjusting for confounders. RESULTS The contribution of ultra-processed foods to daily energy intake was 9.5% for girls and 8.5% for boys. Higher consumption of ultra-processed foods was significantly associated with a lower intake of fiber (OR = 0.932; 95%CI, 0.872-0.996), vitamin B12 (OR = 0.812; 95%CI, 0.668-0.985), and zinc (OR = 0.443; 95%CI, 0.308-0.639) and a higher intake of iron (OR = 1.479; 95%CI, 1.065-2.055) and sodium (OR = 1.001; 95%CI, 1.000-1.001), after adjusting for confounders. CONCLUSION Higher consumption of ultra-processed foods was especially associated with a lower intake of fiber, vitamin B12, and zinc, and with a higher intake of iron.
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Affiliation(s)
- Rita Morais
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (R.M.); (F.F.); (R.B.); (P.P.)
| | - Mónica Rodrigues
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Francisca Ferreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (R.M.); (F.F.); (R.B.); (P.P.)
| | - Renata Barros
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (R.M.); (F.F.); (R.B.); (P.P.)
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (R.M.); (F.F.); (R.B.); (P.P.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Madalena Ortigão
- Helpo–Non-Governmental Organization for Development, 2750-318 Cascais, Portugal; (M.O.); (M.T.)
| | - Maria Tavares
- Helpo–Non-Governmental Organization for Development, 2750-318 Cascais, Portugal; (M.O.); (M.T.)
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (R.M.); (F.F.); (R.B.); (P.P.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
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Berni Canani R, Carucci L, Coppola S, D'Auria E, O'Mahony L, Roth-Walter F, Vassilopolou E, Agostoni C, Agache I, Akdis C, De Giovanni Di Santa Severina F, Faketea G, Greenhawt M, Hoffman K, Hufnagel K, Meyer R, Milani GP, Nowak-Wegrzyn A, Nwaru B, Padua I, Paparo L, Diego P, Reese I, Roduit C, Smith PK, Santos A, Untersmayr E, Vlieg-Boerstra B, Venter C. Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report. Pediatr Allergy Immunol 2024; 35:e14231. [PMID: 39254357 DOI: 10.1111/pai.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/07/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. METHODS We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. RESULTS Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. CONCLUSION More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Enza D'Auria
- Allergy Unit-Buzzi Children's Hospital-University of Milan, Milan, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Franziska Roth-Walter
- Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Emilia Vassilopolou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Iaona Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Fiorenza De Giovanni Di Santa Severina
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Gaby Faketea
- Department of Pediatrics, "Karamandaneio" Children's Hospital of Patra, Patras, Greece
- Department of Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Matt Greenhawt
- Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Karin Hoffman
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Karin Hufnagel
- Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Rosan Meyer
- Department of Nutrition and Dietetics, Winchester University, Winchester, UK
- Department of Medicine, KU Leuven, Leuven, Belgium
| | - Gregorio Paolo Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Nowak-Wegrzyn
- Department of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, New York, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ines Padua
- Department of Sciences, University Institute of Health Sciences, Gandra, Portugal
- i4HB/UCIBIO - Translational Toxicology Research Laboratory, Gandra, Portugal
- CUF Porto Trindade Hospital, Porto, Portugal
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Peroni Diego
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Imke Reese
- Practice for Dietary Advice & Nutrition Therapy in Adverse Food Reactions, Munich, Germany
| | - Caroline Roduit
- Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
- CK-CARE, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Peter K Smith
- Griffith University, Southport, Queensland, Australia
| | - Alexandra Santos
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Eva Untersmayr
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Berber Vlieg-Boerstra
- Department of Paediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands
| | - Carina Venter
- Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
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7
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Hayes E, Dent E, Shannon OM, Zhong LZ, Bozanich T, Blekkenhorst LC, Zhu K, Bondonno CP, Siervo M, Hoogendijk EO, Hodgson JM, Prince RL, Lewis JR, Sim M. Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women. Eur J Nutr 2024; 63:2281-2290. [PMID: 38761280 PMCID: PMC11377636 DOI: 10.1007/s00394-024-03412-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/20/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE Dietary nitrate intake is inversely related to numerous contributors towards frailty, including cardiovascular disease and poor physical function. Whether these findings extend to frailty remain unknown. We investigated if habitual nitrate intake, derived from plants or animal-based foods, was cross-sectionally associated with frailty in women. METHODS Community-dwelling older Australian women (n = 1390, mean age 75.1 ± 2.7 years) completed a validated semi-quantitative food frequency questionnaire (FFQ). Nitrate concentrations in food were obtained from international nitrate databases. We adopted the Rockwood frailty index (FI) of cumulative deficits comprising 33 variables across multiple health domains (scored 0 to 1), which predicts increased hospitalisation and mortality risk. A FI ≥ 0.25 indicated frailty. Cross-sectional associations between nitrate intake (total plant and animal nitrate, separately) and frailty were analysed using multivariable-adjusted logistic regression models (including lifestyle factors), as part of restricted cubic splines. RESULTS A non-linear inverse relationship was observed between total plant nitrate intake and frailty. Compared to women with the lowest plant nitrate intake (Quartile [Q]1), women with greater intakes in Q2 (OR 0.69 95%CI 0.56-0.84), Q3 (OR 0.67 95%CI 0.50-0.90) and Q4 (OR 0.66 95%CI 0.45-0.98) had lower odds for frailty. A nadir in the inverse association was observed once intakes reached ~ 64 mg/d (median Q2). No relationship was observed between total animal nitrate and frailty. CONCLUSION Community-dwelling older women consuming low amounts of plant-derived nitrate were more likely to present with frailty. Consuming at least one daily serving (~ 75 g) of nitrate-rich green leafy vegetables may be beneficial in preventing frailty.
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Affiliation(s)
- Eleanor Hayes
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Elsa Dent
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Oliver M Shannon
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lie Zhou Zhong
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
| | - Trent Bozanich
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
| | - Lauren C Blekkenhorst
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Kun Zhu
- Medical School, The University of Western Australia, Perth, WA, Australia
- Deparment of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Catherine P Bondonno
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Mario Siervo
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands
- Ageing and Later Life Research Program, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands
| | - Jonathan M Hodgson
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Richard L Prince
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia.
- Medical School, The University of Western Australia, Perth, WA, Australia.
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8
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Duquenne P, Capperella J, Fezeu LK, Srour B, Benasi G, Hercberg S, Touvier M, Andreeva VA, St-Onge MP. The Association Between Ultra-Processed Food Consumption and Chronic Insomnia in the NutriNet-Santé Study. J Acad Nutr Diet 2024; 124:1109-1117.e2. [PMID: 38423510 DOI: 10.1016/j.jand.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/02/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The consumption of ultra-processed foods (UPF) is on the rise worldwide, and it has been linked to numerous health conditions, such as diabetes, obesity, and cancer. Few studies have focused on the effect of UPF consumption on sleep health and even fewer on chronic insomnia. OBJECTIVE This study investigated the association between UPF intake and chronic insomnia in a large population-based sample. DESIGN This was a cross-sectional analysis using the NutriNet-Santé study data, an ongoing Web cohort in France. PARTICIPANTS/SETTING Thirty-eight thousand five hundred seventy adult males and females who had completed a sleep questionnaire (2014) and at least two 24-hour dietary records were included in the analysis. MAIN OUTCOMES MEASURES Chronic insomnia was defined according to established criteria. Categorization of food and beverages as UPF was based on the NOVA-Group 4 classification. STATISTICAL ANALYSES PERFORMED The cross-sectional association between UPF intake and chronic insomnia was assessed using multivariable logistic regression. RESULTS Among the 38,570 participants (mean age, 50.0 ±14.8 years, 77.0% female) included in the analysis, 19.4% had symptoms of chronic insomnia. On average, UPF represented 16% of the total amount (g/day) of the overall dietary intake. In the fully adjusted model, UPF consumption was associated with higher odds of chronic insomnia (odds ratio [OR] for an absolute 10% greater UPF intake in the diet = 1.06; 95% confidence interval [CI]: 1.02-1.09). Sex-specific OR for chronic insomnia for an absolute 10% greater UPF intake in the diet were 1.09 (1.01-1.18) among males and 1.05 (1.01-1.09) among females. CONCLUSIONS This large epidemiological study revealed a statistically significant association between UPF intake and chronic insomnia, independent of sociodemographic, lifestyle, diet quality, and mental health status covariates. The findings provide insights for future longitudinal research as well as nutrition- and sleep-focused intervention and prevention programs.
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Affiliation(s)
- Pauline Duquenne
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France.
| | - Julia Capperella
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Giada Benasi
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY
| | - Serge Hercberg
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France; Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY
| | - Marie-Pierre St-Onge
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY.
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9
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Kim HK, Kim H, Lee A. Attributes of multiple concurrent functional gastrointestinal disorders in female university students in South Korea. Women Health 2024; 64:674-686. [PMID: 39192526 DOI: 10.1080/03630242.2024.2396950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 07/24/2024] [Accepted: 08/22/2024] [Indexed: 08/29/2024]
Abstract
Functional gastrointestinal disorders (FGIDs) are common in young adults, particularly women, who tend to develop multiple FGIDs over time. This study aimed to investigate the prevalence of multiple concurrent FGIDs among female university students and identify differences in dietary habits, academic stress, and quality of life (QOL) based on the number of concurrent FGIDs. This secondary analysis included data from 406 female participants, originally collected through an online survey from two universities in one city in Korea. The online survey was accessible only after participants were verified as students through their online community. Concurrent FGID was present in 25.8 percent (n = 16) of the participants with FGIDs (n = 62), with the most common being irritable bowel syndrome + functional dyspepsia overlap (43.8 percent, 7/16). Participants with multiple concurrent FGIDs consumed fewer grains and vegetables, while significantly more of them consumed instant food, fast food, milk, and tea/coffee. They experienced significantly higher academic stress and lower QOL than those without the disease. Female university students with concurrent FGIDs tend to have unhealthy dietary habits, and concurrent FGIDs negatively affect academic stress and QOL. Therefore, female university students should undergo early-stage screening for FGIDs, and a comprehensive program should address their dietary habits and stress-coping skills.
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Affiliation(s)
- Hyo Kyung Kim
- School of Nursing, Hallym University, Chuncheon, South Korea
| | - Hyunjung Kim
- School of Nursing & Research Institute of Nursing Science, Hallym University, Chuncheon, South Korea
| | - Aram Lee
- School of Nursing, Kyungdong University, Wonju, South Korea
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10
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Daas MC, Vellinga RE, Pinho MGM, Boer JMA, Verschuren WMM, van der Schouw YT, Van't Veer P, Biesbroek S. The role of ultra-processed foods in plant-based diets: associations with human health and environmental sustainability. Eur J Nutr 2024:10.1007/s00394-024-03477-w. [PMID: 39180555 DOI: 10.1007/s00394-024-03477-w] [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: 08/14/2023] [Accepted: 07/31/2024] [Indexed: 08/26/2024]
Abstract
PURPOSE Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC). METHODS Analyses were based on 35,030 participants (20-70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption. RESULTS With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and - 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores. CONCLUSION Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.
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Affiliation(s)
- Merel C Daas
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands.
| | - Reina E Vellinga
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands
- Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - Maria Gabriela M Pinho
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, Utrecht, 3584 CB, The Netherlands
| | - Jolanda M A Boer
- Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - W M Monique Verschuren
- Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands
| | - Pieter Van't Veer
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands
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11
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van Zonneveld SM, van den Oever EJ, Haarman BCM, Grandjean EL, Nuninga JO, van de Rest O, Sommer IEC. An Anti-Inflammatory Diet and Its Potential Benefit for Individuals with Mental Disorders and Neurodegenerative Diseases-A Narrative Review. Nutrients 2024; 16:2646. [PMID: 39203783 PMCID: PMC11357610 DOI: 10.3390/nu16162646] [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: 07/25/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
This narrative review synthesizes current evidence regarding anti-inflammatory dietary patterns and their potential benefits for individuals with mental disorders and neurodegenerative diseases. Chronic low-grade inflammation is increasingly recognized as a key factor in the etiology and progression of these conditions. The review examines the evidence for the anti-inflammatory and neuroprotective properties of dietary components and food groups, focusing on whole foods rather than specific nutrients or supplements. Key dietary components showing potential benefits include fruits and vegetables (especially berries and leafy greens), whole grains, legumes, fatty fish rich in omega-3, nuts (particularly walnuts), olive oil, and fermented foods. These foods are generally rich in antioxidants, dietary fiber, and bioactive compounds that may help modulate inflammation, support gut health, and promote neuroprotection. Conversely, ultra-processed foods, red meat, and sugary beverages may be harmful. Based on this evidence, we designed the Brain Anti-Inflammatory Nutrition (BrAIN) diet. The mechanisms of this diet include the modulation of the gut microbiota and the gut-brain axis, the regulation of inflammatory pathways, a reduction in oxidative stress, and the promotion of neuroplasticity. The BrAIN diet shows promise as an aid to manage mental and neurodegenerative disorders.
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Affiliation(s)
- Sophie M. van Zonneveld
- Department of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Ellen J. van den Oever
- Department of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Benno C. M. Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Emmy L. Grandjean
- Department of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Jasper O. Nuninga
- Department of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Ondine van de Rest
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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12
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Erdoğan Gövez N, Köksal E, Martinez-Perez C, Daimiel L. Validity and Reliability of the Turkish Version of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). Nutrients 2024; 16:2552. [PMID: 39125430 PMCID: PMC11314031 DOI: 10.3390/nu16152552] [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: 07/01/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
The global consumption of highly (ultra) processed foods (HPFs) is increasing, and it is associated with non-communicable diseases. This study aimed to assess the validity and reliability of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). This study included 94 adults. Sociodemographic data were collected, and anthropometric and blood pressure measurements were performed. The sQ-HPF was translated into Turkish and culturally adapted. Dietary intake was assessed using three-day dietary records. Factor analysis and Cronbach's alpha were used to evaluate the validity and consistency of the sQ-HPF. Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Three items from the original sQ-HPF were excluded due to low factor loadings. The Kaiser-Meyer Olkin (KMO) coefficient for the measure of sample adequacy was found to be 0.642 and Bartlett's test of sphericity was found to be significant (p < 0.001). A significant correlation was found between the sQ-HPF score and HPF consumption derived from the 3-day dietary records (p < 0.05). Cronbach's alpha was found to be 0.65. Individuals with higher sQ-HPF scores consumed a significantly greater percentage of energy from HPFs (kcal/day) (p < 0.001). The sQ-HPF demonstrated good test-retest reliability (ICC = 0.76). The Turkish version of the sQ-HPF is a valid and reliable tool for assessing HPF consumption patterns and can be used in epidemiological and clinical studies.
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Affiliation(s)
- Nazlıcan Erdoğan Gövez
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara 06490, Turkey;
| | - Eda Köksal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara 06490, Turkey;
| | - Celia Martinez-Perez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
| | - Lidia Daimiel
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
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13
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Menichetti G, Barabási AL, Loscalzo J. Decoding the Foodome: Molecular Networks Connecting Diet and Health. Annu Rev Nutr 2024; 44:257-288. [PMID: 39207880 DOI: 10.1146/annurev-nutr-062322-030557] [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: 09/04/2024]
Abstract
Diet, a modifiable risk factor, plays a pivotal role in most diseases, from cardiovascular disease to type 2 diabetes mellitus, cancer, and obesity. However, our understanding of the mechanistic role of the chemical compounds found in food remains incomplete. In this review, we explore the "dark matter" of nutrition, going beyond the macro- and micronutrients documented by national databases to unveil the exceptional chemical diversity of food composition. We also discuss the need to explore the impact of each compound in the presence of associated chemicals and relevant food sources and describe the tools that will allow us to do so. Finally, we discuss the role of network medicine in understanding the mechanism of action of each food molecule. Overall, we illustrate the important role of network science and artificial intelligence in our ability to reveal nutrition's multifaceted role in health and disease.
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Affiliation(s)
- Giulia Menichetti
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;
- Network Science Institute and Department of Physics, Northeastern University, Boston, Massachusetts, USA
- Harvard Data Science Initiative, Harvard University, Boston, Massachusetts, USA
| | - Albert-László Barabási
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;
- Network Science Institute and Department of Physics, Northeastern University, Boston, Massachusetts, USA
- Department of Network and Data Science, Central European University, Budapest, Hungary
| | - Joseph Loscalzo
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;
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14
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Pries AM, Bassetti E, Badham J, Baker P, Blankenship J, Dunford EK, Kupka R. Ultraprocessing and presence of additives in commercially produced complementary foods in seven Southeast Asian countries: a cross-sectional study. Am J Clin Nutr 2024; 120:310-319. [PMID: 38816268 PMCID: PMC11347792 DOI: 10.1016/j.ajcnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND There has been a dramatic shift in food systems, and the consumption of commercially processed and packaged foods has grown globally, including among older infants and young children. Many of these products are ultraprocessed and contain additives, with concerning implications for the health and nutrition of children. OBJECTIVES The study objectives were as follows: 1) to assess the levels of processing among different commercially produced complementary food product (CPCF) categories marketed in the Southeast Asia region, 2) to compare the nutrient content of CPCF products across levels of processing, and 3) to assess the types of additives present in different CPCF categories. METHODS This cross-sectional study involved secondary analysis of a cross-sectional dataset of product label information from CPCF purchased in 2021 in Cambodia, Indonesia, Lao People's Democratic Republic, Malaysia, Philippines, Thailand, and Viet Nam. Ingredient lists were reviewed to determine the level of processing-based on the Nova classification-and the presence of additives. Nutrient declaration panels were reviewed to determine total sugar, sodium, and total fat. RESULTS Nearly half of all CPCF were ultraprocessed, with total sugar and sodium content significantly higher among ultraprocessed CPCF than unprocessed/minimally processed products. Almost half of CPCF contained additives, with a median of 6 per product. More than 30% of all CPCF made use of cosmetic additives to enhance the products' appearance, flavor, or texture, with emulsifiers, colors, and thickeners the most prevalent. Almost one-third of products contained additives not permitted in Codex Alimentarius standards and guidelines for CPCF. CONCLUSIONS Findings from this study should alert national governments to both adopt and ensure enforcement of Codex guidance on additives and regulations enacted to encourage lower levels of processing for CPCF.
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Affiliation(s)
- Alissa M Pries
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand.
| | | | | | - Philip Baker
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Elizabeth K Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Roland Kupka
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand
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15
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Cheon BK, Tan YF, Forde CG. Food essentialism: Implications for expectations and perceptions of the properties of processed foods. Food Qual Prefer 2024; 117:105173. [PMID: 38706540 PMCID: PMC11067066 DOI: 10.1016/j.foodqual.2024.105173] [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] [Indexed: 05/07/2024]
Abstract
Despite the impact of processed foods on health, sustainability, and food security, consumers vary greatly in expectations about and preferences for processed foods. Essentialism is the lay belief that items in a category share a fundamental and immutable essence that generates the category's defining characteristics. Although essentialism may be an important determinant of consumers' cognitions about processed foods, there has been limited investigation of essentialism's role in food-related perceptions. Across two studies (n=598 total), we used a novel measure of food essentialism to examine whether individual differences in beliefs about foods as having essences (food essentialism) are related to perceptions of foods retaining more of their natural characteristics (sensory and nutritive properties) despite their level of processing. Across diverse food categories (meats, vegetables, fruits, legumes, dairy), higher levels of perceived food processing were associated with lower perceived retention of naturalness, nutritiousness, natural taste, functional post-ingestive benefits, and acceptability (liking). However, participants endorsing greater (vs. lower) food essentialism beliefs exhibited weaker relationships between perceived processing and these characteristics. We also observed variations across food categories in relationships between perceived level of processing and food properties, suggesting that some foods (i.e., milk-based products) are perceived to possess essences that are more robust despite undergoing higher levels of processing. These findings demonstrate that food-specific essentialism beliefs may be a fundamental determinant of consumers' expectations of how human intervention, such as processing, affects natural properties of foods. These beliefs may be a promising target for future research to shift consumer acceptance of processed foods.
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Affiliation(s)
- Bobby K Cheon
- Social & Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
| | - Yan Fen Tan
- Clinical Nutrition Research Centre, Singapore Institute of Food Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ciarán G Forde
- Sensory Science and Eating Behavior Group, Division of Nutrition, Wageningen University and Research, Netherlands
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16
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González-Cantero JO, López-Torres LP, Alvarado-Avalos IR, López-Alcaraz F, Gasca-Suarez E, Cisneros-Hernández AA, Valadez A, Macías-Espinoza F, Dominguez-Rodriguez A. An internet-based self-help intervention for the reduction of consumption of ultra-processed products and increase of physical activity in Mexican university population: study protocol for a randomized controlled trial. Front Nutr 2024; 11:1325528. [PMID: 39221160 PMCID: PMC11363904 DOI: 10.3389/fnut.2024.1325528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 06/19/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction The consumption of ultra-processed products has been associated with the etiology of various diseases, mainly metabolic diseases. On the other hand, physical activity acts as a protective factor that helps prevent the appearance of this type of disease. In addition to the physical effects, both the consumption of ultra-processed products (UPPs) and sedentary behaviors have been associated with a significant impact on people's mental health. These problems occur significantly in university students. Online internet interventions are an alternative that has the advantage of reaching a broader sample size and adapting to various problems. Methods A randomized controlled clinical superiority trial with two independent groups will be developed with 176 participants. Participants in both groups will be evaluated in 5 steps: (1) pretest, (2) middle of the intervention, (3) post-test, (4) follow-up at 3 months, and (5) follow-up at 6 months. In the experimental group ("UNISALUD"), participants will receive an intervention composed of 11 sessions with interactive elements such as videos, audio, and infographics created through the user experience (UX) principles and based on the health action process approach (HAPA). The participants in the control group will be on the waiting list and will receive treatment 27 days after fulfilling the inclusion criteria. Thus, participants will not receive the treatment immediately. Discussion The study is expected to establish the feasibility of a self-help internet-based intervention created based on the user experience methodology and the health action process model, leading to a significant decrease and increase in the consumption of UPPs, ultra-healthy products, and physical activity, respectively. Conclusion Internet-based interventions are scarce in Latin America. Due to their potential, this study will provide data about consumption of UPPs, physical activity, and mental health of the Mexican population, which will influence the reduction of health-related complications through prevention strategies or measures.Clinical Trial Registration:ClinicalTrials.gov, NCT05834842.
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Affiliation(s)
- Joel Omar González-Cantero
- Departamento de Ciencias del Comportamiento, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca, Mexico
| | - Leyna Priscila López-Torres
- Departamento de Ciencias Sociales, Maestría en Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Itzel Refugio Alvarado-Avalos
- Maestría en Psicología de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Estefania Gasca-Suarez
- Maestría en Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Adrian Antonio Cisneros-Hernández
- Departamento de Proyectos de Comunicación, Centro Universitario de Arte, Arquitectura y Diseño, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alexandra Valadez
- Departamento de Transformaciones Sociales, Centro Universitario de Tlajomulco, Universidad de Guadalajara, Tlajomulco, Mexico
| | - Fabiola Macías-Espinoza
- Departamento de Psicología Aplicada, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Brito FDSB, da Costa ES, Romeiro ACT, dos Santos DM, Brito ADS, de Oliveira ASD, Adegboye ARA. Exploring Maternal Socio-Demographic Factors Shaping Children's Dietary Patterns in Brazil: Results from the 2019 National Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:992. [PMID: 39200603 PMCID: PMC11353673 DOI: 10.3390/ijerph21080992] [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: 05/26/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 09/02/2024]
Abstract
This study aimed to identify the dietary patterns of Brazilian children aged 6-23 months and to investigate their association with maternal socio-demographic factors. Data from the 2019 Brazilian National Health Survey were used in this cross-sectional study. Mothers of 1616 children aged 6-23 months reported on their children's dietary intake. Dietary patterns were identified using principal component analysis, and their associations with maternal socio-demographic characteristics were assessed using linear regression models. The first consisted of healthy patterns and the second, unhealthy ones. Linear regression showed that adherence to a healthy dietary pattern was higher among children of mothers who were older (β = 0.02, p = 0.01), had more years of education (β = 0.49, p = 0.04), reported living with a partner (β = 0.29, p = 0.01), and resided in an urban area (β = 0.35, p = 0.01). Conversely, adherence to the unhealthy pattern was positively associated with mothers who declared themselves as black or brown (β = 0.25, p = 0.03). Our results show that older mothers with higher levels of education and paid work and who live with a partner are more likely to contribute to their children's healthy eating patterns. We conclude that socio-demographic factors may influence the quality of the food offered to children. Nevertheless, advocating for public policies promoting nutritious complementary diets emphasising fresh and minimally processed foods remains crucial for children whose mothers do not possess these favourable socio-demographic characteristics.
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Affiliation(s)
- Flávia dos Santos Barbosa Brito
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (E.S.d.C.); (D.M.d.S.); (A.S.D.d.O.)
| | - Emanuela Santos da Costa
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (E.S.d.C.); (D.M.d.S.); (A.S.D.d.O.)
| | | | - Debora Martins dos Santos
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (E.S.d.C.); (D.M.d.S.); (A.S.D.d.O.)
| | - Alexandre dos Santos Brito
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-598, Brazil;
| | - Alessandra Silva Dias de Oliveira
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (E.S.d.C.); (D.M.d.S.); (A.S.D.d.O.)
| | - Amanda Rodrigues Amorim Adegboye
- Centre for Agroecology, Water and Resilience (CAWR), Coventry University, Coventry CV8 3LG, UK
- Centre for Healthcare Research, Coventry University, Coventry CV1 5FB, UK
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Barrett EM, Pettigrew S, Neal B, Rayner M, Coyle DH, Jones A, Maganja D, Gaines A, Mozaffarian D, Taylor F, Ghammachi N, Wu JHY. Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing. Nutr Diet 2024. [PMID: 38984976 DOI: 10.1111/1747-0080.12892] [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: 02/09/2024] [Revised: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 07/11/2024]
Abstract
AIM To modify the Australian and New Zealand Health Star Rating to account for ultra-processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit). METHODS Data was cross-sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five 'negative' points added to ultra-processed products (modification 1; inclusion approach); (2) ultra-processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 'negative' points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1-3 or core. RESULTS All Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category. CONCLUSIONS If ultra-processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra-processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians.
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Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Friedman School of Nutrition Science & Policy, Food is Medicine Institute, Tufts University, Boston, Massachusetts, USA
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mike Rayner
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Damian Maganja
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Allison Gaines
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Food is Medicine Institute, Tufts University, Boston, Massachusetts, USA
- Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Fraser Taylor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nadine Ghammachi
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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da Silva Oliveira EK, Vieira TDS, de Souza OF, Noll PRES, Bezerra IMP, Cavalcanti MPE, de Abreu LC, Riera ARP. Consumption of Ultra-Processed Foods in the Brazilian Amazon during COVID-19. Nutrients 2024; 16:2117. [PMID: 38999865 PMCID: PMC11243564 DOI: 10.3390/nu16132117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND A COVID-19 pandemic erupted, causing a global viral pneumonia outbreak, marking the most significant public health crisis of the 21st century. These changes profoundly impacted population health and well-being, leading to shifts in dietary habits. This study aimed to evaluate the consumption of ultra-processed foods in the Brazilian Amazon before, during, and after the COVID-19 pandemic. METHODS This is a secondary data analysis study derived from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel, 2019-2021) of the Brazilian Ministry of Health. All statistical analyses were performed using the Stata 17 statistical program in the survey module (svy). RESULTS We found an increased frequency in the subgroups of consumption of ultra-processed foods in the capital of the Brazilian Amazon region between the years 2019 and 2021. In the cities of Boa Vista and Macapá, there was a significant increase in the consumption of snacks, salty snacks, cookies, and meat products. Boa Vista and Macapá showed an increase in the percentage difference in the consumption ≥5 of ultra-processed subgroups, being 30.4% (p = 0.014) and 53.7% (p = 0.014), respectively. CONCLUSIONS The study indicated an increase in the consumption of ultra-processed foods in the Brazilian Amazon region during and after social distancing.
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Affiliation(s)
- Elyecleyde Katiane da Silva Oliveira
- Post-Graduation Program in Health Sciences, University Center FMABC, Santo André 09060-650, SP, Brazil
- Server Health Surveillance Coordination, Federal University of Acre, Rio Branco 69920-900, AC, Brazil
| | - Tamires dos Santos Vieira
- Post-Graduation Program in Health and Nutrition, Federal University of Espírito Santo, Vitória 69920-900, ES, Brazil;
| | | | | | - Italla Maria Pinheiro Bezerra
- Graduate Program in Public Policies and Local Development, Superior School of Sciences of the Santa Casa de Misericórdia, Vitória 29027-502, ES, Brazil
| | | | - Luiz Carlos de Abreu
- Department of Integrated Health Education, Federal University of Espírito Santo, Vitória 29043-900, ES, Brazil
- COVID-19 Observatory Brazil and Ireland, University of Limerick, V94 T9PX Limerick, Ireland
| | - Andres Ricardo Perez Riera
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-650, SP, Brazil;
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20
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Costa BDFD, Correa C, Pedrollo EF, Manfro RC, Leitão CB, Souza GC. Ultra-Processed Food Consumption, Poorer Nutritional Quality, and Lower Muscle Mass in Immediate and Late Postkidney Transplant Periods. J Ren Nutr 2024; 34:313-320. [PMID: 38290697 DOI: 10.1053/j.jrn.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/27/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE To assess the consumption of ultra-processed foods (UPFs) in the immediate (2 months after transplantation) and late post-transplant (14 months after transplantation) periods among kidney transplant patients and to examine its correlation with nutritional quality and body composition. DESIGN AND METHODS A cross-sectional analysis of 96 kidney transplant recipients divided into 2 groups: immediate post-transplant (n = 71) and late post-transplant (n = 25). Sociodemographic, anthropometric, and laboratory data were collected and grouped in a database. Food intake was evaluated by a validated food frequency questionnaire and foods were divided according to the NOVA classification system. The consumption of UPFs was calculated and statistical analyses were performed to evaluate its correlation with nutritional components and body composition. RESULTS The consumption of UPFs was 649.4 [420.0-1061.72] kcal/day, accounting for 33.3 ± 11.9% of the total daily energy intake. The immediate post-transplant group showed higher total daily energy and UPFs intake compared to the late post-transplant group (P = .002 and P = .046, respectively), although the energy contribution of UPFs was similar between both groups. UPFs intake was positively correlated with higher percentages of total fat, trans fat, saturated, monounsaturated fat, polyunsaturated fat, starch, and sodium (P < .05 for all analyses). An inverse correlation was observed between UPFs consumption and the percentage of protein and carbohydrates in the food intake (P = .025 and P = .008, respectively). In the immediate post-transplant group, a higher intake of UPFs was correlated with lower muscle mass (r = -0.250, P = .037). CONCLUSIONS The findings of this study reveal a pattern of increased consumption of UPFs among kidney transplant patients in comparison to the national average. This higher intake of UPFs was correlated with lower nutritional quality during both periods. Moreover, a significant correlation was observed between UPFs consumption and adverse body composition parameters, specifically in the immediate post-transplant period.
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Affiliation(s)
- Beatriz Dorneles Ferreira da Costa
- Postgraduate Program in Medical Sciences, Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, and Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Camila Correa
- Postgraduate Program in Medical Sciences, Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, and Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Nephrology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Elis Forcellini Pedrollo
- Postgraduate Program in Medical Sciences, Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, and Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Roberto Ceratti Manfro
- Nephrology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane Bauermann Leitão
- Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Corrêa Souza
- Department of Nutrition, Postgraduate Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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21
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Hu S, Gearhardt AN, LaFata EM. Development of the modified Highly Processed Food Withdrawal Scale (mProWS). Appetite 2024; 198:107370. [PMID: 38653374 DOI: 10.1016/j.appet.2024.107370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
The Highly Processed Food Withdrawal Scale (ProWS) is a 29-item measure that operationalizes physical and psychological indicators of withdrawal symptoms associated with cutting down on the consumption of ultra-processed foods. The current study developed a briefer 7-item version of the ProWS (modified ProWS; mProWS) using the participant sample from the ProWS validation paper (n = 231). Then, in an independent sample recruited from Amazon Mechanical Turk, 244 participants (55.3% females) completed the mProWS, the ProWS, and measures of eating-related constructs in order to evaluate the psychometric properties of the mProWS, relative to the ProWS. The mProWS and the ProWS performed similarly on indexes of reliability, convergent validity with addictive-like eating behavior (e.g., Yale Food Addiction Scale 2.0 symptom count), discriminant validity with distinct measures (e.g., cognitive desire to restrict food consumption), and incremental validity evidenced by associations with weight cycling above and beyond body mass index (BMI) and YFAS 2.0 symptoms. The mProWS may be an appropriate choice for studies with higher participant burden (e.g., ecological momentary assessment) to assess withdrawal symptoms in real-time when they occur in response to cutting down on ultra-processed foods.
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Affiliation(s)
- Shuchen Hu
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, USA.
| | | | - Erica M LaFata
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
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22
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Jouppi RJ, Levine MD. Hedonic hunger, ultra-processed food consumption, and the moderating effects of impulsivity in pregnant individuals with body mass index ≥ 25. Appetite 2024; 198:107385. [PMID: 38692512 PMCID: PMC11109919 DOI: 10.1016/j.appet.2024.107385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/12/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
Evidence suggests higher hedonic hunger (preoccupation with/desire to consume food for pleasure) is associated with greater ultra-processed food (UPF) consumption in non-pregnant individuals with higher, but not lower, self-report impulsivity or delay discounting. The current study tested the association between hedonic hunger and UPF consumption, and the moderating effects of self-report impulsivity and delay discounting, during pregnancy. Individuals (N = 220) with body mass index (BMI)≥25 completed the Power of Food Scale, 24-h dietary recalls, and Barratt Impulsiveness Scale-Version 11 in early-mid pregnancy. A subset enrolled in an ancillary study (n = 143) completed a Delay Discounting Task. Linear regression and moderation models covaried for age, gestational age, pre-pregnancy BMI, and socioeconomic status. The association between hedonic hunger and UPF consumption was nonsignificant (p = 0.47). Self-report impulsivity was not a significant moderator (p = 0.11), but delay discounting was (p = 0.01). Simple slopes analysis revealed a one-unit increase in hedonic hunger was associated with 7% lower UPF intake among participants with lower (M+1SD) delay discounting (p = 0.01) and 1% higher UPF intake among those with higher (M-1SD) delay discounting (p = 0.57). Findings contrast those from research with non-pregnant samples and indicate lower delay discounting may serve as a protective factor, associated with reduced UPF consumption at higher levels of hedonic hunger, during pregnancy.
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Affiliation(s)
- Riley J Jouppi
- Department of Psychology, University of Pittsburgh, Sennott Square - Floor 3, 210 South Bouquet Street, Pittsburgh, 15260, PA, USA.
| | - Michele D Levine
- Department of Psychology, University of Pittsburgh, Department of Psychiatry, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, 15213, PA, USA.
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Fung TT, Rossato SL, Chen Z, Khandpur N, Rodriguez-Artalejo F, Willett WC, Struijk EA, Lopez-Garcia E. Ultraprocessed foods, unprocessed or minimally processed foods, and risk of frailty in a cohort of United States females. Am J Clin Nutr 2024; 120:232-239. [PMID: 38750726 DOI: 10.1016/j.ajcnut.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Ultraprocessed foods (UPFs) and poor diet quality have been associated with frailty but existing studies had relatively short follow-up time. It is also unclear whether the association of UPF was primarily due to its correlation with poorer diet quality. OBJECTIVES We examined the association between unprocessed or minimally processed foods (UMFs) and UPF and risk of frailty and explored whether the association with UPF was mainly driven by poor diet quality. METHODS In total, 63,743 nonfrail females aged 60+ y from the Nurses' Health Study (cohort study) were followed up for ≥26 y. Diet was assessed every 4 y by food frequency questionnaires. UPF and UMF intakes were calculated using the Nova classification. Diet quality was estimated using the Alternate Healthy Eating Index (AHEI) 2010. The association of UMF and UPF with risk of frailty was examined using multivariable adjusted Cox proportional hazard model. RESULTS During the follow-up period, we recorded 15,187 incident cases of frailty. The hazard ratio (HR) of frailty for the highest compared with the lowest quintile of UMFs (servings per day) was 0.86 (95% CI: 0.83, 0.95; P-trend < 0.001). However, this was no longer statistically significant after adjustment for AHEI-2010. UPFs (servings per day) was directly associated with risk of frailty, even after adjustment for AHEI-2010 (1.31; 95% CI: 1.23, 1.39; P-trend < 0.001). Among those at the highest category of the AHEI-2010, UPFs remained directly associated with frailty (HR comparing top with bottom quintile: 1.40; 95% CI:1.24, 1.57; P-trend < 0.001). For UPF components, we found a higher frailty risk with each serving per day of artificial and sugar-sweetened beverages; fat, spreads, and condiments; yogurt and dairy-based desserts; and other UPFs. However, processed whole grains were not associated with frailty. CONCLUSIONS Higher intake of UPF is associated with a higher risk of frailty in older females. This is not explained by a lower diet quality contributed by UPFs.
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Affiliation(s)
- Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Sinara L Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Laboratory of Research and Extension in Epidemiolgy (Lapex-Epi), Institute of Geography Universidade Federal de Uberlândia. Uberlândia, Brazil
| | - Zhangling Chen
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Division of Human Nutrition and Health, Wageningen University, Netherlands; Faculty of Public Health, University of Sao Paulo, Brazil
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Instituto Madrileño De Estudios Avanzado-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid+Centro Superior de Investigaciones Científicas, Madrid, Spain
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Pires RK, Griep RH, Scaranni PDODS, Moreno AB, Molina MDCB, Luft VC, da Fonseca MDJM, Cardoso LDO. Stress and the Consumption of Ultra-Processed Foods during COVID-19's Social Distancing: Are Mental Disorders Mediators in This Association? ELSA-Brasil Results. Nutrients 2024; 16:2097. [PMID: 38999844 PMCID: PMC11243013 DOI: 10.3390/nu16132097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.
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Affiliation(s)
- Raphaela Kistenmacker Pires
- Postgraduate Program in Public Health Epidemiology, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
| | - Rosane Harter Griep
- Laboratory of Education in Environment and Health, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
| | | | - Arlinda B. Moreno
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (A.B.M.); (M.d.J.M.d.F.); (L.d.O.C.)
| | - Maria del Carmen B. Molina
- Postgraduate Program in Nutrition and Health, Universidade Federal do Espírito Santo, Vitoria 29075-910, Brazil;
| | - Vivian C. Luft
- Postgraduate Program in Epidemiology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Brazil;
| | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (A.B.M.); (M.d.J.M.d.F.); (L.d.O.C.)
| | - Leticia de Oliveira Cardoso
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (A.B.M.); (M.d.J.M.d.F.); (L.d.O.C.)
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25
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Rossato S, Oakes EG, Barbhaiya M, Sparks JA, Malspeis S, Willett WC, Khandpur N, Costenbader KH. Ultraprocessed Food Intake and Risk of Systemic Lupus Erythematosus Among Women Observed in the Nurses' Health Study Cohorts. Arthritis Care Res (Hoboken) 2024. [PMID: 38937143 DOI: 10.1002/acr.25395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE We assessed ultraprocessed food (UPF) intake and systemic lupus erythematosus (SLE) incidence within the prospective Nurses' Health Study (NHS) cohorts. METHODS A total of 204,175 women were observed (NHS 1984-2016; NHSII 1991-2017). Semiquantitative food frequency questionnaires were completed every two to four years. UPF intake was determined as per the Nova classification. Nurses self-reported new doctor-diagnosed SLE, confirmed by medical records. Time-varying Cox regressions estimated hazard ratios (HRs; 95% confidence intervals [CIs]) for patients with incident SLE and SLE by anti-double-stranded DNA (dsDNA) antibody at diagnosis, according to cumulatively updated daily (a) UPF servings, (b) total intake (in grams and milliliters), and (c) percentage of total intake. Analyses adjusted for age, race, cohort, caloric and alcohol intakes, household income, smoking, body mass index (BMI), physical activity, menarchal age, and oral contraceptive use. We tested for interaction with BMI and examined UPF categories. RESULTS Mean baseline age was ~50 years (NHS) and ~36 years (NHSII); 93% self-reported White race. A total of 212 patients with incident SLE were identified. SLE risk was higher in the third versus first UPF tertile (servings per day pooled multivariable [MV] HR 1.56, 95% CI 1.04-2.32; P = 0.03). Results were stronger for dsDNA antibody in patients with SLE (servings per day pooled MV HR 2.05, 95% CI 1.15-3.65; P = 0.01) and for absolute (servings or total) than percentage of total intake. Sugar-sweetened/artificially sweetened beverages were associated with SLE risk (third vs first tertile MV HR 1.45, 95% CI 1.01-2.09). No BMI interactions were observed. CONCLUSION Higher cumulative average daily UPF intake was associated with >50% increased SLE risk and with doubled risk for anti-dsDNA antibody in patients with SLE. Many deleterious effects on systemic inflammation and immunity are postulated.
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Affiliation(s)
- Sinara Rossato
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Emily G Oakes
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Medha Barbhaiya
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York
| | - Jeffrey A Sparks
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan Malspeis
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Walter C Willett
- Harvard T. H. Chan School of Public Health and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Neha Khandpur
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, and Wageningen University, Wageningen, The Netherlands
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Wiss DA, LaFata EM. Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle? Nutrients 2024; 16:1955. [PMID: 38931309 PMCID: PMC11206753 DOI: 10.3390/nu16121955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.
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Affiliation(s)
- David A. Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
- Nutrition in Recovery LLC, 1902 Westwood Blvd. #201, Los Angeles, CA 90025, USA
| | - Erica M. LaFata
- Center for Weight Eating and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA 19104, USA;
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da Silva BF, de Arruda Neta ADCP, de Alencar Rodrigues RE, de Araújo JM, Moreira PVL, Ferreira FELL, de Toledo Vianna RP, da Silva Neto JM, de Carli E, de Lima RLFC. Costs of obesity attributable to the consumption of sugar-sweetened beverages in Brazil. Sci Rep 2024; 14:13936. [PMID: 38886385 PMCID: PMC11183236 DOI: 10.1038/s41598-024-59991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/17/2024] [Indexed: 06/20/2024] Open
Abstract
Excess sugar is considered one of the primary factors contributing to overweight status. In Brazil, sugar-sweetened beverages (SSBs) contain a significant amount of this nutrient and are consumed excessively. These beverages are associated with adverse health outcomes and impose costs on the healthcare system. The literature currently lacks studies that aim to attribute specific nutrients or foods as causes of diseases and also evaluate their economic impact, especially in middle- and low-income countries. This study aims to estimate the direct and indirect costs of obesity, stratified by sex and age group, resulting from the excessive consumption of sugar-sweetened beverages in Brazil from 2008 to 2020, and to project these costs for the year 2036. The estimation of obesity costs attributable to excessive consumption of SSBs was based on relative risks and the population prevalence of obesity, considering expenditures on hospitalizations and outpatient procedures in the Unified Health System (SUS). Cost information was obtained from the health information systems available at SUS. The highest burden attributable to the consumption of SSBs was observed among younger individuals and progressively decreased with advancing age. The total direct costs in the period between 2008 and 2020 amounted to approximately US$ 6.33 million, 87% of which was related to expenses for females. Additionally, deaths resulting from the consumption of SSBs cost the economy US$ 40 million due to the premature loss of productivity. The total costs of obesity attributable to the consumption of SSBs are substantial, impacting public spending and generating social and productivity losses that burden the economy. It is crucial to develop and implement cost-effective fiscal and regulatory policies aimed at preventing and combating obesity.
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Affiliation(s)
- Bruna Farias da Silva
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | | | | | | | | | - Rodrigo Pinheiro de Toledo Vianna
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
- Department of Nutrition, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Eduardo de Carli
- Department of Nutrition, School of Public Health. University of São Paulo, São Paulo, Brazil
| | - Rafaela Lira Formiga Cavalcanti de Lima
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
- Department of Nutrition, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
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Ravandi B, Mehler P, Ispirova G, Barabási AL, Menichetti G. GroceryDB: Prevalence of Processed Food in Grocery Stores. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2022.04.23.22274217. [PMID: 38883708 PMCID: PMC11177926 DOI: 10.1101/2022.04.23.22274217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
The offering of grocery stores is a strong driver of consumer decisions, shaping their diet and long-term health. While highly processed food like packaged products, processed meat, and sweetened soft drinks have been increasingly associated with unhealthy diet, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals to make informed choices. Here we introduce GroceryDB, a database with over 50,000 food items sold by Walmart, Target, and Wholefoods, unveiling how big data can be harnessed to empower consumers and policymakers with systematic access to the degree of processing of the foods they select, and the potential alternatives in the surrounding food environment. The wealth of data collected on ingredient lists and nutrition facts allows a large scale analysis of ingredient patterns and degree of processing stratified by store, food category, and price range. We find that the nutritional choices of the consumers, translated as the degree of food processing, strongly depend on the food categories and grocery stores. Moreover, the data allows us to quantify the individual contribution of over 1,000 ingredients to ultra-processing. GroceryDB and the associated http://TrueFood.Tech/ website make this information accessible, guiding consumers toward less processed food choices while assisting policymakers in reforming the food supply.
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Affiliation(s)
- Babak Ravandi
- Network Science Institute and Department of Physics, Northeastern University, Boston, USA
| | - Peter Mehler
- Department of Computer Science, IT University of Copenhagen, Copenhagen, Denmark
| | - Gordana Ispirova
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Albert-László Barabási
- Network Science Institute and Department of Physics, Northeastern University, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
- Department of Network and Data Science, Central European University, Budapest, Hungary
| | - Giulia Menichetti
- Network Science Institute and Department of Physics, Northeastern University, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
- Harvard Data Science Initiative, Harvard University, Boston, USA
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Maganinho M, Almeida C, Padrão P. Industrially Produced Plant-Based Food Products: Nutritional Value and Degree of Processing. Foods 2024; 13:1752. [PMID: 38890980 PMCID: PMC11171564 DOI: 10.3390/foods13111752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/20/2024] Open
Abstract
The plant-based food market is rapidly growing, offering innovative options to meet consumer expectations. However, a comprehensive analysis of the nutritional quality of these foods is lacking. We aimed to characterize industrial plant-based food products' nutritional value and degree of processing. A cross-sectional study was conducted on two market-leading Portuguese food retail chains by assessing the nutritional composition of all the available pre-packaged plant-based food products (n = 407). These products were categorized into meal alternatives, dairy alternatives, and other products containing dairy/meat alternative ingredients including ready meals and desserts. The products' nutritional quality was assessed according to the cut-offs established by the Portuguese Directorate General of Health [DGS] on total fat, saturated fat, sugar, and salt, and considering the degree of processing using NOVA classification. One-tenth of the products were classified as having a high total fat, saturated fat, sugars, or salt content. In some sub-categories, half of foods were classified as high in saturated fat, and over two-thirds were considered high salt products. Less than one-third exhibit a good nutritional profile based on the national cut-offs. A total of 84.3% of plant-based food products were ultra-processed. These findings emphasize the need to improve the nutritional profile of plant-based options.
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Affiliation(s)
- Marta Maganinho
- Faculdade de Ciências, Universidade do Porto, 4169-007 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
| | - Carla Almeida
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
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Mekonnen TC, Melaku YA, Shi Z, Gill TK. Ultra-processed food consumption and risk of chronic respiratory diseases mortality among adults: evidence from a prospective cohort study. Eur J Nutr 2024; 63:1357-1372. [PMID: 38413485 PMCID: PMC11139728 DOI: 10.1007/s00394-024-03356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE The purpose of the study was to determine the relationships between ultra-processed food (UPF) consumption and risk of mortality due to chronic respiratory diseases (CRDs) overall, chronic obstructive pulmonary disease (COPD), and lung cancer. METHODS A total of 96,607 participants aged 55 years and over were included from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer trial. Dietary intake was measured using food frequency questionnaire. Cox regression was fitted to estimate the risk of all-cause mortality and mortality due to CRDs overall, COPD and lung cancer associated with UPF intake. Competing risk regression was used to account for deaths from other causes and censoring. RESULTS During the follow-up of 1,379,655.5 person-years (median 16.8 years), 28,700 all-cause, 4092 CRDs, 2015 lung cancer and 1,536 COPD mortality occurred. A higher intake of UPF increased the risk of mortality from CRDs overall by 10% (HR 1.10; 95% CI 1.01, 1.22) and COPD by 26% (HR 1.26; 95% CI 1.06, 1.49) but not associated with lung cancer mortality risk (HR 0.97; 95% CI 0.84, 1.12). However, the risk of lung cancer increased by 16% (HR 1.16; 95% CI 1.01, 1.34) in the highest UPF intake after multiple imputation. Dose-response relationships existed for CRDs and COPD mortality but not lung cancer. CONCLUSION UPF consumption was associated with an increased risk of CRD mortality. The association between UPF consumption and lung cancer mortality is inconclusive and only significant when multiple imputation was applied.
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Affiliation(s)
- Tefera Chane Mekonnen
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australian Health and Medical Research Institute, Level 7, SAHMRI North Terrace, Adelaide, SA, 5000, Australia.
- School of Public Health, College of Medicine and Health Science, Wollo University, 1145, Dessie, Ethiopia.
| | - Yohannes Adama Melaku
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australian Health and Medical Research Institute, Level 7, SAHMRI North Terrace, Adelaide, SA, 5000, Australia
- Flinders Health and Medical Institute, Flinders University, Adelaide, South, 5001, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Zumin Shi
- Human Nutrition Department, QU Health, Qatar University, Doha, Qatar
| | - Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australian Health and Medical Research Institute, Level 7, SAHMRI North Terrace, Adelaide, SA, 5000, Australia
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Mehtab W, Agarwal S, Agarwal H, Ahmed A, Agarwal A, Prasad S, Chauhan A, Bhola A, Singh N, Ahuja V, Malhotra A, Makharia GK. Gluten-free foods are expensive and nutritionally imbalanced than their gluten-containing counterparts. Indian J Gastroenterol 2024; 43:668-678. [PMID: 38753225 DOI: 10.1007/s12664-024-01519-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/01/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES Nutritional quality of gluten-free (GF) food products is very important, as patients with celiac disease consume these products for lifelong. There is paucity of data on the nutritional content and cost of GF food products compared with their gluten-containing (GC) counterparts from India (Asia). DESIGN After a detailed market survey, packaged and labeled GF food products (n=485) and their packaged GC counterparts (n=790) from the supermarkets of Delhi (India) and e-commerce websites were included. Nutritional content and cost/100 g food (in US dollars) were calculated using the information on food label. RESULTS Gluten-free food products were 232% (range: 118% to 376%) more expensive than their GC counterparts. Energy content of all GF food products was similar to their GC counterparts, except cereal-based snacks (GF: 445 kcal vs. GC: 510 kcal, p<0.001). The protein content was significantly lower in GF pasta and macaroni products (single-grain: GF: 6.5 g vs. GC:11. 5 g, p-0.002; multigrain: GF:7.6 g vs. GC:11.5 g, p-0.027), cereal flours (single-grain: GF: 7.6 g vs. GC: 12.3 g, p<0.001; multigrain: GF:10.9 g vs. GC: 14.1 g, p-0.009) and nutritional bars (GF: 21.81 g vs. GC:26 g, p-0.028) than their GC counterparts. Similarly, the dietary-fiber content of GF pasta and macaroni products, cereal flours, cereal premix and nutritional bars of GF foods was significantly lower than their GC counterparts. Gluten-free bread and confectionary items, biscuits and cookies and snacks had higher total fats and trans-fat content than their GC counterparts. Gluten-free cereal-based snacks had higher sodium content than their GC counterparts (GF: 820 mg vs. GC:670 mg; p<0.001). CONCLUSION GF foods are significantly more expensive, contain less protein and dietary fiber and higher fat, trans-fat and sodium than their GC counterparts. Strategies must be developed to reduce the cost and improve the nutritional profile of GF foods.
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Affiliation(s)
- Wajiha Mehtab
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
- Department of Home Science, University of Delhi, New Delhi, 110 021, India
| | - Samagra Agarwal
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Harsh Agarwal
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Anam Ahmed
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Ashish Agarwal
- Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, 342 005, India
| | - Shubham Prasad
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Ashish Chauhan
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India
| | - Anjali Bhola
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Namrata Singh
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Vineet Ahuja
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, 110 052, India
| | - Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
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LaFata EM, Allison KC, Audrain-McGovern J, Forman EM. Ultra-Processed Food Addiction: A Research Update. Curr Obes Rep 2024; 13:214-223. [PMID: 38760652 PMCID: PMC11150183 DOI: 10.1007/s13679-024-00569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE OF REVIEW Detail recent advancements in the science on ultra-processed food (UPF) addiction, focusing on estimated prevalence rates and emerging health disparities; progress towards identifying biological underpinnings and behavioral mechanisms; and implications for weight management. RECENT FINDINGS Notable developments in the field have included: (1) estimating the global prevalence of UPF addiction at 14% of adults and 15% of youths; (2) revealing health disparities for persons of color and those with food insecurity; (3) observing altered functioning across the brain-gut-microbiome axis; (4) providing early evidence for UPF withdrawal; and (5) elucidating poorer weight management outcomes among persons with UPF addiction. The breadth of recent work on UPF addiction illustrates continued scientific and public interest in the construct and its implications for understanding and treating overeating behaviors and obesity. One pressing gap is the lack of targeted interventions for UPF addiction, which may result in more optimal clinical outcomes for this underserved population.
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Affiliation(s)
- Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States.
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
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Pinto-Sanchez MI, Blom JJ, Gibson PR, Armstrong D. Nutrition Assessment and Management in Celiac Disease. Gastroenterology 2024; 167:116-131.e1. [PMID: 38593924 DOI: 10.1053/j.gastro.2024.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 04/11/2024]
Abstract
Celiac disease (CeD) is the most common immune condition affecting the gastrointestinal tract; it is triggered by gluten and the only available treatment is a strict gluten-free diet (GFD). Therefore, for patients with CeD, adopting a GFD is not a lifestyle choice. The major problem is that a GFD is restrictive and, like all restrictive diets, it has the potential for adverse nutritional outcomes, especially if adopted for a long term. It is well known that GFD can be nutritionally inadequate and is frequently associated with vitamin and mineral deficiencies; it is also associated with excessive sugar and fat intake, particularly when gluten-free substitutes are consumed. Consequently, people with CeD are affected by higher rates of overweight and obesity and metabolic complications, such as fatty liver and cardiovascular disease. Therefore, assessment of nutritional status and diet quality at diagnosis and while on a long-term GFD is key in the management of CeD. This narrative review addresses nutritional considerations in CeD and management of common challenges associated with a GFD.
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Affiliation(s)
- M Ines Pinto-Sanchez
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jedid-Jah Blom
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Peter R Gibson
- Central Clinical School, Department of Gastroenterology, Monash University, Clayton, Victoria, Australia
| | - David Armstrong
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
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Andrade GC, Caldeira TCM, Mais LA, Bortoletto Martins AP, Claro RM. Food price trends during the COVID-19 pandemic in Brazil. PLoS One 2024; 19:e0303777. [PMID: 38781260 PMCID: PMC11115311 DOI: 10.1371/journal.pone.0303777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
The present study aims to analyze the trends in food price in Brazil with emphasis on the period of the Covid-19 pandemic (from March 2020 to March 2022). Data from the Brazilian Household Budget Survey and the National System of Consumer Price Indexes were used as input to create a novel data set containing monthly prices (R$/Kg) for the foods and beverages most consumed in the country between January 2018 and March 2022. All food items were divided according to the Nova food classification system. We estimated the mean price of each food group for each year of study and the entire period. The monthly price of each group was plotted to analyze changes from January 2018 to March 2022. Fractional polynomial models were used to synthesize price changes up to 2025. Results of the present study showed that in Brazil unprocessed or minimally processed foods and processed culinary ingredients were more affordable than processed and ultra-processed foods. However, trend analyses suggested the reversal of the pricing pattern. The anticipated changes in the prices of minimally processed food relative to ultra-processed food, initially forecasted for Brazil, seem to reflect the impact of the Covid-19 pandemic on the global economy. These results are concerning as the increase in the price of healthy foods aggravates food and nutrition insecurity in Brazil. Additionally, this trend encourages the replacement of traditional meals for the consumption of unhealthy foods, increasing a health risk to the population.
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Affiliation(s)
- Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo (USP), São Paulo, SP, Brazil
| | | | | | - Ana Paula Bortoletto Martins
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo (USP), São Paulo, SP, Brazil
- School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Rafael Moreira Claro
- Postgraduate Program in Public Health, Medical School, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Nutrition Department, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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35
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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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36
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Nguyen H, Jones A, Barrett EM, Shahid M, Gaines A, Hu M, Pettigrew S, Wu JHY, Coyle DH. Extent of alignment between the Australian Dietary Guidelines and the NOVA classification system across the Australian packaged food supply. Nutr Diet 2024. [PMID: 38738833 DOI: 10.1111/1747-0080.12880] [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: 11/30/2023] [Revised: 03/14/2024] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
AIMS The Australian Dietary Guidelines are currently being revised and ultra-processed foods have been identified as a high priority action area. To better understand how well the current Dietary Guidelines align with level of processing classifications, the aim of this study was to assess the alignment between the Australian Dietary Guidelines and the NOVA classification system for classifying the healthiness of packaged foods. METHODS Data were sourced from the Australian FoodSwitch dataset, which included 28 071 packaged food and beverage products available in major Australian supermarkets in 2022. Products were classified as (i) core or discretionary (Australian Dietary Guidelines) and (ii) non-ultra-processed or ultra-processed (NOVA). Agreement between the two systems (core vs. non-ultra-processed and discretionary vs. ultra-processed) was evaluated using the kappa statistic. RESULTS There was 'moderate' agreement (κ = 0.41, 95% CI: 0.40-0.42) between the Australian Dietary Guidelines and the NOVA system, with 69.8% of products aligned across the two systems. Alignment was more common for discretionary foods (80.6% were ultra-processed) than core foods (59.9% aligned were not-ultra-processed). Food categories exhibiting the strongest levels of alignment included confectionary, foods for specific dietary use, and egg and egg products. Discordance was most common for convenience foods, sugars, honey and related products, and cereal and grain products. CONCLUSIONS Despite moderate alignment between the Australian Dietary Guidelines and NOVA, the discordance observed for almost one-third of products highlights the opportunity to develop recommendations for ultra-processed foods within the guidelines to advise Australians how these foods should be considered as part of a healthy diet.
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Affiliation(s)
- Hillary Nguyen
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, University of California, Berkeley, California, USA
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Eden M Barrett
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria Shahid
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Allison Gaines
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Monica Hu
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, University of California, Berkeley, California, USA
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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Fang Z, Rossato SL, Hang D, Khandpur N, Wang K, Lo CH, Willett WC, Giovannucci EL, Song M. Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study. BMJ 2024; 385:e078476. [PMID: 38719536 PMCID: PMC11077436 DOI: 10.1136/bmj-2023-078476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality. DESIGN Population based cohort study. SETTING Female registered nurses from 11 US states in the Nurses' Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018). PARTICIPANTS 74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline. MAIN OUTCOME MEASURES Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes). RESULTS 30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 years of follow-up, respectively. Compared with those in the lowest quarter of ultra-processed food consumption, participants in the highest quarter had a 4% higher all cause mortality (hazard ratio 1.04, 95% confidence interval 1.01 to 1.07) and 9% higher mortality from causes other than cancer or cardiovascular diseases (1.09, 1.05 to 1.13). The all cause mortality rate among participants in the lowest and highest quarter was 1472 and 1536 per 100 000 person years, respectively. No associations were found for cancer or cardiovascular mortality. Meat/poultry/seafood based ready-to-eat products (for example, processed meat) consistently showed strong associations with mortality outcomes (hazard ratios ranged from 1.06 to 1.43). Sugar sweetened and artificially sweetened beverages (1.09, 1.07 to 1.12), dairy based desserts (1.07, 1.04 to 1.10), and ultra-processed breakfast food (1.04, 1.02 to 1.07) were also associated with higher all cause mortality. No consistent associations between ultra-processed foods and mortality were observed within each quarter of dietary quality assessed by the Alternative Healthy Eating Index-2010 score, whereas better dietary quality showed an inverse association with mortality within each quarter of ultra-processed foods. CONCLUSIONS This study found that a higher intake of ultra-processed foods was associated with slightly higher all cause mortality, driven by causes other than cancer and cardiovascular diseases. The associations varied across subgroups of ultra-processed foods, with meat/poultry/seafood based ready-to-eat products showing particularly strong associations with mortality.
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Affiliation(s)
- Zhe Fang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sinara Laurini Rossato
- Laboratory of Research and Extension in Epidemiology (Lapex-Epi), Institute of Geography, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dong Hang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Gusu School, Nanjing Medical University, Nanjing, China
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Kai Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chun-Han Lo
- Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Hang D, Du M, Wang L, Wang K, Fang Z, Khandpur N, Rossato SL, Steele EM, Chan AT, Hu FB, Meyerhardt JA, Mozaffarian D, Ogino S, Sun Q, Wong JB, Zhang FF, Song M. Ultra-processed food consumption and mortality among patients with stages I-III colorectal cancer: a prospective cohort study. EClinicalMedicine 2024; 71:102572. [PMID: 38572081 PMCID: PMC10990709 DOI: 10.1016/j.eclinm.2024.102572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/24/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Background Ultra-processed foods (UPFs) are emerging as a risk factor for colorectal cancer (CRC), yet how post-diagnostic UPF intake may impact CRC prognosis remains unexplored. Methods Data collected from food frequency questionnaires were used to estimate intakes of total UPFs and UPF subgroups (serving/d) at least 6 months but less than 4 years post-diagnosis among 2498 patients diagnosed with stages I-III CRC within the Nurses' Health Study and Health Professionals Follow-up Study during 1980-2016. Hazard ratios (HR) and 95% confidence intervals (CIs) of all-cause, CRC- and cardiovascular disease (CVD)-specific mortality in association with UPF consumption were estimated using an inverse probability weighted multivariable Cox proportional hazards regression model, adjusted for confounders. Findings The mean (SD) age of patients at diagnosis was 68.5 (9.4) years. A total of 1661 deaths were documented, including 321 from CRC and 335 from CVD. Compared to those in the lowest quintile (median = 3.6 servings/d), patients in the highest quintile (median = 10 servings/d) of post-diagnostic UPF intake had higher CVD mortality (HR = 1.65, 95% CI = 1.13-2.40) but not CRC or all-cause mortality. Among UPF subgroups, higher consumption of fats/condiments/sauces was associated with a higher risk of CVD-specific mortality (highest vs. lowest quintile of intake, HR = 1.96, 95% CI = 1.41-2.73), and higher intake of ice cream/sherbet was associated with an increased risk of CRC-specific mortality (highest vs. lowest quintile, HR = 1.86, 95% CI: 1.33-2.61). No statistically significant association was found between UPF subgroups and overall mortality. Interpretation Higher post-diagnostic intake of total UPFs and fats/condiments/sauces in CRC survivors is associated with higher CVD mortality, and higher ice cream/sherbet intake is linked to higher CRC mortality. Funding US National Institutes of Health and the American Cancer Society.
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Affiliation(s)
- Dong Hang
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mengxi Du
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lu Wang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kai Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhe Fang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Human Nutrition and Health, Wageningen University, Netherlands
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | - Eurídice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition (NUPENS), Faculty of Public Health, University of São Paulo, Brazil
| | - Andrew T. Chan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jeffrey A. Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, MA, USA
| | - Shuji Ogino
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Nutrition, Harvard Medical School, Boston, MA, USA
- Tokyo Medical and Dental University (Institute of Science Tokyo), Tokyo, Japan
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - John B. Wong
- Division of Clinical Decision Making, Tufts Medical Center, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Aljahdali AA, Rossato SL, Baylin A. Ultra-processed foods consumption among a USA representative sample of middle-older adults: a cross-sectional analysis. Br J Nutr 2024; 131:1461-1472. [PMID: 38174358 PMCID: PMC10950447 DOI: 10.1017/s0007114523003033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
The study evaluated the association between ultra-processed foods (UPF) and nutrient intake and identified the socio-demographic characteristics associated with UPF consumption among a nationally representative sample of middle-older adults. Dietary assessment was collected in 2013 using a validated FFQ. The Nova system was used to classify food and drinks into UPF. The percentage of dietary energy from UPF was calculated and used throughout the analyses, and average nutrient intake across quintiles of UPF was evaluated. The determinants associated with the dietary caloric contribution of UPF intake were investigated using linear regression models. A cross-sectional analysis of a nationally representative study of Americans over the age of 50, the Health and Retirement Study, was conducted. The analysis included 6220 participants. The mean age was 65 (se 0·28) years, with 55 % being female. UPF intake accounted for 51 % (se 0·25) of total intake. An increase in the percentage of (%UPF) consumption was correlated with an increase in calories, carbohydrates, saturated fat and sugar, and a decrease in fibre, vitamins and minerals. %UPF intake was inversely associated with being Hispanic, higher income, physical activity, vegetarian diet and Mediterranean diet but positively associated with very low food insecurity. UPF represented half of the calories consumed. A higher %UPF intake was associated with a lower nutrient profile, suggesting decreasing %UPF intake as a strategy to improve the nutritional quality of middle-older adults. A few socio-demographic factors were associated with %UPF, which would help in planning strategies to reduce UPF consumption.
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Affiliation(s)
- Abeer Ali Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Global Public Health, University of Michigan, Ann Arbor, MI, USA
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40
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Juul F, Bere E. Ultra-processed foods - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10616. [PMID: 38720949 PMCID: PMC11077402 DOI: 10.29219/fnr.v68.10616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/05/2024] [Accepted: 02/22/2024] [Indexed: 05/12/2024] Open
Abstract
Ultra-processed foods (UPFs) are increasingly consumed worldwide and have been linked to several chronic diseases. This paper aims to describe the totality of the available evidence regarding UPFs in relation to health-related outcomes as a basis for setting food-based dietary guidelines for the Nordic Nutrition Recommendations 2023. Systematic literature searches were conducted to identify systematic reviews, meta-analyses, randomized controlled trials (RCTs), and prospective cohort studies examining the association between UPF intake and non-communicable diseases or mortality. A total of 12 systematic reviews (including five meta-analyses) and 44 original research studies (43 prospective cohort studies and one RCT) were included. All original research studies were deemed to be of good methodological quality. The current evidence supports that greater consumption of UPFs is associated with weight gain and increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. The available literature also supports an association between UPFs and hypertension, cancer, and depression; however, the limited number of studies and subjects investigated preclude strong conclusions. Due to the highly diverse nature of UPFs, additional studies are warranted, with special emphasis on disentangling mediating mechanisms, whether nutritional or non-nutrient based. Nevertheless, the available evidence regarding UPFs in relation to weight gain, CVD, type 2 diabetes, and all-cause mortality is considered strong enough to support dietary recommendations to limit their consumption.
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Affiliation(s)
- Filippa Juul
- School of Global Public Health, New York University, New York, NY, USA
- Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Elling Bere
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
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D’Angelo Campos A, Ng SW, McNeel K, Hall MG. How Promising Are "Ultraprocessed" Front-of-Package Labels? A Formative Study with US Adults. Nutrients 2024; 16:1072. [PMID: 38613105 PMCID: PMC11013171 DOI: 10.3390/nu16071072] [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: 03/05/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
High levels of food processing can have detrimental health effects independent of nutrient content. Experts and advocates have proposed adding information about food processing status to front-of-package labeling schemes, which currently exclusively focus on nutrient content. How consumers would perceive "ultraprocessed" labels has not yet been examined. To address this gap, we conducted a within-subjects online experiment with a convenience sample of 600 US adults. Participants viewed a product under three labeling conditions (control, "ultraprocessed" label, and "ultraprocessed" plus "high in sugar" label) in random order for a single product. The "ultraprocessed" label led participants to report thinking more about the risks of eating the product and discouraging them from wanting to buy the product more than the control, despite not grabbing more attention than the control. The "ultraprocessed" plus "high in sugar" labels grabbed more attention, led participants to think more about the risks of eating the product, and discouraged them from wanting to buy the product more than the "ultraprocessed" label alone. "Ultraprocessed" labels may constitute promising messages that could work in tandem with nutrient labels, and further research should examine how they would influence consumers' actual intentions and behaviors.
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Affiliation(s)
- Aline D’Angelo Campos
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
| | - Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Katherine McNeel
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA
| | - Marissa G. Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Carroll JE, Sturgeon SR, Bertone-Johnson E, VanKim N, Longacre MR, Dalton MA, Emond JA. Factors Correlated With Ultra-Processed Food (UPF) Intake in Preschool-Aged Children and Association With Weight. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:196-208. [PMID: 38340130 PMCID: PMC10999344 DOI: 10.1016/j.jneb.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Understand the correlates of ultra-processed food (UPF) intake and examine the association of UPF on body mass index in children aged 3-5 years. DESIGN Secondary analysis of a prospective cohort of 3-5-year-olds/parent, followed 1-year between March 2014 and October 2016. Usual UPF intake from 2 3-day food records completed 1 year apart, a standardized nutrient database customized with child-specific foods, and a NOVA food classification system was used. Child/parent characteristics and media use were measured via parent-reported surveys. Child weight/height objectively measured. SETTING New Hampshire community. PARTICIPANTS Six hundred and sixty-seven parent-child dyads were screened, and 624 were enrolled with 90% follow-up. MAIN OUTCOME MEASURE(S) Primary outcome: identify correlates of UPF intake. SECONDARY OUTCOME determine if UPF intake is associated with body mass index change. ANALYSIS Adjusted β linear regression, linear regression, P <0.05. RESULTS Ultra-processed food accounted for 67.6% of total caloric intake. In adjusted models, children's UPF intake was positively associated with increasing child age, greater hours watching television, and more frequent parent soda/fast-food intake. Ultra-processed food intake was negatively associated with higher parent education and reported race/ethnicity other than non-Hispanic White. There was no association between UPF intake and weight. CONCLUSIONS AND IMPLICATIONS There are several predictors of UPF intake in young children. Family-level interventions could be implemented to encourage the intake of minimally processed foods before and during preschool years.
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Affiliation(s)
- Jennifer E Carroll
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH.
| | - Susan R Sturgeon
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Nicole VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Meghan R Longacre
- Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | - Madeline A Dalton
- Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | - Jennifer A Emond
- Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH
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Rey-García J, Mérida DM, Donat-Vargas C, Sandoval-Insausti H, Rodríguez-Ayala M, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Less Favorable Nutri-Score Consumption Ratings Are Prospectively Associated with Abdominal Obesity in Older Adults. Nutrients 2024; 16:1020. [PMID: 38613053 PMCID: PMC11013145 DOI: 10.3390/nu16071020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/23/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Nutri-Score is a front-of-package (FOP) labeling designed to assist consumers in selecting healthier options at the point of purchase and ultimately enhance their health. This study aims to evaluate the association between the Nutri-Score system and incident abdominal obesity (AO) in community-dwelling older adults. A prospective cohort of 628 individuals aged ≥ 60 were recruited in Spain between 2008-2010 and were reexamined between 2015-2017. Dietary intake was evaluated utilizing a validated computerized dietary history. Food was categorized based on the Nutri-Score system into five levels from A (green, representing the best quality) to E (red, representing the poorest quality). A five-color Nutri-Score dietary index (5-CNS DI) in g/day/kg was calculated for each participant. AO was determined by a waist circumference (WC) of ≥102 cm for men and ≥88 cm for women. Logistic regression models were adjusted for the main potential confounders. During a mean six-year follow-up, 184 incident cases of AO occurred. The odds ratio (OR) and 95% confidence interval (CI) for AO, when comparing the highest and lowest quartiles of the 5-CNS DI, were 2.45 (1.17-5.14), with a p-value for trend of 0.035. In sensitivity analyses, the OR was 2.59 (1.22-5.52, p-trend: 0.032) after adjustment for WC at baseline, and 1.75 (0.74-4.18, p-trend: 0.316) after adjustment for ultra-processed food consumption. In conclusion, less favorable food-consumption ratings in the Nutri-Score are associated with incident AO in the elderly. These findings support the use of this FOP system to potentially improve metabolic health.
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Affiliation(s)
- Jimena Rey-García
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain;
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
| | - Diana María Mérida
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
| | - Carolina Donat-Vargas
- ISGlobal-Institut de Salut Global de Barcelona, 08036 Barcelona, Spain;
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | | | - Montserrat Rodríguez-Ayala
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
- Department of Microbiology and Parasitology, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - José Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- IMDEA-Food Institute, Campus de Excelencia Internacional (CEI)/Universidad Autónoma de Madrid (UAM) + Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (D.M.M.); (M.R.-A.); (J.R.B.); (F.R.-A.)
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- IMDEA-Food Institute, Campus de Excelencia Internacional (CEI)/Universidad Autónoma de Madrid (UAM) + Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain
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Gulyas BZ, Caton SJ, Edmondson JL. Quantifying the relationship between gardening and health and well-being in the UK: a survey during the covid-19 pandemic. BMC Public Health 2024; 24:810. [PMID: 38486178 PMCID: PMC10941614 DOI: 10.1186/s12889-024-18249-8] [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: 06/22/2023] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Rates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F&V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited. METHODS We quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants' involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables. RESULTS After adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F&V consumption. Higher F&V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F&V consumption. CONCLUSIONS Our results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.
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Affiliation(s)
- Boglarka Z Gulyas
- Plants, Photosynthesis and Soil, School of Biosciences, University of Sheffield, S10 2TN, Sheffield, UK
- Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, S10 2TN, Sheffield, UK
| | - Samantha J Caton
- Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, S10 2TN, Sheffield, UK
| | - Jill L Edmondson
- Plants, Photosynthesis and Soil, School of Biosciences, University of Sheffield, S10 2TN, Sheffield, UK.
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Salehi Z, Malmir H, Ghosn B, Onvani S, Ardestani ME, Feizi A, Esmaillzadeh A, Azadbakht L. Exploring the association between ultra-processed foods and COPD: a case-control study. BMC Pulm Med 2024; 24:124. [PMID: 38459450 PMCID: PMC10924350 DOI: 10.1186/s12890-024-02903-3] [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: 03/04/2023] [Accepted: 02/08/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND While it is known that the overconsumption of ultra-processed foods (UPFs) is associated with a heightened risk of respiratory ailments, the specific effects of UPF intake on COPD remain unclear. This study was designed to explore the potential link between COPD and the consumption of UPFs among adult individuals in Iran. METHODS In this hospital-based case-control study conducted at Alzahra University Hospital in Isfahan, Iran, we enrolled 84 patients newly diagnosed with COPD, along with 252 healthy controls matched for age and sex. COPD was defined based on the results of spirometry tests, specifically when the forced expiratory volume per second (FEV1) was less than 80% or the ratio of FEV1 to forced vital capacity (FVC) was less than 70%. To evaluate the dietary intake of the participants, we utilized a validated food frequency questionnaire (FFQ) consisting of 168 items. Additionally, we gathered data on potential confounding factors using a pre-tested questionnaire. RESULTS The mean ages for the case and control groups were 57.07 and 55.05 years, respectively. Our study found no significant association between the intake of ultra-processed foods (UPFs) and the likelihood of COPD, with an odds ratio (OR: 0.78, 95% CI: 0.34-1.77). This lack of association persisted even after adjusting for factors such as energy intake, sex, and age (OR: 0.48; 95% CI: 0.19-1.21). Further controlling for potential confounders like body mass index (BMI), physical activity, and smoking status did not alter this finding (OR: 0.367; 95% CI: 0.123-1.1008, P = 0.074). CONCLUSIONS In our study, we observed no significant association between the intake of Ultra-Processed Foods (UPFs) and the odds of Chronic Obstructive Pulmonary Disease (COPD). This finding remained consistent even after adjusting for factors such as energy intake, sex, age, Body Mass Index (BMI), physical activity, and smoking status. Therefore, within the scope of our study, it appears that the consumption of UPFs does not significantly impact the likelihood of developing COPD. However, we recommend further research to deepen our understanding of the intricate relationship between dietary habits and respiratory health.
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Affiliation(s)
- Zahra Salehi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran
| | - Hanieh Malmir
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran
| | - Shokouh Onvani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Emami Ardestani
- Division of Pulmonology, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran.
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Elfassy T, Juul F, Mesa RA, Palaniappan L, Srinivasan M, Yi SS. Associations Between Ultra-processed Food Consumption and Cardiometabolic Health Among Older US Adults: Comparing Older Asian Americans to Older Adults From Other Major Race-Ethnic Groups. Res Aging 2024; 46:228-240. [PMID: 38128550 DOI: 10.1177/01640275231222928] [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] [Indexed: 12/23/2023]
Abstract
Using data from the National Health and Nutrition Examination Survey (2001-2018; N = 19,602), this study examined whether ultra-processed food (UPF) consumption is associated with cardiometabolic health (obesity, hypertension, high cholesterol, and diabetes), among White, Black, Hispanic, and Asian Americans (AA) US adults 50 or older. Diet was assessed using 24 hour dietary recall. NOVA dietary classification system was used to calculate the percentage of caloric intake derived from UPFs. Cardiometabolic information was assessed through physical examination, blood tests, and self-reported medication information. A median of 54% (IQR: 40%, 68%) of caloric intake was attributed to UPFs and was lowest for AAs (34%, IQR: 20%, 49%) and highest for White adults (56%; IQR: 42, 69%). In multivariable adjusted models, UPF consumption was associated with greater odds of obesity, high cholesterol, and diabetes. UPF consumption is associated with poor cardiometabolic health among all US older adults. For AAs, UPFs may be particularly obesogenic.
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Affiliation(s)
- Tali Elfassy
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Filippa Juul
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA
| | - Robert A Mesa
- Division of Epidemiology, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Latha Palaniappan
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Palo Alto, CA, USA
| | - Malathi Srinivasan
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Palo Alto, CA, USA
| | - Stella S Yi
- Center for the Study of Asian American Health, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Sekyi E, Agyapong NAF, Eshun G. Food consumption by NOVA food classification, metabolic outcomes, and barriers to healthy food consumption among university students. Food Sci Nutr 2024; 12:1983-1994. [PMID: 38455168 PMCID: PMC10916562 DOI: 10.1002/fsn3.3894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 03/09/2024] Open
Abstract
The NOVA food classification system is a simple tool that can be used to assess the consumption levels of different categories of foods based on their level of processing. The degree to which food is processed has a significant impact on health outcomes. In Ghana, no study exists on the consumption of the different NOVA food groups among tertiary students and how it relates to their metabolic outcomes. This study assessed the frequency of food intake according to the NOVA classification and how they relate to body mass index, waist circumference, and blood pressure. The barriers to the consumption of healthy foods among students were also assessed. This was a cross-sectional study conducted among 352 students of the Takoradi Technical University. Questionnaire was used to obtain sociodemographic information as well as data on perceived barriers to healthy food consumption. Food frequency questionnaire was used to obtain data on dietary intake. The weight, height, waist circumference, waist-to-hip ratio, and blood pressure of all participants were measured. Chi-square was used to compare categorical variables between males and females and to determine the association between the frequency of food intake according to the NOVA classification and metabolic indicators. The prevalence of overweight and obesity was 23.8%. More than half (51.1%) of the students had elevated blood pressure. The majority of study participants (54.2%) had a high frequency of consumption of both unprocessed and ultra-processed foods. Male students who frequently consumed ultra-processed foods (1-6 times/day) had significantly high blood pressure. High consumption of both ultra-processed and unprocessed foods was also associated with elevated blood pressure among male students. Limited time to prepare healthy meals and the high cost of unprocessed foods were among barriers to which most students strongly agreed to. Establishment of canteens that provide affordable healthy foods, teaching students time management, and nutrition education can mitigate barriers to healthy food consumption.
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Affiliation(s)
- Elizabeth Sekyi
- Department of Hospitality ManagementTakoradi Technical UniversityTakoradiGhana
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Guy Eshun
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
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Torres-Collado L, Rychter A, González-Palacios S, Compañ-Gabucio LM, Oncina-Cánovas A, García de la Hera M, Vioque J. A high consumption of ultra-processed foods is associated with higher total mortality in an adult Mediterranean population. Clin Nutr 2024; 43:739-746. [PMID: 38320465 DOI: 10.1016/j.clnu.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The consumption of ultra-processed foods (UPF) has been associated with higher all-cause and cardiovascular disease (CVD) mortality, although this association has not been sufficiently investigated in Mediterranean populations. We aimed to evaluate the association between UPF consumption and all-cause, CVD and cancer mortality in an adult population in Spain. METHODS We analysed data from 1,538 participants aged 20 years and above in the Valencia Nutrition Survey in 1995. Diet was assessed at baseline using a validated food frequency questionnaire and the consumption of UPF was calculated using the NOVA system. Information on socio-demographic characteristics, lifestyles, and presence of diseases was also collected at baseline. Cause of death was ascertained during an 18-year follow-up period. We used Cox regression and competing risk models as proposed by Fine and Gray's to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 %CI). RESULTS After 18 years of follow-up, we documented 312 deaths (36.5 % of CVD and 25.6 % of cancer). Compared with participants in the lowest tertile of UPF consumption, those in the highest tertile showed 40 % higher risk of all-cause mortality, HR 1.40 (95 %CI: 1.04-1.90), and evidence of a higher CVD mortality, HR 1.39 (95 %CI: 0.80-2.41) and of cancer mortality, HR 1.53 (95 %CI: 0.83-2.82). CONCLUSIONS This study suggests that a high UPF consumption is associated with a higher all-cause mortality in a Mediterranean population after a long follow-up period. Considering the increase in UPF consumption and their detrimental health effects on mortality, these results should be confirmed by other studies in other populations.
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Affiliation(s)
- Laura Torres-Collado
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland; Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Sandra González-Palacios
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Laura María Compañ-Gabucio
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Oncina-Cánovas
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manoli García de la Hera
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Padial M, Taylor A, Sabatino A, Piccoli GB, Avesani CM. From ultra-processed foods towards healthy eating for CKD patients: a proposal of educational infographics. J Nephrol 2024; 37:323-329. [PMID: 37995043 PMCID: PMC11043116 DOI: 10.1007/s40620-023-01817-3] [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: 09/05/2023] [Accepted: 10/19/2023] [Indexed: 11/24/2023]
Abstract
Ultraprocessed food (UPF) is defined as industrialized, packaged and ready-to-eat food produced on a large scale, using sophisticated industrial machinery. Examples of UPFs include salty and sweet snacks, industrialized biscuits and packaged meals, processed meats and sugary drinks. Ultraprocessed food has a long-shelf life, is highly palatable, microbiologically safe, affordable and most of all, easy to consume. For these reasons, its consumption has been increasing worldwide, and is replacing healthy homemade meals. The main concern of this dietary shift is that UPFs come with the addition of salt, sugar, unhealthy fats, and several additives and taste enhancers that contain, among other substances, relevant quantities of potassium, phosphate and sodium. A large proportion of UPF in the diet may carry risks for patients with chronic kidney disease (CKD) since it can worsen blood pressure and glycemic control, and lead to constipation, hyperkalemia and hyperphosphatemia. Acknowledging the importance of UPF in kidney health implies integrating nutritional counseling with information on UPFs, and specific educational material can be helpful for patients, caregivers, and also for health care providers. We developed a set of 3 infographics dedicated to CKD patients, with information on how to identify UPFs, reasons for decreasing consumption, how to compose a healthy CKD plate and tips for reading food labels in supermarkets and grocery shops. We hope that this material can be useful in CKD outpatient clinics and dialysis centers as well as in general practitioners' offices, caring for early stage CKD.
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Affiliation(s)
- Marina Padial
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
- Servicio de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND, Hospital Regional Universitario de Málaga, Avda. Carlos Haya, s/n, 29010, Málaga, Spain.
- Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain.
| | - Angeline Taylor
- Renal Unit, Royal Devon and Exeter (Wonford) Hospital, Exeter, UK
| | - Alice Sabatino
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
- Department of Nephrology, Parma University Hospital, Parma, Italy
| | | | - Carla Maria Avesani
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Wang Z, Lu C, Wang Y, E F, Mentis AFA, Li X, Yang K. Association between ultra-processed foods consumption and the risk of hypertension: An umbrella review of systematic reviews. Hellenic J Cardiol 2024; 76:99-109. [PMID: 37543089 DOI: 10.1016/j.hjc.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Several systematic reviews (SRs) have investigated the association between ultra-processed foods (UPFs) and the risk of hypertension in various populations. However, the quality of the evidence remains unclear. This umbrella review was thus conducted to fill this gap. METHODS We searched for SRs with and without meta-analyses comparing high UPF versus low UPF consumption on the risk of hypertension in the Cochrane Library, Embase, PubMed, and Web of Science from inception to August 2022. This study was registered in PROSPERO (No. CRD42022352934). The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis 2009 (PRISMA 2009) statement were used to evaluate the methodological and reporting quality of the included SRs. Stata 15/SE was used to reanalyse the data using the random-effects model, and the risk of bias of observational studies from included SRs was reassessed using the Newcastle-Ottawa Scale (NOS) tool. The certainty of the evidence body was assessed using the GRADE recommendation. RESULTS Seven SRs were included in the umbrella review. Among them, nine observational studies (5 cross-sectional and 4 cohort studies), whose available data were resynthesised using meta-analysis. The methodological and reporting quality of the included SRs were relatively poor. The meta-analysis results revealed suggestive evidence of an association between high UPF consumption and the incidence of hypertension (odds ratio: 1.23, 95% confidence interval: 1.11 to 1.37, p < 0.001, 95% prediction interval: 0.92 to 1.64, critically low certainty) compared to low UPF consumption. CONCLUSION High UPF consumption is associated with an increased risk of hypertension. However, well-conducted SRs, including high-quality prospective cohort studies, are needed to further verify these findings.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yongsheng Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Fenfen E
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | | | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
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