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Shafiee A, Aghajanian S, Heidari E, Abbasi M, Jafarabady K, Baradaran S, Bakhtiyari M. Contribution of obesity in the association between fast-food consumption and depression: A mediation analysis. J Affect Disord 2024; 362:623-629. [PMID: 39019234 DOI: 10.1016/j.jad.2024.07.036] [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: 10/16/2023] [Revised: 06/17/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Depression is a significant mental health concern, and the ubiquitous presence of fast-food in modern diets raises questions about its impact on mental well-being. Understanding the intricate relationship between fast-food consumption, obesity, and depression is essential for addressing the complex web of factors contributing to this public health issue. METHODS In this study, we analyzed data from the National Health and Nutritional Examination Surveys (NHANES) spanning from 2008 to 2018, involving 31,460 participants. RESULTS Among the 31,460 subjects in the survey, 2871 exhibited signs of depression, with an average age of 48.2 years. Each additional weekly fast-food meal was linked to 4 % higher odds of depression, with consuming over two such meals increasing the odds by 24 %. Adjusted models exploring the relationship between body mass index (BMI), fast-food consumption, and depression indicated an increased risk with greater fast-food intake, especially within subgroups based on obesity status. Mediation analysis revealed that fast-food consumption and depression were largely independent of obesity, with obesity accounting for only 6.5 % of the total effect. No significant mediation effect was found in the overweight subgroup, but the mediated effect was increased with higher BMI in more obese patients, notably in those with BMI ≥ 30 or ≥40. Sensitivity analysis confirmed these findings with more conservative estimates across all subgroups. CONCLUSION This study highlights a substantial connection between fast-food consumption and depression. While obesity plays a role, it does not fully mediate the relationship, suggesting the presence of other contributing factors.
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Affiliation(s)
- Arman Shafiee
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Sepehr Aghajanian
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Heidari
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Abbasi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Kyana Jafarabady
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sania Baradaran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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AlSharari SD, Alameen AA, Aldafiri FS, Ali YS, Alshammari MA, Sari Y, Damaj MI. Activation of α7 nicotinic receptors attenuated hyperalgesia and anxiety induced by palatable obesogenic diet withdrawal. J Pharmacol Sci 2024; 156:86-101. [PMID: 39179339 DOI: 10.1016/j.jphs.2024.07.006] [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: 04/25/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 08/26/2024] Open
Abstract
Consumption of palatable food (PF) can alleviate anxiety, and pain in humans. Contrary, spontaneous withdrawal of long-term PF intake produces anxiogenic-like behavior and abnormal pain sensation, causing challenges to weight-loss diet and anti-obesity agents. Thus, we examined α7-nicotinic acetylcholine receptors (α7nAChR) involvement since it plays essential role in nociception and psychological behaviors. METHODS Adult male C57BL/6 mice were placed on a Standard Chow (SC) alone or with PF on intermittent or continuous regimen for 6 weeks. Then, mice were replaced with normal SC (spontaneous withdrawal). Body weight, food intake, and calories intake with and without the obesogenic diet were measured throughout the study. During PF withdrawal, anxiety-like behaviors and pain sensitivity were measured with PNU-282987 (α7nAChR agonist) administration. RESULTS Six weeks of SC + PF-intermittent and continuous paradigms produced a significant weight gain. PF withdrawal displayed hyperalgesia and anxiety-like behaviors. During withdrawal, PNU-282987 significantly attenuated hyperalgesia and anxiety-like behaviors. CONCLUSION The present study shows that a PF can increase food intake and body weight. Also, enhanced pain sensitivity and anxiety-like behavior were observed during PF withdrawal. α7nAChR activation attenuated anxiolytic-like behavior and hyperalgesia in PF abstinent mice. These data suggest potential therapeutic effects of targeting α7 nAChRs for obesity-withdrawal symptoms in obese subjects.
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Affiliation(s)
- Shakir D AlSharari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | - Alaa A Alameen
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | - Fawzeyah S Aldafiri
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yousif S Ali
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Musaad A Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Youssef Sari
- Department of Pharmacology and Experimental Therapeutics, University of Toledo, Toledo, OH, USA
| | - M I Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
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Robinson E, Jones A. Causality or confounding? Applying E values to examine associations between ultra-processed food consumption and risk of weight gain. Int J Obes (Lond) 2024; 48:1342-1346. [PMID: 38879728 PMCID: PMC11347361 DOI: 10.1038/s41366-024-01566-8] [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: 02/16/2024] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Ultra-processed food (UPF) consumption is associated prospectively with weight gain and obesity in observational studies of adults. Unaccounted for confounding is a risk when attempting to make causal inference from observational studies. Limited research has examined how feasible it is that unmeasured confounding may explain associations between UPF consumption and weight gain in observational research. METHODS We introduce the E value to obesity researchers. The E value is defined as the minimum hypothetical strength of association that one or more unaccounted for confounding variables would need to have with an exposure (UPF consumption) and outcome (weight gain) to explain the association between the exposure and outcome of interest. We meta-analysed prospective studies on the association between UPF consumption and weight gain in adults to provide an effect estimation. Next, we applied the E value approach to this effect estimate and illustrated the potential role that unmeasured or hypothetical residual confounding variables could theoretically have in explaining associations. RESULTS Higher consumption of UPFs was associated with increased weight gain in meta-analysis (RR = 1.14). The corresponding E value = 1.55, indicating that unaccounted for confounding variables with small-to-moderate sized associations with UPF consumption and weight gain (e.g., depressive symptoms, trait overeating tendencies, access to healthy and nutritious food) could individually or collectively hypothetically account for observed associations between UPF consumption and weight gain. CONCLUSIONS Unaccounted for confounding could plausibly explain the prospective association between UPF consumption and weight gain in adults. High quality observational research controlling for potential confounders and evidence from study types devoid of confounding are now needed.
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Affiliation(s)
- Eric Robinson
- Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Andrew Jones
- School of Psychology, Liverpool John Moores University, Liverpool, UK
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Tan LJ, Oh SJ, Nasan-Ulzii B, Lee W, Hong SW, Shin S. Association between dietary patterns and obesity: a longitudinal prospective cohort study. Public Health 2024; 234:217-223. [PMID: 39089174 DOI: 10.1016/j.puhe.2024.04.002] [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: 12/14/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES The obesity prevalence in South Korea in 2021 stood at 38.4%. South Korea faces unique challenges in providing essential and emergency guidelines for weight management because of stepping into an aging society. We aimed to determine the daily diet patterns among the general Korean population and to investigate the association between such patterns and different obesity. STUDY DESIGN Longitudinal prospective cohort study. METHODS A total of 6539 adult participants (mean age 50.8 years, 52.9% male) with normal-weight adults were included from the Ansan-Ansung cohort of 10,030 Korean adults aged 40 or older and followed for an average of 11 years. Obesity was defined according to the criteria from the Korean Society for The Study of Obesity. Baseline dietary intake was assessed using a validated 103-item food frequency questionnaire. Dietary patterns were derived from k-means cluster analysis. RESULTS In the multivariate analysis, referring to white rice + baechu kimchi, participants from multigrain rice + baechu kimchi showed lower HR for obesity development (waist circumference defined-obesity; HR: 0.87, 95% CI: 0.79, 0.95; body fat percentage defined-obesity; HR: 0.89, 95% CI: 0.80, 0.98). Further analysis documented that except for body fat percentage defined-obesity, consuming milk or dairy products was linked to a reduced incidence of the other three obesity (body mass index defined-obesity; HR: 0.84, 95% CI: 0.72, 0.99; waist circumference defined-obesity; HR: 0.82, 95% CI: 0.71, 0.94; waist-to-hip ratio defined-obesity; HR: 0.75, 95% CI: 0.61, 0.91). CONCLUSIONS Following a diet that includes multigrain rice, fermented baechu kimchi, and dairy products is linked to a decreased risk of obesity in Korean adults. Public health programs and policies could incorporate these dietary recommendations, targeting specific population groups such as schoolchildren, adults, and the elderly. Additionally, further research is needed to explore the synergistic effects of various foods and their interactions within dietary patterns on obesity outcomes.
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Affiliation(s)
- L-J Tan
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - S-J Oh
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - B Nasan-Ulzii
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - W Lee
- Technology Innovation Research Division, World Institute of Kimchi, Gwangju 61755, South Korea
| | - S W Hong
- Technology Innovation Research Division, World Institute of Kimchi, Gwangju 61755, South Korea.
| | - S Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea.
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Monda A, de Stefano MI, Villano I, Allocca S, Casillo M, Messina A, Monda V, Moscatelli F, Dipace A, Limone P, Di Maio G, La Marra M, Di Padova M, Chieffi S, Messina G, Monda M, Polito R. Ultra-Processed Food Intake and Increased Risk of Obesity: A Narrative Review. Foods 2024; 13:2627. [PMID: 39200554 PMCID: PMC11353718 DOI: 10.3390/foods13162627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/15/2024] [Accepted: 08/20/2024] [Indexed: 09/02/2024] Open
Abstract
The prevalence of obesity has become a global health concern, with significant impacts on quality of life and mortality rates. Recent research has highlighted the role of ultra-processed foods (UPFs) in driving the obesity epidemic. UPFs undergo extensive processing, often containing high levels of sugars, fats, and additives, while lacking essential nutrients. Studies have linked UPF consumption to obesity and cardiometabolic diseases, underscoring the importance of dietary patterns rich in whole foods. Thus, the aim of this narrative review is to elucidate the correlation between ultra-processed foods and the increased trend of obesity and its related complications. These foods, prevalent in modern diets, contribute to nutritional deficiencies and excessive caloric intake, exacerbating obesity rates. Lifestyle factors such as busy schedules and quick meal management further drive UPF consumption, disrupting hunger regulation and promoting overeating. UPF consumption correlates with adverse health outcomes, including dyslipidemia, hypertension, and insulin resistance. Promoting whole, minimally processed foods and implementing school-based nutrition education programs are crucial steps. Also, numerous challenges exist, including unequal access to healthy foods, the industry's influence, and behavioral barriers to dietary change. Future research should explore innovative approaches, such as nutrigenomics and digital health technologies, to personalize interventions and evaluate policy effectiveness. Collaboration across disciplines and sectors will be vital to develop comprehensive solutions and improve public health outcomes globally.
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Affiliation(s)
- Antonietta Monda
- Department of Human Science and Promotion of Quality of Life, Telematic University San Raffaele, 00166 Rome, Italy;
| | - Maria Ida de Stefano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.I.d.S.); (R.P.)
| | - Ines Villano
- Department of Wellness, Nutrition and Sport, Telematic University Pegaso, 80143 Naples, Italy; (I.V.); (F.M.); (A.D.); (P.L.)
| | - Salvatore Allocca
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Maria Casillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Antonietta Messina
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Vincenzo Monda
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80132 Naples, Italy;
| | - Fiorenzo Moscatelli
- Department of Wellness, Nutrition and Sport, Telematic University Pegaso, 80143 Naples, Italy; (I.V.); (F.M.); (A.D.); (P.L.)
| | - Anna Dipace
- Department of Wellness, Nutrition and Sport, Telematic University Pegaso, 80143 Naples, Italy; (I.V.); (F.M.); (A.D.); (P.L.)
| | - Pierpaolo Limone
- Department of Wellness, Nutrition and Sport, Telematic University Pegaso, 80143 Naples, Italy; (I.V.); (F.M.); (A.D.); (P.L.)
| | - Girolamo Di Maio
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Marco La Marra
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Marilena Di Padova
- Department of Humanistic Studies, University of Foggia, 71122 Foggia, Italy;
| | - Sergio Chieffi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Giovanni Messina
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.A.); (M.C.); (G.D.M.); (M.L.M.); (S.C.); (G.M.)
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.I.d.S.); (R.P.)
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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] [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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Ghosh-Jerath S, Khandpur N, Kumar G, Kohli S, Singh M, Bhamra IK, Marrocos-Leite FH, Reddy KS. Mapping ultra-processed foods (UPFs) in India: a formative research study. BMC Public Health 2024; 24:2212. [PMID: 39143524 PMCID: PMC11323379 DOI: 10.1186/s12889-024-19624-1] [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: 07/04/2023] [Accepted: 07/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Increased consumption of ultra-processed foods (UPFs) which have additives such as artificial colours, flavours and are usually high in salt, sugar, fats and specific preservatives, are associated with diet-related non-communicable diseases (NCDs). In India, there are no standard criteria for identifying UPFs using a classification system based on extent and purpose of industrial processing. Scientific literature on dietary intake of foods among Indian consumers classifies foods as unhealthy based on presence of excessive amounts of specific nutrients which makes it difficult to distinguish UPFs from other commercially available processed foods. METHODS A literature review followed by an online grocery retailer scan for food label reading was conducted to map the types of UPFs in Indian food market and scrutinize their ingredient list for the presence of ultra-processed ingredients. All UPFs identified were randomly listed and then grouped into categories, followed by saliency analysis to understand preferred UPFs by consumers. Indian UPF categories were then finalized to inform a UPF screener. RESULTS A lack of application of a uniform definition for UPFs in India was observed; hence descriptors such as junk-foods, fast-foods, ready-to-eat foods, instant-foods, processed-foods, packaged-foods, high-fat-sugar-and-salt foods were used for denoting UPFs. After initial scanning of such foods reported in literature based on standard definition of UPFs, an online grocery retailer scan of food labels for 375 brands (atleast 3 brands for each food item) confirmed 81 food items as UPFs. A range of packaged traditional recipes were also found to have UPF ingredients. Twenty three categories of UPFs were then developed and subjected to saliency analysis. Breads, chips and sugar-sweetened beverages (e.g. sodas and cold-drinks) were the most preferred UPFs while frozen ready-to-eat/cook foods (e.g. chicken nuggets and frozen kebabs) were least preferred. CONCLUSION India needs to systematically apply a food classification system and define Indian food categories based on the level of industrial processing. Mapping of UPFs is the first step towards development of a quick screener that would generate UPF consumption data to inform clear policy guidelines and regulations around UPFs and address their impact on NCDs.
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Affiliation(s)
- Suparna Ghosh-Jerath
- The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre, New Delhi, Delhi, 110025, India.
| | | | | | - Sahiba Kohli
- The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre, New Delhi, Delhi, 110025, India
| | - Meenu Singh
- Public Health Foundation of India, New Delhi, India
| | | | - Fernanda H Marrocos-Leite
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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Montes YD, Vergara TA, Molina RT, Guerrero GM, Arrieta LAA, Aschner P, Acosta-Reyes J, Florez-Garcia V, Lechuga EN, Barengo NC. The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities. Prim Care Diabetes 2024; 18:458-465. [PMID: 38862312 DOI: 10.1016/j.pcd.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 05/25/2024] [Accepted: 06/02/2024] [Indexed: 06/13/2024]
Abstract
AIMS To assess the association between sociodemographic and clinical factors with body mass index (BMI) in a population at risk of type 2 diabetes (T2D) in Bogotá and Barranquilla, Colombia. METHODS This cross-sectional study used data from the PREDICOL Study. Participants with a FINDRISC ≥ 12 who underwent an Oral Glucose Tolerance Test (OGTT) were included in the study (n=1166). The final analytical sample size was 1101 participants. Those with missing data were excluded from the analysis (n=65). The main outcome was body mass index (BMI), which was categorized as normal, overweight, and obese. We utilized unadjusted and adjusted ordinal logistic regression analysis to calculate odds ratios (OR) and 95 % confidence intervals (CI). RESULTS The prevalence of overweight and obesity was 41 % (n=449) and 47 % (n=517), respectively. Participants with a 2-hour glucose ≥139 mg/dl had 1.71 times higher odds of being overweight or obese (regarding normal weight) than participants with normal 2-hour glucose values. In addition, being a woman, waist circumference altered, and blood pressure >120/80 mmHg were statistically significantly associated with a higher BMI. CONCLUSION Strategies to control glycemia, blood pressure, and central adiposity are needed in people at risk of T2D. Future studies should be considered with a territorial and gender focus, considering behavioral, and sociocultural patterns.
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Affiliation(s)
- Yenifer Diaz Montes
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; Faculty of Nursing Sciences, Universidad Cooperativa de Colombia, Santa Marta, Colombia.
| | - Tania Acosta Vergara
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Rafael Tuesca Molina
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; ScienceFlows Research Group, Universidad de Valencia, Valencia, Spain
| | - Gillian Martinez Guerrero
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Luis A Anillo Arrieta
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; College of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia
| | - Pablo Aschner
- Colombian Association for Diabetes, Bogotá, Colombia; Universidad Javeriana, Bogotá, Colombia; San Ignacio University Hospital, Bogotá, Colombia
| | - Jorge Acosta-Reyes
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Victor Florez-Garcia
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Edgar Navarro Lechuga
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Noël C Barengo
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
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9
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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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10
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Morcel J, Béghin L, Michels N, De Ruyter T, Drumez E, Cailliau E, Polito A, Le Donne C, Barnaba L, Azzini E, De Henauw S, Miguel Berges ML, Cacau LT, Moreno LA, Gottrand F. Nutritional and physical fitness parameters in adolescence impact cardiovascular health in adulthood. Clin Nutr 2024; 43:1857-1864. [PMID: 38959665 DOI: 10.1016/j.clnu.2024.06.022] [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: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND & AIMS Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. METHODS The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. RESULTS Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). CONCLUSIONS Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. CLINICAL TRIAL REGISTRY NUMBER Clinicaltrials.gov NCT02899416.
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Affiliation(s)
- Jules Morcel
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
| | - Nathalie Michels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Thaïs De Ruyter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Elodie Drumez
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Emeline Cailliau
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Angela Polito
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Cinzia Le Donne
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Lorenzo Barnaba
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Elena Azzini
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maria Luisa Miguel Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
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11
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Yao Q, de Araujo CD, Juul F, Champagne CM, Bray GA, Sacks FM, Vadiveloo MK. Isocaloric replacement of ultraprocessed foods was associated with greater weight loss in the POUNDS Lost trial. Obesity (Silver Spring) 2024; 32:1281-1289. [PMID: 38932724 PMCID: PMC11212670 DOI: 10.1002/oby.24044] [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: 10/19/2023] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Higher intake of ultraprocessed foods (UPFs) is associated with obesity. We examined whether replacing UPFs (NOVA 4) with minimally processed foods and culinary ingredients (NOVA 1 + 2) was associated with differential weight change in this secondary prospective analysis of the Preventing Overweight Using Novel Dietary Strategies (POUNDS) Lost trial. METHODS We estimated percent energy intake (%kcal) from the four NOVA groups using 24-h dietary recalls in a subset of 356 participants. Multivariable-adjusted substitution models examined whether replacing %kcal from UPFs with NOVA 1 + 2 was associated with greater weight, body fat percentage, trunk fat, and waist circumference reduction at 6 months; changes in parameters were compared among NOVA 1 + 2 tertiles (T). RESULTS Participants were on average 52.3 years of age, 85% White, 55% female, and 58.2% nonsmoking, with a mean BMI of 32.7 kg/m2. Replacing 10%kcal of UPFs with NOVA 1 + 2 was associated with greater 6-month weight (ß = 0.51, 95% CI: -0.93 to -0.09, p = 0.02), body fat percentage (ß = 2.7, 95% CI: -5.10 to -0.43, p = 0.02), and trunk fat reduction (ß = 3.9, 95% CI: -7.01 to -0.70, p = 0.02), but not waist circumference reduction. Participants in T3 (-8.33 kg) versus T1 (-5.32 kg) of NOVA 1 + 2 had greater weight loss (p < 0.001). CONCLUSIONS Isocaloric substitution of UPFs with NOVA 1 + 2 was associated with marginally greater weight loss under energy restriction. These modest findings support more research exploring the mechanisms linking UPFs with body weight regulation beyond energy intake.
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Affiliation(s)
- Qisi Yao
- Department of Nutrition, University of Rhode Island, Kingston, Rhode Island, USA
| | - Carolina D de Araujo
- Department of Nutrition, University of Rhode Island, Kingston, Rhode Island, USA
| | - Filippa Juul
- School of Global Public Health, New York University, New York, New York, USA
| | | | - George A Bray
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Maya K Vadiveloo
- Department of Nutrition, University of Rhode Island, Kingston, Rhode Island, USA
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12
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Sané S, Diouara AAM, Coundoul S, Tene SD, Kane A, Wade SF, Tamba A, Diop M, Mbaye MN, Thiam F, Dieng M, Mbengue M, Nguer CM, Sarr AD, Ndao AS, Touré Kane C. A metagenomic assessment of bacterial community in spices sold open-air markets in Saint-Louis, Senegal. Sci Rep 2024; 14:14709. [PMID: 38926602 PMCID: PMC11208442 DOI: 10.1038/s41598-024-65756-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/24/2024] [Indexed: 06/28/2024] Open
Abstract
Natural spices play an essential role in human nutrition and well-being. However, their processing on different scales can expose them to potential sources of contamination. This study aimed to describe the bacterial community genomic footprint in spices sold in Senegal. Spice samples were collected in August 2022 in Saint-Louis, Senegal. The genomic region coding bacterial 16S rRNA was then amplified and sequenced using Oxford Nanopore Technology (ONT). Sequencing was carried out on two batches of samples, one containing part of the "Local Spices or Herbs" (n = 10), and the other, a mixture of 7 spices, Curcuma, Thyme and the other part of the "Local Spices or Herbs" (n = 39). Results showed high bacterial diversity and the predominance of Escherichia coli and Salmonella enterica in samples, with total reads of 65,744 and 165,325 for the two batches, respectively. The sample category "Homemade mixture of food condiments ", which includes all "Local Spices or Herbs" samples, showed remarkable bacterial diversity. These were followed by Curcuma, a blend of 7 spices and thyme. Also, the different categories of spices studied show similarities in their bacterial composition. These results highlight the microbial community's highly diverse genomic profile, including pathogenic bacteria, in spice samples.
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Affiliation(s)
- Sarbanding Sané
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Abou Abdallah Malick Diouara
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal.
| | - Seynabou Coundoul
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Sophie Déli Tene
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Alé Kane
- Laboratoire des Sciences Biologiques, Agronomiques, Alimentaires et de Modélisation des Systèmes Complexes (LABAAM), UFR S2ATA, Université Gaston Berger, 234, Saint-Louis, Senegal
| | - Serigne Fallou Wade
- École Supérieure des Sciences Agricoles et de l'Alimentation, Université Amadou Makhtar MBOW, Dakar, Senegal
| | - Abdoulaye Tamba
- Institut Supérieur d'Enseignement Professionnel (ISEP), Bignona, Senegal
| | - Mamadou Diop
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Mame Ndew Mbaye
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Fatou Thiam
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Modou Dieng
- Laboratoire d'Analyses et Essais (LAE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | - Malick Mbengue
- Laboratoire de Microbiologie Appliquée et de Génie Industriel, École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, 5085, Dakar-Fann, Dakar, Senegal
| | - Cheikh Momar Nguer
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta DIOP, 5085, Dakar-Fann, Dakar, Senegal
| | | | - Ababacar Sadikh Ndao
- Institut de Technologie Nucléaire Appliqué (ITNA), Université Cheikh Anta DIOP, 5005, Dakar, Senegal
| | - Coumba Touré Kane
- Institut de Technologie Nucléaire Appliqué (ITNA), Université Cheikh Anta DIOP, 5005, Dakar, Senegal
- Université Sine Saloum El Hadj Ibrahima Niass (USSEIN), Kaolack 55, Senegal
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13
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Dagbasi A, Byrne C, Blunt D, Serrano-Contreras JI, Becker GF, Blanco JM, Camuzeaux S, Chambers E, Danckert N, Edwards C, Bernal A, Garcia MV, Hanyaloglu A, Holmes E, Ma Y, Marchesi J, Martinez-Gili L, Mendoza L, Tashkova M, Perez-Moral N, Garcia-Perez I, Robles AC, Sands C, Wist J, Murphy KG, Frost G. Diet shapes the metabolite profile in the intact human ileum, which affects PYY release. Sci Transl Med 2024; 16:eadm8132. [PMID: 38896603 DOI: 10.1126/scitranslmed.adm8132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
The human ileum contains a high density of enteroendocrine L-cells, which release the appetite-suppressing hormones glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY) in response to food intake. Recent evidence highlighted the potential role of food structures in PYY release, but the link between food structures, ileal metabolites, and appetite hormone release remains unclear owing to limited access to intact human ileum. In a randomized crossover trial (ISRCTN11327221; isrctn.com), we investigated the role of human ileum in GLP-1 and PYY release by giving healthy volunteers diets differing in fiber and food structure: high-fiber (intact or disrupted food structures) or low-fiber disrupted food structures. We used nasoenteric tubes to sample chyme from the intact distal ileum lumina of humans in the fasted state and every 60 min for 480 min postprandially. We demonstrate the highly dynamic, wide-ranging molecular environment of the ileum over time, with a substantial decrease in ileum bacterial numbers and bacterial metabolites after food intake. We also show that high-fiber diets, independent of food structure, increased PYY release compared with a low-fiber diet during 0 to 240 min postprandially. High-fiber diets also increased ileal stachyose, and a disrupted high-fiber diet increased certain ileal amino acids. Treatment of human ileal organoids with ileal fluids or an amino acid and stachyose mixture stimulated PYY expression in a similar profile to blood PYY concentrations, confirming the role of ileal metabolites in PYY release. Our study demonstrates the diet-induced changes over time in the metabolite environment of intact human ileum, which play a role in PYY release.
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Affiliation(s)
- Aygul Dagbasi
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Claire Byrne
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Dominic Blunt
- Department of Imaging, Charing Cross Hospital, Imperial NHS Trust, London W6 8RF, UK
| | - Jose Ivan Serrano-Contreras
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Georgia Franco Becker
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Jesus Miguens Blanco
- Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Stephane Camuzeaux
- National Phenome Centre, Imperial College London, Hammersmith Hospital Campus, London W12 0HS, UK
| | - Edward Chambers
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Nathan Danckert
- Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | | | - Andres Bernal
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Maria Valdivia Garcia
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Aylin Hanyaloglu
- Institute of Reproductive and Development Biology (IRDB), Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Hammersmith Hospital, London W12 0NN, UK
| | - Elaine Holmes
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Yue Ma
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Julian Marchesi
- Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Laura Martinez-Gili
- Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
- Section of Bioinformatics, Division of Systems Medicine, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London W12 0NN, UK
| | - Lilian Mendoza
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Martina Tashkova
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | | | - Isabel Garcia-Perez
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Andres Castillo Robles
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Caroline Sands
- National Phenome Centre, Imperial College London, Hammersmith Hospital Campus, London W12 0HS, UK
| | - Julien Wist
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
- Chemistry Department, Universidad del Valle, Cali 76001, Colombia
| | - Kevin G Murphy
- Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
| | - Gary Frost
- Section of Nutrition, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK
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14
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Debras C, Cordova R, Mayén AL, Maasen K, Knaze V, Eussen SJPM, Schalkwijk CG, Huybrechts I, Tjønneland A, Halkjær J, Katzke V, Bajracharya R, Schulze MB, Masala G, Pala V, Pasanisi F, Macciotta A, Petrova D, Castañeda J, Santiuste C, Amiano P, Moreno-Iribas C, Borné Y, Sonestedt E, Johansson I, Esberg A, Aglago EK, Jenab M, Freisling H. Dietary intake of dicarbonyl compounds and changes in body weight over time in a large cohort of European adults. Br J Nutr 2024; 131:1902-1914. [PMID: 38383991 DOI: 10.1017/s0007114524000503] [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: 02/23/2024]
Abstract
Dicarbonyl compounds are highly reactive precursors of advanced glycation end products (AGE), produced endogenously, present in certain foods and formed during food processing. AGE contribute to the development of adverse metabolic outcomes, but health effects of dietary dicarbonyls are largely unexplored. We investigated associations between three dietary dicarbonyl compounds, methylglyoxal (MGO), glyoxal (GO) and 3-deoxyglucosone (3-DG), and body weight changes in European adults. Dicarbonyl intakes were estimated using food composition database from 263 095 European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home in Relation to Anthropometry participants with two body weight assessments (median follow-up time = 5·4 years). Associations between dicarbonyls and 5-year body-weight changes were estimated using mixed linear regression models. Stratified analyses by sex, age and baseline BMI were performed. Risk of becoming overweight/obese was assessed using multivariable-adjusted logistic regression. MGO intake was associated with 5-year body-weight gain of 0·089 kg (per 1-sd increase, 95 % CI 0·072, 0·107). 3-DG was inversely associated with body-weight change (-0·076 kg, -0·094, -0·058). No significant association was observed for GO (0·018 kg, -0·002, 0·037). In stratified analyses, GO was associated with body-weight gain among women and older participants (above median of 52·4 years). MGO was associated with higher body-weight gain among older participants. 3-DG was inversely associated with body-weight gain among younger and normal-weight participants. MGO was associated with a higher risk of becoming overweight/obese, while inverse associations were observed for 3-DG. No associations were observed for GO with overweight/obesity. Dietary dicarbonyls are inconsistently associated with body weight change among European adults. Further research is needed to clarify the role of these food components in overweight and obesity, their underlying mechanisms and potential public health implications.
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Affiliation(s)
- Charlotte Debras
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Reynalda Cordova
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Ana-Lucia Mayén
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Kim Maasen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Viktoria Knaze
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Simone J P M Eussen
- Department of Epidemiology, CARIM School for Cardiovascular Diseases/CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer research Center (DKFZ), Heidelberg, Germany
| | - Rashmita Bajracharya
- Department of Cancer Epidemiology, German Cancer research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery School of Medicine, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029Madrid, Spain
| | - Jazmin Castañeda
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet del Llobregat, Spain
| | - Carmen Santiuste
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 2013 San Sebastian, Spain; Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Conchi Moreno-Iribas
- Instituto de Salud Pública y Laboral de Navarra, 31003 Pamplona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; Navarra Institute for Health Research (IdiSNA), 31008Pamplona, Spain
| | - Yan Borné
- Nutrition Epidemiology, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
| | - Emily Sonestedt
- Nutrition Epidemiology, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Anders Esberg
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Elom Kouassivi Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Mazda Jenab
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
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15
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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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Meine GC, Picon RV, Espírito Santo PA, Sander GB. Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2024; 119:1056-1065. [PMID: 38832708 DOI: 10.14309/ajg.0000000000002826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 04/14/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model. RESULTS Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer. DISCUSSION The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.
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Affiliation(s)
- Gilmara Coelho Meine
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Gastroenterology, Department of Internal Medicine, Universidade Feevale, Novo Hamburgo, Brazil
| | - Rafael Veiga Picon
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Guilherme Becker Sander
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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de Medeiros JM, Silva-Neto LGR, Dos Santos TLF, Dos Santos Neto JE, de Menezes Toledo Florêncio TM. Higher consumption of ultra-processed foods is associated with obesity and abdominal obesity in socially vulnerable Brazilian women. NUTR BULL 2024; 49:199-208. [PMID: 38623590 DOI: 10.1111/nbu.12675] [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: 11/22/2023] [Revised: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
This study aimed to assess the consumption of ultra-processed foods (UPF) and identify their association with obesity and abdominal obesity in adult women of reproductive age living in situations of social vulnerability in Maceió, Northeastern Brazil. This was a cross-sectional study carried out between October 2020 and May 2021. An anthropometric evaluation was carried out to assess obesity and abdominal obesity. A dietary assessment was also conducted using a 24-h food recall to determine the calorie intake from UPF. To estimate intra-individual variability in food consumption, the probabilistic Multiple Source Method was used. These data in the form of tertiles were used to analyse the association between the consumption of UPF and obesity and abdominal obesity. Logistic regressions were used to analyse the association. A directed acyclic graph (DAG) was created for this analysis. This study included 1702 women of which 53.7% were 31 years old or older, and 74.2% lived in poverty. It identified that 36.5% and 38.1% of the women had obesity and abdominal obesity, respectively, and that an average of 33.8% of calories consumed came from UPF. In the analysis of association guided by the DAG, it was observed that women with a high-calorie intake from UPF had a 1.3 times higher probability of being obese. It was also observed that women with a moderate and high-calorie intake from UPF were 1.4 and 1.3 times more likely, respectively, to have abdominal obesity. Thus, it can be concluded that socially vulnerable women in Brazil have a relatively high consumption of UPF and that this condition increases the probability of obesity in this population group.
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Affiliation(s)
- Jocione Mara de Medeiros
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceio, Brazil
| | | | - Thays Lane Ferreira Dos Santos
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - João Eudes Dos Santos Neto
- Hospital Universitário Alcides Carneiro, Empresa Brasileira de Serviços Hospitalares, Campina Grande, Brazil
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Wei Y, Zhang T, Liu Y, Liu H, Zhou Y, Su J, Chen L, Bai L, Xia Y. Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis. Clin Nutr 2024; 43:1363-1371. [PMID: 38678821 DOI: 10.1016/j.clnu.2024.04.030] [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: 03/02/2023] [Revised: 10/16/2023] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The associations between ultra-processed food (UPF) consumption, genetic susceptibility, and the risk of osteoarthritis (OA) remain unknown. This study was to examine the effect of UPF consumption, genetic susceptibility, and their interactions on hip/knee OA. METHODS Cohort analyses included 163,987 participants from the UK Biobank. Participants' UPF consumption was derived from their 24-h dietary recall using a questionnaire. Genetic risk scores (GRSs) of 70 and 83 single nucleotide polymorphisms (SNPs) for hip and knee OA were constructed. FINDINGS After 1,461,447 person-years of follow-up, 11,540 patients developed OA. After adjustments, compared to participants in the low quartile of UPF consumption, those in the high quartile had a 10 % (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03-1.18) increased risk of knee OA. No significant association was found between UPF consumption and hip OA. Replacing 20% of UPF diet weight with an equivalent proportion of unprocessed or minimally processed food caused a 6% (HR, 0.94; 95% CI, 0.89-0.98) decreased risk of knee OA, respectively. A significant interaction was found between UPF consumption, genetic predisposition, and the risk of knee OA (P = 0.01). Participants with lower OA-GRS scores experienced higher knee OA risks due to UPF consumption. INTERPRETATION UPF consumption was associated with a higher risk of knee OA but not hip OA, particularly in those with lower genetic susceptibility. These results highlight the importance of reducing UPF consumption to prevent knee OA.
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Affiliation(s)
- Yingliang Wei
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingjing Zhang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Jianbang Su
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Lunhao Bai
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China.
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Gombi-Vaca MF, Martinez-Steele E, Andrade GC, Louzada MLDC, Levy RB. Association between ultra-processed food and snacking behavior in Brazil. Eur J Nutr 2024; 63:1177-1186. [PMID: 38360983 DOI: 10.1007/s00394-024-03340-y] [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: 01/15/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Ultra-processed food may play a role in facilitating snacking behavior because of their convenience and low satiety potential. This study aimed to describe the association between consumption of ultra-processed foods and frequency of snacking. METHODS We analyzed data from 46,164 participants (≥ 10 years old) in the 2017-2018 Brazilian Household Budget Survey. Dietary data were collected by 24-h dietary recalls over one or two days for each participant. We estimated energy intake, ultra-processed food consumption, and level of snacking. We measured the association between ultra-processed food consumption and level of snacking using multinomial logistic regression, stratified by age group (adolescents, 10-19 years old; adults, 20-64 years old; elders, 65 or older). RESULTS We found a statistically significant tendency of increased daily energy intake and consumption of snacks and that ultra-processed food consumption was positively associated with the level of snacking for all age groups. For adolescents, adults, and elders in the highest quintile of ultra-processed food consumption as a share of their entire diet, the relative risk ratio (95% CI) of having more than two snacks per day compared to no snacks was 14.21 (9.09-22.21), 4.44 (3.54-5.57), and 4.21 (2.67-6.64), respectively, when compared to the lowest quintile. CONCLUSION Higher consumption of ultra-processed food was associated with snacking behavior, and the strength of this association was stronger among adolescents. Efforts to mitigate ultra-processed food attributes that facilitate snacking should be incorporated into strategies to promote healthier food choices, especially among adolescents.
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Affiliation(s)
- Maria Fernanda Gombi-Vaca
- Department of Preventive Medicine, School of Medicine (FMUSP), University of São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246, Brazil.
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil.
- Rudd Center for Food Policy and Health, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA.
| | - Euridice Martinez-Steele
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine (FMUSP), University of São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
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20
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Alves MA, Lotufo PA, Benseñor I, Marchioni DML. Dietary patterns and adiposity over time - analysis of the ELSA-Brasil. Eur J Nutr 2024; 63:1203-1211. [PMID: 38366269 DOI: 10.1007/s00394-024-03350-w] [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: 05/25/2023] [Accepted: 01/20/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE Combining different statistical methods to identify dietary patterns (DP) may provide new insights on how diet is associated with adiposity. This study investigated the association of DP derived from three data-driven methods and adiposity indicators over time. METHODS This study used data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). DP were identified at baseline applying three statistical methods: Factor Analysis (FA), Treelet Transform (TT), and Reduced Rank Regression (RRR). The association between DP and adiposity indicators (weight, body mass index, waist circumference, body fat percentage and fat mass index) over the period of 8.2 years of follow-up was assessed by linear mixed-models. RESULTS Convenience DP, marked by unhealthy food groups, was associated with higher adiposity over the follow-up period, regardless of the method applied. The DP identified by TT and marked by high consumption of rice and beans was associated with lower adiposity, whereas the similar DP identified by FA, but additionally characterised by consumption of poultry and red meat was associated with higher adiposity. Prudent DP, marked by plant-based food groups and fish, identified by FA was associated with lower adiposity across the median follow-up time. CONCLUSION Applying different methods to identify DP showed that a convenience DP was associated with higher adiposity independent of the method applied. We also identified the nuances within adherence to a Brazilian traditional dietary pattern characterised by the consumption of rice and beans, that only when combined with reduced consumption of animal protein and unhealthy foods was associated with lower adiposity over time.
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Affiliation(s)
- Mariane A Alves
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria L Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
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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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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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23
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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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Popkin BM, Miles DR, Taillie LS, Dunford EK. A policy approach to identifying food and beverage products that are ultra-processed and high in added salt, sugar and saturated fat in the United States: a cross-sectional analysis of packaged foods. LANCET REGIONAL HEALTH. AMERICAS 2024; 32:100713. [PMID: 38495314 PMCID: PMC10943474 DOI: 10.1016/j.lana.2024.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
Background Governments globally aim to reduce the intake of unhealthy foods. Many policies exist that aim to address foods high in saturated fat, salt and sugar (HFSS) but the identification of ultra-processed foods (UPF) have presented a greater challenge due to the lack of an appropriate policy definition. To support policymakers, we provide approaches that can support governments to identify both HFSS foods and UPFs. Methods Four approaches combining elements of UPF definitions (i.e., presence of additives) and HFSS definitions were compared attempting to simplify and standardize the identification of less healthy products. Nationally representative food purchase data from NielsenIQ linked with nutrition facts label data were used to examine the mean proportion of product volume purchased by US households to be targeted. Differences between approaches were examined using Student t test; Bonferroni adjusted P value < 0.0001 was considered significant. Findings In 2020, 50% of 33,054,687 products purchased by US households were considered UPFs (65% of foods and 38% of beverages) and 43% HFSS (65% of foods and 26% of beverages), however there was not 100% agreement between the two definitions (P < 0.0001). By starting with HFSS criteria and adding elements of UPF (colors and flavors), we were able to provide a method with 100% agreement between the identification of UPFs and HFSS products. Interpretation Results demonstrated how combining HFSS criteria with UPF criteria can be used to identify less healthy foods and ensure policymakers have both a simple and accurate method to target products for policy intervention. Funding Bloomberg Philanthropies and the Global Food Research Program of UNC-Chapel Hill provided funds.
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Affiliation(s)
- Barry M. Popkin
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Donna R. Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Elizabeth K. Dunford
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
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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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Nees S, Lutsiv T, Thompson HJ. Ultra-Processed Foods-Dietary Foe or Potential Ally? Nutrients 2024; 16:1013. [PMID: 38613046 PMCID: PMC11013700 DOI: 10.3390/nu16071013] [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: 02/09/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The prevalence of non-communicable diseases (NCDs) has steadily increased in the United States. Health experts attribute the increasing prevalence of NCDs, in part, to the consumption of ultra-processed foods (UPFs) based on epidemiological observations. However, no definitive evidence of causality has been established. Consequently, there is an ongoing debate over whether adverse health outcomes may be due to the low nutrient density per kilocalorie, the processing techniques used during the production of UPFs, taste preference-driven overconsumption of calories, or unidentified factors. Recognizing that "the science is not settled," we propose an investigative process in this narrative review to move the field beyond current controversies and potentially identify the basis of causality. Since many consumers depend on UPFs due to their shelf stability, affordability, availability, ease of use, and safety from pathogens, we also suggest a paradigm for guiding both the formulation of UPFs by food designers and the selection of UPFs by consumers.
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Affiliation(s)
- Sabrina Nees
- Graduate Program in Horticulture and Human Health, Colorado State University, Fort Collins, CO 80523, USA;
| | - Tymofiy Lutsiv
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA;
- Graduate Program in Cell and Molecular Biology, Colorado State University, Fort Collins, CO 80523, USA
| | - Henry J. Thompson
- Graduate Program in Horticulture and Human Health, Colorado State University, Fort Collins, CO 80523, USA;
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA;
- Graduate Program in Cell and Molecular Biology, Colorado State University, Fort Collins, CO 80523, USA
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He X, Zhang X, Si C, Feng Y, Zhu Q, Li S, Shu L. Ultra-processed food consumption and chronic kidney disease risk: a systematic review and dose-response meta-analysis. Front Nutr 2024; 11:1359229. [PMID: 38606016 PMCID: PMC11007045 DOI: 10.3389/fnut.2024.1359229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
BackgroundHigh intake of ultra-processed food (UPF) has been associated with increased risk of chronic kidney disease(CKD), but the results remain inconsistent. We therefore performed this systematic review and dose–response meta-analysis of observational studies that shed light on the association between UPF consumption and the risk of CKD.MethodsA systematic literature search of PubMed, Embase, Web of Science, Scopus and China National Knowledge Infrastructure (CNKI) databases was carried out to find the eligible articles published up to October 31, 2023. Random-effects or fixed-effects models were used to pool the relative risks(RRs) and their 95% confidence intervals (CIs).The potential sources of heterogeneity across studies were examined using the Cochran’s Q test and I-square(I2). Publication bias was examined using the visual inspection of asymmetry in funnel plots and quantified by Begg’s and Egger’s tests.ResultsEight studies (six cohort and two cross-sectional studies) exploring the association between UPF consumption and risk of CKD, were included in the final analysis. The pooled analyses revealed that high consumption of UPF was associated with an increased risk of CKD (RR = 1.25; 95%CI: 1.09–1.42, p < 0.0001). Moreover, a 10% increase of UPF consumption was associated with a 7% higher risk of CKD (RR = 1.07; 95%CI: 1.04–1.10, p < 0.001). Dose–response analysis of all included studies showed a linear association between UPF consumption and the risk of CKD (RR = 1.02; 95%CI:0.99–1.05, Pdose–response = 0.178, Pnonlinearity = 0.843).ConclusionOur findings indicate that high consumption of UPF is significantly associated with an increased risk of CKD. Future research with prospective design is required to confirm this positive association.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023478483, PROSPERO identifier CRD42023478483.
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Affiliation(s)
- Xingzhen He
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xiaoyan Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Caijuan Si
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yuliang Feng
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Qin Zhu
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Songtao Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
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Jalali M, Bahadoran Z, Mirmiran P, Khalili D, Symonds ME, Azizi F, Faghih S. Higher ultra-processed food intake is associated with an increased incidence risk of cardiovascular disease: the Tehran lipid and glucose study. Nutr Metab (Lond) 2024; 21:14. [PMID: 38504359 PMCID: PMC10949749 DOI: 10.1186/s12986-024-00788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major cause of death worldwide, although limited data are currently available regarding the impact of consuming ultra-processed food (UPF) on its incidence. Given the increased consumption of UPF in Iran, we aimed to investigate the association between UPF intake and CVD risk. METHODS Individuals without CVD (n = 2050) aged ≥ 30 years old were recruited from the Tehran Lipid and Glucose Study (TLGS). Dietary data were collected using a validated food frequency questionnaire (FFQ) and UPF intakes were assessed based on the Nova food classification. Multivariable Cox proportional hazard models adjusted for potential confounders were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for the risk of CVD across tertiles of UPF intake. RESULTS A 10.1% incidence of CVD occurred over a median follow-up of 10.6 years, with a 22% increase in CVD risk per each 50 g/day UPF intake. Participants with the highest intake of UPF had a 68% greater incidence of CVD compared to those with the lowest intake (HR = 1.68, 95% CI=1.14-2.48) after controlling for potential confounders. Regarding sub-groups of UPF, participants in the 3rd tertile compared to the reference had a significantly increased risk of CVD (HR = 1.56, 95% CI=1.04-2.34). Nevertheless, intake of bread, fast food, sweetened beverages, sweets and desserts, high-fat dairy products, and other UPFs were not associated with greater CVD risk. CONCLUSION Our findings support the hypothesis that the incidence of CVD is enhanced with the higher consumption of UPF in a representative sample of the Iranian population.
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Affiliation(s)
- Mohammad Jalali
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran.
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Davood Khalili
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran.
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Dicken SJ, Batterham RL. Ultra-processed Food and Obesity: What Is the Evidence? Curr Nutr Rep 2024; 13:23-38. [PMID: 38294671 PMCID: PMC10924027 DOI: 10.1007/s13668-024-00517-z] [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] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE OF REVIEW Obesity is a growing global healthcare concern. A proposed driver is the recent increase in ultra-processed food (UPF) intake. However, disagreement surrounds the concept of UPF, the strength of evidence, and suggested mechanisms. Therefore, this review aimed to critically appraise the evidence on UPF and obesity. RECENT FINDINGS Observational studies demonstrate positive associations between UPF intake, weight gain, and overweight/obesity, more clearly in adults than children/adolescents. This is supported by high-quality clinical data. Several mechanisms are proposed, but current understanding is inconclusive. Greater UPF consumption has been a key driver of obesity. There is a need to change the obesogenic environment to support individuals to reduce their UPF intake. The UPF concept is a novel approach that is not explained with existing nutrient- and food-based frameworks. Critical analysis of methodologies provides confidence, but future observational and experimental research outputs with greater methodological rigor will strengthen findings, which are outlined.
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Affiliation(s)
- Samuel J Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London, WC1E 6JF, UK
| | - Rachel L Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London, WC1E 6JF, UK.
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), London, NW1 2BU, UK.
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), London, W1T 7DN, UK.
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Ferreira SRG, Macotela Y, Velloso LA, Mori MA. Determinants of obesity in Latin America. Nat Metab 2024; 6:409-432. [PMID: 38438626 DOI: 10.1038/s42255-024-00977-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/04/2024] [Indexed: 03/06/2024]
Abstract
Obesity rates are increasing almost everywhere in the world, although the pace and timing for this increase differ when populations from developed and developing countries are compared. The sharp and more recent increase in obesity rates in many Latin American countries is an example of that and results from regional characteristics that emerge from interactions between multiple factors. Aware of the complexity of enumerating these factors, we highlight eight main determinants (the physical environment, food exposure, economic and political interest, social inequity, limited access to scientific knowledge, culture, contextual behaviour and genetics) and discuss how they impact obesity rates in Latin American countries. We propose that initiatives aimed at understanding obesity and hampering obesity growth in Latin America should involve multidisciplinary, global approaches that consider these determinants to build more effective public policy and strategies, accounting for regional differences and disease complexity at the individual and systemic levels.
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Affiliation(s)
| | - Yazmín Macotela
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, UNAM Campus-Juriquilla, Querétaro, Mexico
| | - Licio A Velloso
- Obesity and Comorbidities Research Center, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | - Marcelo A Mori
- Institute of Biology, Universidade Estadual de Campinas, Campinas, Brazil.
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Lv JL, Wei YF, Sun JN, Shi YC, Liu FH, Sun MH, Chang Q, Wu QJ, Zhao YH. Ultra-processed food consumption and metabolic disease risk: an umbrella review of systematic reviews with meta-analyses of observational studies. Front Nutr 2024; 11:1306310. [PMID: 38356860 PMCID: PMC10864658 DOI: 10.3389/fnut.2024.1306310] [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: 10/03/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Background and aims There is an ongoing debate on whether to advocate reducing ultra-processed food (UPF) in dietary guidelines to control metabolic disease (such as obesity and type 2 diabetes mellitus [T2DM]). We aimed to summarize the evidence from systematic reviews with meta-analyses between UPF consumption and metabolic diseases risk, assess the credibility, and verify the robustness of these associations. Methods We systematically searched PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to July 15, 2023, to identify relevant systematic reviews with meta-analyses. We used the random-effects model to evaluate the summary effect size, along with 95% confidence interval and prediction interval. We also assessed heterogeneity, evidence of small-study effects and excess significance bias, and categorized the credibility of each association based on quantitative umbrella review criteria. Additionally, we conducted subgroup and sensitivity analyses to assess the robustness of associations based on continents, study design, dietary assessment methods, definition methods of UPF, population, and units of UPF consumption. Results Overall, 6 systematic reviews with 13 meta-analyses were included. Three (23.08%) meta-analyses were classified as highly suggestive evidence for meeting the criteria that associations were significant at p < 10-6, had more than 1,000 cases, and presented the largest study with significance at p < 0.05. Among them, the highest UPF consumption quantile was associated with an increased risk of obesity (OR = 1.55, 95% CI: 1.36-1.77) when compared with the lowest UPF consumption quantile. The highest UPF consumption quantile was associated with an increased risk of T2DM (RR = 1.40, 95% CI: 1.23-1.59) when compared with the lowest UPF consumption quantile, and a 10% increase in UPF consumption (% g/d) was associated with an increased risk of T2DM (RR = 1.12, 95% CI: 1.10-1.13). Meanwhile, the robustness of these associations was verified by a series of subgroup and sensitivity analyses. Conclusion UPF consumption may be a risk factor for several metabolic diseases. However, well-designed studies are still needed to verify our findings in the future.
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Affiliation(s)
- Jia-Le Lv
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Nan Sun
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Chen Shi
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
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Santangeli E, Abbati C, Chen R, Di Carlo A, Leoni S, Piscaglia F, Ferri S. Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review. Nutrients 2024; 16:427. [PMID: 38337711 PMCID: PMC10857546 DOI: 10.3390/nu16030427] [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: 12/08/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
In recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due to an obesogenic lifestyle (lack of physical activity and overall malnutrition, with an excess of caloric intake together with a deficit of proteins and micronutrients), these patients frequently develop a complex clinical condition defined as sarcopenic obesity (SO). The interplay between cirrhosis and SO lies in the sharing of multiple pathogenetic mechanisms, including malnutrition/malabsorption, chronic inflammation, hyperammonemia and insulin resistance. The presence of SO worsens the outcome of cirrhotic patients, affecting overall morbidity and mortality. International nutrition and liver diseases societies strongly agree on recommending the use of food as an integral part of the healing process in the comprehensive management of these patients, including a reduction in caloric intake, protein and micronutrient supplementation and sodium restriction. Based on the pathophysiological paths shared by cirrhosis and SO, this narrative review aims to highlight the nutritional interventions currently advocated by international guidelines, as well as to provide hints on the possible role of micronutrients and nutraceuticals in the treatment of this multifaceted clinical condition.
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Affiliation(s)
- Ernestina Santangeli
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (E.S.); (C.A.); (R.C.); (F.P.)
| | - Chiara Abbati
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (E.S.); (C.A.); (R.C.); (F.P.)
| | - Rusi Chen
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (E.S.); (C.A.); (R.C.); (F.P.)
| | - Alma Di Carlo
- Division of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.D.C.); (S.L.)
| | - Simona Leoni
- Division of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.D.C.); (S.L.)
| | - Fabio Piscaglia
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (E.S.); (C.A.); (R.C.); (F.P.)
- Division of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.D.C.); (S.L.)
| | - Silvia Ferri
- Division of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.D.C.); (S.L.)
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Zhang T, Xu X, Chang Q, Lv Y, Zhao Y, Niu K, Chen L, Xia Y. Ultraprocessed food consumption, genetic predisposition, and the risk of gout: the UK Biobank study. Rheumatology (Oxford) 2024; 63:165-173. [PMID: 37129545 DOI: 10.1093/rheumatology/kead196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE This study aimed to examine the interactions between ultraprocessed food (UPF) consumption and genetic predisposition with the risk of gout. METHODS This prospective cohort study analysed 181 559 individuals from the UK Biobank study who were free of gout at baseline. UPF was defined according to the NOVA classification. Assessment of genetic predisposition for gout was developed from a genetic risk score of 33 single nucleotide polymorphisms. Cox proportional hazards were used to estimate the associations between UPF consumption, genetic predisposition and the risk of gout. RESULTS Among the 181 559 individuals in the study, 1558 patients developed gout over 1 648 167 person-years of follow-up. In the multivariable adjustment model, compared with the lowest quartile of UPF consumption, the hazard ratio (HR) and 95% CI of the highest UPF consumption was 1.16 (1.01, 1.33) for gout risk, and there was a non-linear correlation between UPF consumption and the development of gout. In substitution analyses, replacing 20% of the weight of UPF in the daily intake with an equal amount of unprocessed or minimally processed food resulted in a 13% lower risk of gout (HR: 0.87; 95% CI: 0.79, 0.95). In the joint-effect analysis, the HR (95% CI) for gout was 1.90 (1.39, 2.60) in participants with high genetic predisposition and high UPF consumption, compared with those with low genetic predisposition and low UPF consumption. CONCLUSION In summary, UPF consumption was found to be associated with a higher risk of gout, particularly in those participants with genetic predisposition to gout. Our study indicated that reducing UPF consumption is crucial for gout prevention.
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Affiliation(s)
- Tingjing Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Wannan Medical College, Wuhu, China
| | - Xin Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Yanling Lv
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Kaijun Niu
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, Tianjin, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
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Grinshpan LS, Eilat-Adar S, Ivancovsky-Wajcman D, Kariv R, Gillon-Keren M, Zelber-Sagi S. Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review. JHEP Rep 2024; 6:100964. [PMID: 38234408 PMCID: PMC10792654 DOI: 10.1016/j.jhepr.2023.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/12/2023] [Accepted: 10/31/2023] [Indexed: 01/19/2024] Open
Abstract
Background High ultra-processed food (UPF) consumption is associated with the development of various diet-related non-communicable diseases, especially obesity and type 2 diabetes. The present study aimed to systematically review the association between UPF consumption and non-alcoholic fatty liver disease (NAFLD) and its leading risk factors; metabolic syndrome (MetS) and insulin resistance (IR). Methods A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science, CINAHL, and Cochrane (March 2023), and references of the identified articles were checked. The search keywords were defined through an exploratory investigation in addition to MeSH and similarly controlled vocabulary thesauruses. Observational and interventional studies were included. Studies that focused only on specific groups of processed foods or overlapping dietary patterns were excluded. The quality assessment was conducted using the Joanna Briggs Institute's critical appraisal tools for observational studies and Cochrane's risk of bias 2 tool for randomized-control trials. A narrative synthesis was employed to report the results. Results Fifteen studies were included, with a total of 52,885 participants, one randomized-controlled trial, and fourteen observational studies (nine cross-sectional and five prospective). The review has shown a significant association between UPF consumption and NAFLD in three studies out of six, MetS in five out of eight, and IR in one out of three. All large-scale prospective cohorts that studied NAFLD or MetS outcomes demonstrated a positive association. In contrast, studies that did not demonstrate significant associations were mostly cross-sectional and small. The evidence for an association with IR was insufficient and conflicting. Conclusion The included studies are few, observational, and based upon self-reported dietary assessment tools. However, current evidence indicates that UPF is not only associated with obesity and type 2 diabetes but may also be a risk factor for NAFLD and MetS. UPF is a worldwide concern deserving further longitudinal research. Impact and implications Overconsumption of ultra-processed food (UPF) may lead to the development of obesity and type 2 diabetes, but the association with non-alcoholic fatty liver disease (NAFLD) is not well established. The present systematic review shows that UPF may be associated with NAFLD, although more large prospective studies are needed. These findings emphasize the importance of minimizing the consumption of UPF to prevent NAFLD and other metabolic diseases among the general adult population. This systematic review and further prospective studies, epidemiological or interventional, can help physicians provide patients with evidence-based nutritional recommendations and will support policymakers in restricting the marketing of UPF as well as promoting affordable, healthy, and minimally processed foods.
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Affiliation(s)
- Laura Sol Grinshpan
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Gastroenterology Tel-Aviv Medical Center, Tel-Aviv, Israel
| | | | - Dana Ivancovsky-Wajcman
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Gastroenterology Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Revital Kariv
- Department of Gastroenterology Tel-Aviv Medical Center, Tel-Aviv, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michal Gillon-Keren
- Institute of Endocrinology and Diabetes, Schneider Children’s Medical Center, Petah Tikva, Israel
- Faculty of Sciences, Kibbutzim College of Education Technology and the Arts, Tel-Aviv, Israel
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Gastroenterology Tel-Aviv Medical Center, Tel-Aviv, Israel
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Grant WB. A Brief History of the Progress in Our Understanding of Genetics and Lifestyle, Especially Diet, in the Risk of Alzheimer's Disease. J Alzheimers Dis 2024; 100:S165-S178. [PMID: 39121130 DOI: 10.3233/jad-240658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
The two major determining factors for Alzheimer's disease (AD) are genetics and lifestyle. Alleles of the apolipoprotein E (APOE) gene play important roles in the development of late-onset AD, with APOEɛ4 increasing risk, APOEɛ3 being neutral, and APOEɛ2 reducing risk. Several modifiable lifestyle factors have been studied in terms of how they can modify the risk of AD. Among these factors are dietary pattern, nutritional supplements such as omega-3 fatty acids, and B vitamins, physical exercise, and obesity, and vitamin D. The Western diet increases risk of AD, while dietary patterns such as the Mediterranean and vegetarian/vegan diets reduce risk. Foods associated with reduced risk include coffee, fruits and vegetables, whole grains and legumes, and fish, while meat and ultraprocessed foods are associated with increased risk, especially when they lead to obesity. In multi-country ecological studies, the amount of meat in the national diet has the highest correlation with risk of AD. The history of research regarding dietary patterns on risk of AD is emphasized in this review. The risk of AD can be modified starting at least by mid-life. People with greater genetic risk for AD would benefit more by choosing lifestyle factors to reduce and/or delay incidence of AD.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, CA, USA
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Cho Y, Ryu S, Kim R, Shin MJ, Oh H. Ultra-processed Food Intake and Risk of Type 2 Diabetes in Korean Adults. J Nutr 2024; 154:243-251. [PMID: 38007182 DOI: 10.1016/j.tjnut.2023.11.021] [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: 07/17/2023] [Revised: 10/25/2023] [Accepted: 11/22/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Several studies from the United States and European countries reported a positive association between ultra-processed food intake and diabetes risk. However, little is known about the association in Asian populations. It is also unknown about the individual ultra-processed food items that are most unfavorably associated with diabetes risk. OBJECTIVE We examined the associations of ultra-processed food intake (combined, as well as individual ultra-processed food items) with the risk of type 2 diabetes. METHODS This prospective analysis included 7438 participants aged 40-69 y from the Korean Genome and Epidemiology Study Ansan-Ansung cohort. Dietary intake was assessed at baseline using a 103-item semiquantitative food-frequency questionnaire. Ultra-processed foods were classified using the Nova definition. Incident type 2 diabetes cases were identified via follow-up interviews and health examination. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS During the follow-up (2001-2019; median: 15 y), a total of 1187 type 2 diabetes cases were identified. Compared with the lowest quartile of ultra-processed food intake, the highest quartile was positively associated with diabetes risk [HR (95% CI) = 1.34 (1.13, 1.59), P-trend = 0.002]. The association did not change after additional adjustment for diet quality or BMI. Among individual ultra-processed food items, a higher consumption of ham/sausage [per 1% increase in the weight ratio: HR (95% CI) = 1.40 (1.05, 1.86)], instant noodles [1.07 (1.02, 1.11)], ice cream [1.08 (1.03, 1.13)], and carbonated beverages [1.02 (1.00, 1.04)] were associated with an increased risk of type 2 diabetes, whereas a higher intake of candy/chocolate was associated with a decreased risk [0.78 (0.62, 0.99)]. CONCLUSIONS Our data suggest that the high intake of ultra-processed foods, particularly ham/sausage, instant noodles, ice cream, and carbonated beverages, is associated with an increased risk of type 2 diabetes in Korean adults.
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Affiliation(s)
- Yoonkyoung Cho
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Seaun Ryu
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
| | - Min-Jeong Shin
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; School of Biosystems and Biomedical Sciences, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Department of Health Policy and Management, Korea University, Seoul, Republic of Korea.
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Sutton CA, Stratton M, L'Insalata AM, Fazzino TL. Ultraprocessed, hyper-palatable, and high energy density foods: Prevalence and distinction across 30 years in the United States. Obesity (Silver Spring) 2024; 32:166-175. [PMID: 37794529 DOI: 10.1002/oby.23897] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 08/08/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Ultraprocessed foods (UPF), hyper-palatable foods (HPF), and high energy density (HED) foods may contribute to obesity risk. All have distinct definitions; however, it is unknown the degree to which they may identify overlapping or distinct foods. This study examined the availability of UPF, HPF, and HED foods in the US food system from 1988 to 2018 and the degree of distinction across definitions. METHODS Four data sets representing the US food system (1988, 2001, 2006, 2018) from the US Department of Agriculture were analyzed. UPF were identified based on the extent of industrialized processing. HPF were identified using the standardized definition that specifies palatability-inducing nutrient combinations. HED was characterized as >2.0 kcal/g. RESULTS Across years, 58% to 65% of foods were classified as UPF, 55% to 69% as HPF, and 37% to 47% as HED. Prevalence of UPF, HPF, and HED foods was higher in 2018 versus 1988 (p values < 0.001); HPF evidenced the largest increase (14%) and UPF evidenced the smallest (4%) over time. There was moderate to high overlap in foods (40%-70%) across definitions. CONCLUSIONS Together, UPF, HPF, and HED foods comprise most foods in the US food supply. Changes in availability varied across definitions, with substantial increases in HPF and HED and relative stability of UPF.
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Affiliation(s)
- Cassandra A Sutton
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Matthew Stratton
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Alexa M L'Insalata
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
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Baruwa OJ, Gbadebo BM, Adeleye OJ, Tabana H, Fagbamigbe AF. Decomposing the rural-urban disparities in overweight and obesity among women of reproductive age in Nigeria. BMC Womens Health 2023; 23:680. [PMID: 38129895 PMCID: PMC10734196 DOI: 10.1186/s12905-023-02813-2] [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: 07/11/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Overweight and obese women face various reproductive and other health challenges, and in some cases, even mortality. Despite evidence of rural-urban disparities in overweight and obesity among women of reproductive age, there is limited evidence regarding the predictors of these disparities. This study aims to investigate the factors associated with overweight and obesity and examine the contributors to rural-urban disparities in overweight and obesity among women of reproductive age in Nigeria. METHODS We utilized the 2018 Nigeria Demographic and Health Survey dataset. The survey employed a two-stage cluster sampling technique based on Nigeria's 2006 census enumeration areas for sample selection. Overweight and obesity were defined as a body mass index (BMI) ≥ 25. Data analyses were conducted using the Logistic Regression Model and the threefold Blinder-Oaxaca decomposition model (α0.05). RESULTS The study revealed that older women (OR = 2.44; CI = 2.11-2.83), those with higher wealth (OR = 2.05; CI = 1.81-2.31), contraceptive users (OR = 1.41; CI = 1.27-1.57), and residents of the South-South region (OR = 1.24; CI = 1.07-1.45) were more likely to be overweight/obese. The decomposition analysis indicated that the mean predicted prevalence of overweight and obesity is 35.5% in urban areas, compared to 21.1% in rural areas of Nigeria. Factors such as wealth status, educational level, media exposure, and contraceptive use were identified as significant contributors to these disparities. CONCLUSION The findings underscore the importance of addressing socioeconomic disparities when designing healthcare interventions to reduce the burden of overweight and obesity, particularly in urban areas. Prioritizing these factors can facilitate efforts to promote healthier lifestyles and enhance overall well-being.
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Affiliation(s)
| | - Babatunde Makinde Gbadebo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine. University of Ibadan, Ibadan, Nigeria.
| | - Oluwafemi John Adeleye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine. University of Ibadan, Ibadan, Nigeria
| | - Hanani Tabana
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine. University of Ibadan, Ibadan, Nigeria
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Mestre Font M, Busquets-Cortés C, Ramírez-Manent JI, Tomás-Gil P, Paublini H, López-González ÁA. Influence of Sociodemographic Variables and Healthy Habits on the Values of Insulin Resistance Indicators in 386,924 Spanish Workers. Nutrients 2023; 15:5122. [PMID: 38140381 PMCID: PMC10746000 DOI: 10.3390/nu15245122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) is an alteration of the action of insulin in cells, which do not respond adequately to this action, leading to an increase in blood glucose levels. IR produces a very diverse clinical picture and increases the cardiometabolic risk of the population that suffers from it. Among the factors that influence IR are genetics, unhealthy lifestyle habits, overweight, and obesity. The objective of this work was to determine how different sociodemographic variables and healthy habits influence the values of different scales that assess the risk of presenting IR in a group of Spanish workers. METHODS An observational, cross-sectional, descriptive study was carried out in 386,924 workers from different Spanish regions. Different sociodemographic variables and lifestyle habits were studied (age, social class, educational level, smoking, Mediterranean diet, physical exercise) along with their association with four scales to evaluate the risk of insulin resistance (TyG index, TyG-BMI, METS-IR, TG/HDL-c). To analyse the quantitative variables, Student's t test was used, while the Chi-squared test was used for the qualitative variables. A multinomial logistic regression analysis was performed, calculating the odds ratio with its 95% confidence intervals. The accepted level of statistical significance was set at p < 0.05. RESULTS In the multivariate analysis, all variables, except educational level, increased the risk of presenting high values on the IR risk scales, especially a sedentary lifestyle and low adherence to the Mediterranean diet. CONCLUSIONS Our results demonstrate an association between the practice of regular physical exercise and a reduction in the risk of IR; a strong role of the Mediterranean diet as a protective factor for IR; an association between aging and increased IR, which has also been suggested in other studies; and, finally, a relationship between a low socioeconomic level and an increase in IR.
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Affiliation(s)
- Miguel Mestre Font
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
| | - Carla Busquets-Cortés
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
| | - José Ignacio Ramírez-Manent
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
- Familiy Medicine, Balearic Islands Health Service, 07003 Palma, Spain
| | - Pilar Tomás-Gil
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
| | - Hernán Paublini
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
| | - Ángel Arturo López-González
- ADEMA-Health Group, Instituto Universitario en Ciencias de la Salud, University of Balearic Islands, 07122 Palma, Spain; (M.M.F.); (C.B.-C.); (P.T.-G.); (H.P.); (Á.A.L.-G.)
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Bestari FF, Andarwulan N, Palupi E. Synthesis of Effect Sizes on Dose Response from Ultra-Processed Food Consumption against Various Noncommunicable Diseases. Foods 2023; 12:4457. [PMID: 38137261 PMCID: PMC10742878 DOI: 10.3390/foods12244457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Ultra-processed foods (UPFs), according to the NOVA classification food system, are food products that are processed using advanced processing technology, which improves palatability and sensory quality. However, UPFs increase the daily intake of energy, sodium, sugar, and total fat (including saturated fat), and decrease the intake of fiber. This might trigger overweight and obesity, the initial stages of noncommunicable diseases (NCDs). However, the effect of UPF consumption on NCDs remains under debate. This study aimed to synthesize the effect size of UPF dose response on various NCDs by using a meta-analysis method. The main output was a hazard ratio (HR) and a 95% confidence interval (CI). Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) selection guidelines, 18 research articles were chosen for further effect size synthesis. The results showed that UPF consumption significantly increased the daily intake of carbohydrates, added sugar, saturated fat, sodium, energy, cholesterol, and total fat; increases of 49.64, 40.78, 30.00, 27.76, 26.67, 25.69, and 15.77%, respectively, were observed. Moreover, with UPF consumption, the fiber intake was way below the daily dietary recommendation (DR), at -38.55%. Further, a 10% increment in UPF consumption significantly affects diabetes, cardiovascular diseases, obesity, and cancer (HR ± 95% CI: 1.115 ± 0.044, 1.096 ± 0.053, 1.068 ± 0.050, and 1.020 ± 0.020, respectively). Thus, limiting daily UPF consumption could help prevent obesity and various NCDs.
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Affiliation(s)
- Fairuz Firda Bestari
- Department of Food Science, Faculty of Agricultural Technology, IPB University, Bogor 16680, Indonesia
| | - Nuri Andarwulan
- Department of Food Science, Faculty of Agricultural Technology, IPB University, Bogor 16680, Indonesia
| | - Eny Palupi
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor 16680, Indonesia
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Buyukdere Y, Akyol A. From a toxin to an obesogen: a review of potential obesogenic roles of acrylamide with a mechanistic approach. Nutr Rev 2023; 82:128-142. [PMID: 37155834 PMCID: PMC10711450 DOI: 10.1093/nutrit/nuad041] [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: 05/10/2023] Open
Abstract
Obesity and obesity-related disorders such as cancer, type 2 diabetes, and fatty liver have become a global health problem. It is well known that the primary cause of obesity is positive energy balance. In addition, obesity is the consequence of complex gene and environment interactions that result in excess calorie intake being stored as fat. However, it has been revealed that there are other factors contributing to the worsening of obesity. The presence of nontraditional risk factors, such as environmental endocrine-disrupting chemicals, has recently been associated with obesity and comorbidities caused by obesity. The aim of this review was to examine the evidence and potential mechanisms for acrylamide having endocrine-disrupting properties contributing to obesity and obesity-related comorbidities. Recent studies have suggested that exposure to environmental endocrine-disrupting obesogens may be a risk factor contributing to the current obesity epidemic, and that one of these obesogens is acrylamide, an environmental and industrial compound produced by food processing, particularly the processing of foods such as potato chips, and coffee. In addition to the known harmful effects of acrylamide in humans and experimental animals, such as neurotoxicity, genotoxicity, and carcinogenicity, acrylamide also has an obesogenic effect. It has been shown in the literature to a limited extent that acrylamide may disrupt energy metabolism, lipid metabolism, adipogenesis, adipocyte differentiation, and various signaling pathways, and may exacerbate the disturbances in metabolic and biochemical parameters observed as a result of obesity. Acrylamide exerts its main potential obesogenic effects through body weight increase, worsening of the levels of obesity-related blood biomarkers, and induction of adipocyte differentiation and adipogenesis. Additional mechanisms may be discovered. Further experimental studies and prospective cohorts are needed, both to supplement existing knowledge about acrylamide and its effects, and to clarify its established relationship with obesity and its comorbidities.
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Affiliation(s)
- Yucel Buyukdere
- are with the Department of Nutrition and Dietetics, Hacettepe University, Ankara, Turkey
| | - Asli Akyol
- are with the Department of Nutrition and Dietetics, Hacettepe University, Ankara, Turkey
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Vincze F, Muka T, Eichelmann F, Llanaj E. Eating out intensity, ultra-processed foods and BMI among Albanian youth. Public Health Nutr 2023; 26:2953-2962. [PMID: 37842793 PMCID: PMC10755451 DOI: 10.1017/s1368980023002173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/31/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Ultra-processed foods (UPF) and eating out of home (OH) are changing nutrition, particularly among youth in constrained settings. We aimed to assess the role of eating OH intensity on the associations of UPF and unprocessed or minimally processed foods (UMPF) with BMI among Albanian youth. DESIGN Cross-sectional. SETTING Albania, a south-eastern European country. PARTICIPANTS 281 youth, predominantly females. METHODS UPF and UMPF were defined based on NOVA, while eating OH intensity based on energy percentage from OH foods. Multivariable models tested associations of UPF and UMPF with BMI stratified by eating OH intensity, controlled for relevant covariates including diet quality, portion size and costs. RESULTS The respondents age ranged between 18 and 23 years with a female predominance (87·5 %). Mean energy from UPF and UMPF was 846 (sd: 573·0) and 802·9 (422·5) kcals, respectively. Among substantial at home eaters UPF intake was not associated (β = −0·07, 95 % CI (−0·13, 0·267)) with BMI; however, UMPF negatively associated with BMI (β = −0·24, 95 % CI (−0·43, −0·06)). Among those defined as substantial OH eaters, UPF (β = 0·24, 95 % CI (0·08, 0·40)) and UMPF (β = 0·18, 95 % CI (0·04, 0·33)) were positively associated with BMI. CONCLUSIONS Our findings provide evidence for the hypothesis that eating OH plays an important role in the association of UPF and UMPF with BMI in youth. While causality cannot be established due to cross-sectional design, to the best of our knowledge, we provide the first assessment of UPF and UMPF intake in a south-eastern European setting, while highlighting the need for establishing and integrating youth nutrition into national nutritional surveillance systems for key dietary risk factors in Albania.
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Affiliation(s)
- Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Meta-Research Innovation Centre at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Epistudia, Bern, Switzerland
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, Nuthetal, 14558, Germany
- German Centre for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Erand Llanaj
- Epistudia, Bern, Switzerland
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, Nuthetal, 14558, Germany
- German Centre for Diabetes Research (DZD), München-Neuherberg, Germany
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Vandevijvere S, De Pauw R, Djojosoeparto S, Gorasso V, Guariguata L, Løvhaug AL, Mialon M, Van Dam I, von Philipsborn P. Upstream Determinants of Overweight and Obesity in Europe. Curr Obes Rep 2023; 12:417-428. [PMID: 37594616 DOI: 10.1007/s13679-023-00524-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW To review the upstream determinants of overweight and obesity in Europe, including food and built environments, and political, commercial, and socioeconomic determinants. RECENT FINDINGS Overweight and obesity affect 60% of European adults, and one in three children, and are more common in individuals with low compared to high socioeconomic position (SEP). Individuals in low SEP groups are more exposed to unhealthy built and food environments, including higher exposure to unhealthy food marketing. Industries influencing the food system have much economic power, resulting in ignoring or silencing the role of ultra-processed foods and commercial practices in weight gain. Overall, effective policies to address overweight and obesity have been insufficiently implemented by governments. To accelerate implementation, strengthened political commitment is essential. Policies must also focus on the upstream, structural, and systemic drivers of overweight and obesity; be comprehensive; and target socioeconomic inequalities in diets and physical activity.
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Affiliation(s)
- Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Sanne Djojosoeparto
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Leonor Guariguata
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Iris Van Dam
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Peter von Philipsborn
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Munich, Germany
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O'Connor LE, Higgins KA, Smiljanec K, Bergia R, Brown AW, Baer D, Davis C, Ferruzzi MG, Miller K, Rowe S, Rueda JMW, Andres A, Cash SB, Coupland J, Crimmins M, Fiecke C, Forde CG, Fukagawa NK, Hall KD, Hamaker B, Herrick KA, Hess JM, Heuven LA, Juul F, Malcomson FC, Martinez-Steele E, Mattes RD, Messina M, Mitchell A, Zhang FF. Perspective: A Research Roadmap about Ultra-Processed Foods and Human Health for the United States Food System: Proceedings from an Interdisciplinary, Multi-Stakeholder Workshop. Adv Nutr 2023; 14:1255-1269. [PMID: 37722488 PMCID: PMC10721509 DOI: 10.1016/j.advnut.2023.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023] Open
Abstract
Our objective was to convene interdisciplinary experts from government, academia, and industry to develop a Research Roadmap to identify research priorities about processed food intake and risk for obesity and cardiometabolic diseases (CMD) among United States populations. We convened attendees at various career stages with diverse viewpoints in the field. We held a "Food Processing Primer" to build foundational knowledge of how and why foods are processed, followed by presentations about how processed foods may affect energy intake, obesity, and CMD risk. Breakout groups discussed potential mechanistic and confounding explanations for associations between processed foods and obesity and CMD risk. Facilitators created research questions (RQs) based on key themes from discussions. Different breakout groups convened to discuss what is known and unknown for each RQ and to develop sub-RQs to address gaps. Workshop attendees focused on ultra-processed foods (UPFs; Nova Group 4) because the preponderance of evidence is based on this classification system. Yet, heterogeneity and subjectivity in UPF classification was a challenge for RQ development. The 6 RQs were: 1) What objective methods or measures could further categorize UPFs, considering food processing, formulation, and the interaction of the two? 2) How can exposure assessment of UPF intake be improved? 3) Does UPF intake influence risk for obesity or CMDs, independent of diet quality? 4) What, if any, attributes of UPFs influence ingestive behavior and contribute to excess energy intake? 5) What, if any, attributes of UPFs contribute to clinically meaningful metabolic responses? 6) What, if any, external environmental factors lead people to consume high amounts of UPFs? Uncertainty and complexity around UPF intake warrant further complementary and interdisciplinary causal, mechanistic, and methodological research related to obesity and CMD risk to understand the utility of applying classification by degree of processing to foods in the United States.
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Affiliation(s)
- Lauren E O'Connor
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States.
| | - Kelly A Higgins
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | | | - Robert Bergia
- Archer Daniels Midland (ADM), Decatur, IL, United States
| | - Andrew W Brown
- University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Little Rock, AR, United States
| | - David Baer
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Cindy Davis
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Mario G Ferruzzi
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Kevin Miller
- Bell Institute of Health & Nutrition, General Mills, Minneapolis, MN, United States
| | | | | | - Aline Andres
- University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, United States
| | - John Coupland
- Penn State University, University Park, PA, United States
| | - Meghan Crimmins
- University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Chelsey Fiecke
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Ciarán G Forde
- Wageningen University and Research, Wageningen, The Netherlands
| | - Naomi K Fukagawa
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Bruce Hamaker
- Purdue University, West Lafayette, IN, United States
| | - Kirsten A Herrick
- National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Julie M Hess
- Agricultural Research Service, US Department of Agriculture, Grand Forks, ND, United States
| | - Lise Aj Heuven
- Wageningen University and Research, Wageningen, The Netherlands
| | - Filippa Juul
- New York University School of Global Public Health, New York, NY, United States
| | | | | | | | - Mark Messina
- Soy Nutrition Institute Global, Pittsfield, MA, United States
| | - Alyson Mitchell
- Food Science and Technology, University of California at Davis, CA, United States
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, United States
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Santos FSD, Martinez Steele E, Costa CDS, Gabe KT, Leite MA, Claro RM, Touvier M, Srour B, da Costa Louzada ML, Levy RB, Monteiro CA. Nova diet quality scores and risk of weight gain in the NutriNet-Brasil cohort study. Public Health Nutr 2023; 26:2366-2373. [PMID: 37522809 DOI: 10.1017/s1368980023001532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE To assess the prospective association of two diet quality scores based on the Nova food classification with BMI gain. DESIGN The NutriNet-Brasil cohort is an ongoing web-based prospective study with continuous recruitment of participants aged ≥ 18 years since January 2020. A short 24-h dietary recall screener including 'yes/no' questions about the consumption of whole plant foods (WPF) and ultra-processed foods (UPF) was completed by participants at baseline. The Nova-WPF and the Nova-UPF scores were computed by adding up positive responses regarding the consumption of thirty-three varieties of WPF and twenty-three varieties of UPF, respectively. Participants reported their height at baseline and their weight at both baseline and after approximately 15 months of follow-up. A 15-month BMI (kg/m2) increase of ≥5 % was coded as BMI gain. SETTING Brazil. PARTICIPANTS 9551 participants from the NutriNet-Brasil cohort. RESULTS Increasing quintiles of the Nova-UPF score were linearly associated with higher risk of BMI gain (relative risk Q5/Q1 = 1·34; 95 % CI 1·15, 1·56), whereas increasing quintiles of the Nova-WPF score were linearly associated with lower risk (relative risk Q5/Q1 = 0·80; 95 % CI 0·69, 0·94). We identified a moderate inverse correlation between the two scores (-0·33) and a partial mediating effect of the alternative score: 15 % for the total effect of the Nova-UPF score and 25 % for the total effect of the Nova-WPF score. CONCLUSIONS The Nova-UPF and Nova-WPF scores are independently associated with mid-term BMI gain further justifying their use in diet quality monitoring systems.
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Affiliation(s)
- Francine Silva Dos Santos
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eurídice Martinez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Caroline Dos Santos Costa
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Kamila Tiemman Gabe
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Maria Alvim Leite
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Guo L, Li F, Tang G, Yang B, Yu N, Guo F, Li C. Association of ultra-processed foods consumption with risk of cardio-cerebrovascular disease: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2023; 33:2076-2088. [PMID: 37573217 DOI: 10.1016/j.numecd.2023.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/14/2023]
Abstract
AIMS The epidemiological evidence regarding the impact of ultra-processed foods (UPFs) on the risk of cardio-cerebrovascular diseases (CCVDs) is controversial. The aim of this systematic review and meta-analysis is to examine the association between UPF consumption and the risk of CCVDs within cohort studies. DATA SYNTHESIS A systematic literature search was conducted across multiple databases, including PubMed/Medline, Embase, Web of Science, Scopus, and the Cochrane Library databases, covering the inception of these databases up until January 1st, 2023. A total of 39 cohort studies involving 63,573,312 human participants were deemed eligible according to the inclusion criteria. Utilizing random-effects models, risk ratios (RRs) were estimated to determine the pooled results. Our findings indicate a significant association between a higher consumption of UPF and an increased likelihood of CCVDs (RR: 1.08, 95% CI: 1.01-1.16, I2 = 89%; p < 0.01) compared to individuals who either abstain from or consume lesser amounts of UPF. Nonlinear dose-response meta-analyses showed that a consistent high intake of UPFs was associated with an elevated risk of developing CCVDs (p non-linearity <0.001). Notably, the risk of CCVDs escalated by approximately 7% with an UPF intake of up to 1 serving per day. Subgroup analysis further revealed a significant augmentation in the risk of total CVD and hypertension with increased UPF consumption. CONCLUSIONS A higher intake of UPF significantly increases the risk of developing CCVDs. Prospective studies controlling for confounding factors are needed to validate the relationship between UPF intake and the development of CCVDs.
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Affiliation(s)
- Lei Guo
- Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Fumin Li
- School of Medicine. University of Electronic Science and Technology of China, Department of Orthopedics, Sichuan Academy of Medical Sciences &Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - Guo Tang
- Department of Emergency, West China Hospital, Sichuan University, Chengdu 610000, China
| | - Bo Yang
- Department of Center for Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Nengwei Yu
- Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Fuqiang Guo
- Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
| | - Chunling Li
- Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
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Portel CDS, da Silva WP, Tavares Filho ER, Pagani MM, Pimentel TC, Mársico ET, de Freitas MQ, Cruz AGD, Esmerino EA. Are healthiness and pleasure dimensions perceived similarly by people with food addiction in Brazil? A case study using holistic sensory methodologies. Food Res Int 2023; 173:113206. [PMID: 37803534 DOI: 10.1016/j.foodres.2023.113206] [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: 03/12/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 10/08/2023]
Abstract
The relationship between the consumption of hyper-palatable ultra-processed foods and the process of addiction gains notoriety due to its relationship with obesity. Food addiction is a complex phenomenon intrinsically related to the individual's behavioral, emotional, and subjective aspects. Therefore, using classical approaches to sensory science may be insufficient to understand better the individual's sensory experience with hyper-palatable foods. In this context, sensory and consumer science techniques with holistic approaches have been aimed at accessing more subjective consumer perceptions. This study used the Yale Food Addiction Scale (YFAS 2.0) to investigate the prevalence of food addiction and the Structured Projective Mapping (S-MP) and Sorting techniques to verify how individuals with and without food addiction perceive and understand different types of food. The prevalence of food addiction was 21.77% (n = 59 out of 271) and was associated with a higher BMI but not with sociodemographic aspects. Projective Mapping (RV = 0.937) and Sorting (RV = 0.934) indicated that perception in relation to attributes such as health and pleasure was similar for all investigated foods in individuals with or without food addiction. The presence of addictive eating behavior does not seem to be related to the way individuals perceive foods from different categories, for example, minimally or highly processed and hyper-palatable foods.
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Affiliation(s)
- Carolina de Souto Portel
- Department of Food, Federal Institute of Education, Science and Technology of Rio de Janeiro (IFRJ), 20270-021 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wanessa Pires da Silva
- Department of Food Technology, Federal Fluminense University, Faculty of Veterinary, 24230-340 Niterói, Rio de Janeiro, Brazil
| | - Elson Rogério Tavares Filho
- Department of Food, Federal Institute of Education, Science and Technology of Rio de Janeiro (IFRJ), 20270-021 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Marques Pagani
- Department of Food Technology, Federal Rural University of Rio de Janeiro, Faculty of Food Engineering, 23897-001 Seropédica, Rio de Janeiro, Brazil
| | - Tatiana Colombo Pimentel
- Department of Food Technology, Federal Institute of Education, Science and Technology of Paraná, 87703-536 Paranavaí, Brazil
| | - Eliane Teixeira Mársico
- Department of Food Technology, Federal Fluminense University, Faculty of Veterinary, 24230-340 Niterói, Rio de Janeiro, Brazil
| | - Mônica Queiroz de Freitas
- Department of Food Technology, Federal Fluminense University, Faculty of Veterinary, 24230-340 Niterói, Rio de Janeiro, Brazil
| | - Adriano Gomes da Cruz
- Department of Food, Federal Institute of Education, Science and Technology of Rio de Janeiro (IFRJ), 20270-021 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erick Almeida Esmerino
- Department of Food, Federal Institute of Education, Science and Technology of Rio de Janeiro (IFRJ), 20270-021 Rio de Janeiro, Rio de Janeiro, Brazil; Department of Food Technology, Federal Fluminense University, Faculty of Veterinary, 24230-340 Niterói, Rio de Janeiro, Brazil.
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Silveira VNDC, França AKTDC, Campelo CL, Machado PMA, dos Santos AM. Proposition of an Energy Intake Estimating Scale through Item Response Theory. Nutrients 2023; 15:4511. [PMID: 37960164 PMCID: PMC10650126 DOI: 10.3390/nu15214511] [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: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Traditional methods for assessing individual energy consumption often involve lengthy and intricate procedures. This study aims to introduce an Energy Consumption Estimation Scale, utilizing Item Response Theory (IRT) for adolescents aged 18-19 years. METHODS This psychometric investigation applies IRT to 93 items extracted from a validated food frequency questionnaire. The study encompasses a representative sample of 2515 adolescents from the São Luís birth cohort in Brazil. The latent trait, energy intake, is derived using IRT and subsequently validated through hierarchical multiple linear regression modeling. Significance was established at p < 0.05. RESULTS A Samejima's model was successfully fitted (CFI and TLI > 0.9 and RMSEA < 0.08), effectively capturing variations across all energy consumption levels. Factors associated with the latent trait demonstrate consistent behavioral patterns. Adolescents with higher energy intake exhibited increased consumption of dairy products, artificially sweetened beverages, and seasonal fruits and vegetables. CONCLUSIONS The proposed Energy Consumption Estimation Scale demonstrates a reliable measurement of energy intake and serves as a practical and concise alternative for assessing energy consumption among adolescents. These findings suggest the potential for adapting similar models for different age groups and incorporating diverse food items based on the obtained results.
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Affiliation(s)
- Victor Nogueira da Cruz Silveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
| | | | - Cleber Lopes Campelo
- Higher School of Health Sciences—Bachelor of Nursing, State University of Amazonas, Nurse at Brazilian Hospital Services Company (EBSERH), Manaus 69850-000, Brazil;
| | | | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
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He Q, Sun M, Zhao H, Sun N, Han Q, Feng Z, Li T, Wang Y, Li G, Ma Z, Liu X, Shen Y. Ultra-processed food consumption, mediating biomarkers, and risk of chronic obstructive pulmonary disease: a prospective cohort study in the UK Biobank. Food Funct 2023; 14:8785-8796. [PMID: 37674411 DOI: 10.1039/d3fo02069j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background: Ultra-processed food (UPF) is a popular supplement in the UK and other developed countries. However, whether and how UPF intake is associated with chronic obstructive pulmonary disease (COPD) remains unclear. Objective: We aimed to examine the association between UPF consumption and COPD incidence and explore the potential mediating effects of COPD-related biomarkers. Methods: This prospective cohort study included 207 002 participants without COPD at recruitment and completed 24-hour dietary recalls. UPF was defined according to the NOVA classification system. Incident COPD was ascertained using electronic hospital and mortality records. Cox regression models were used to estimate UPF consumption and the subsequent risk of COPD. Substitution analysis was performed to assess the risk of COPD by substituting UPF with an equivalent proportion of unprocessed or minimally processed food (UNPF). Mediation analyses were performed to evaluate the contribution of biomarkers related to the lipid profile, glucose metabolism, and systemic inflammation to the observed associations. Results: During a median follow-up of 13.1 (interquartile range: 12.5-13.9) years, 4670 COPD events were recorded. The adjusted hazard ratio (HR) of COPD in the highest quintile versus the lowest quintile of the UPF consumption proportion (weight percentage of the UPF) was 1.22 (95% confidence interval [CI]: 1.11-1.34). There was a 10% elevated risk of COPD incidence per SD increase in UPF intake (HR: 1.10; 95% CI: 1.08-1.13). Replacing 20% of the UNPF weight with the UPF was associated with a 13% decrease in COPD risk (95% CI: 0.84-0.91). In mediation analyses, biomarkers explained 1.0-10.1% of the association between UPF intake and COPD. Results from stratified and sensitivity analyses further support the robustness of these findings. Conclusions: Elevated UPF consumption was associated with a higher risk of COPD, and this association was primarily mediated by glucose, inflammation, and lipids, whereas substituting UNPF for UPF was associated with a decreased risk of COPD.
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Affiliation(s)
- Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Mengtong Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Hanqing Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Na Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Qiang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Yu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Guoxian Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Ze Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
| | - Xiaoqin Liu
- The National Centre for Register-based Research, Aarhus University, Denmark
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, P. R. China.
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50
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Tan LJ, Hwang SB, Shin S. The Longitudinal Effect of Ultra-Processed Food on the Development of Dyslipidemia/Obesity as Assessed by the NOVA System and Food Compass Score. Mol Nutr Food Res 2023; 67:e2300003. [PMID: 37650269 DOI: 10.1002/mnfr.202300003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/10/2023] [Indexed: 09/01/2023]
Abstract
SCOPE Ultra-processing food (UPF) has been a nutrition and health interest. This study is aimed to investigate the association between UPF consumption and the risk of obesity or dyslipidemia. METHODS AND RESULTS This study is performed using an ongoing cohort study including 17 310 individuals aged ≥40 years in South Korea. UPF is categorized by the NOVA system and FCS, respectively. After an average 5-year follow-up, there is a positive association between NOVA-defined UPF and dyslipidemia. The risk of the Q4 group is almost 20% higher than that of the Q1 group (men, adjusted HR = 1.209 [95% CI 1.039-1.407], women, adjusted HR = 1.195 [95% CI 1.096-1.303]). Consuming high-FCS foods (less processed and healthier foods) show a lower risk for dyslipidemia in both sexes and lower obesity risk in women compared to low-FCS consumption (men, dyslipidemia, adjusted HR = 0.857 [95% CI 0.744-0.988]; women, dyslipidemia, adjusted HR = 0.919 [95% CI 0.850-0.993], obesity, adjusted HR = 0.759 [95% CI 0.628-0.916]). CONCLUSION Higher UPF intakes assessed by the NOVA system and FCS are associated with increased incidences of dyslipidemia and obesity. Furthermore, NOVA-defined UPF shows a statistically significant negative association with AMED score, indicating poor diet quality.
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Affiliation(s)
- Li-Juan Tan
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Su Bin Hwang
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
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