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Xiao B, Huang J, Chen L, Lin Y, Luo J, Chen H, Fu L, Tang F, Ouyang W, Wu Y. Ultra-processed food consumption and the risk of incident chronic kidney disease: a systematic review and meta-analysis of cohort studies. Ren Fail 2024; 46:2306224. [PMID: 38345016 PMCID: PMC10863522 DOI: 10.1080/0886022x.2024.2306224] [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: 07/19/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Recent individual studies have indicated that ultra-processed food (UPF) consumption may be associated with the incidence of chronic kidney disease (CKD). We conducted a systematic review and meta-analysis based on those longitudinal studies evaluating the relationship between UPF consumption and the risk of incident CKD, and synthesizing the results. METHOD PubMed, Embase, The Cochrane Library, Web of Science, and Scopus were searched from inception through 22 March 2023. Any longitudinal studies evaluating the relationship between UPF consumption and the risk of incident CKD were included. Two researchers independently conducted the literature screening and data extraction. RR and its 95% CI were regarded as the effect size. The Newcastle-Ottawa Scale (NOS) was applied to assess the quality of the studies included, and the effect of UPF consumption on the risk of incident CKD was analyzed with STATA version 15.1. This study's protocol was registered in PROSPERO (CRD42023411951). RESULTS Four cohort studies with a total of 219,132 participants were included after screening. The results of the meta-analysis suggested that the highest UPF intake was associated with an increased risk of incident CKD (RR = 1.25; 95% CI: 1.18-1.33). CONCLUSIONS High-dose UPF intake was associated with an increased risk of incident CKD. However, the underlying mechanisms remain unknown. Thus, more standardized clinical studies and further exploration of the mechanisms are needed in the future.
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Affiliation(s)
- Bingjie Xiao
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinxian Huang
- The Fourth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Linyi Chen
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Lin
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianghong Luo
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huifen Chen
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lizhe Fu
- Chronic Disease Management Outpatient, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Fang Tang
- Chronic Disease Management Outpatient, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Wenwei Ouyang
- Key Unit of Methodology in Clinical Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Yifan Wu
- Chronic Disease Management Outpatient, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
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Leone A, De la Fuente-Arrillaga C, Mas MV, Sayon-Orea C, Menichetti F, Martínez-Gonzalez MA, Bes-Rastrollo M. Association between the consumption of ultra-processed foods and the incidence of peptic ulcer disease in the SUN project: a Spanish prospective cohort study. Eur J Nutr 2024; 63:2367-2378. [PMID: 38809325 PMCID: PMC11377682 DOI: 10.1007/s00394-024-03439-2] [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: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Consumption of ultra-processed foods (UPF) has increased despite potential adverse health effects. Recent studies showed an association between UPF consumption and some gastrointestinal disorders. We evaluated the association between UPF consumption and peptic ulcer disease (PUD) in a large Spanish cohort. METHODS We conducted a prospective analysis of 18,066 participants in the SUN cohort, followed every two years. UPF was assessed at baseline and 10 years after. Cases of PUD were identified among participants reporting a physician-made diagnosis of PUD during follow-ups. Cases were only partially validated against medical records. Cox regression was used to assess the association between baseline UPF consumption and PUD risk. Based on previous findings and biological plausibility, socio-demographic and lifestyle variables, BMI, energy intake, Helicobacter pylori infection, gastrointestinal disorders, aspirin and analgesic use, and alcohol and coffee consumption were included as confounders.We fitted GEE with repeated dietary measurements at baseline and after 10 years of follow-up. Vanderweele's proposed E value was calculated to assess the sensitivity of observed associations to uncontrolled confounding. RESULTS During a median follow-up of 12.2 years, we recorded 322 new PUD cases (1.56 cases/1000 person-years). Participants in the highest baseline tertile of UPF consumption had an increased PUD risk compared to participants in the lowest tertile (HR = 1.52, 95% CI: 1.15, 2.00, Ptrend=0.002). The E-values for the point estimate supported the observed association. The OR using repeated measurements of UPF intake was 1.39 (95% CI: 1.03, 1.87) when comparing extreme tertiles. CONCLUSION The consumption of UPF is associated with an increased PUD risk.
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Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status and The Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.
- Clinical Nutrition Unit, Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, Milan, 20100, Italy.
| | - Carmen De la Fuente-Arrillaga
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Carmen Sayon-Orea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarra Institute of Public Health, Pamplona, Spain
| | - Francesca Menichetti
- International Center for the Assessment of Nutritional Status and The Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| | - Miguel Angel Martínez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Erdoğan Gövez N, Köksal E, Martinez-Perez C, Daimiel L. Validity and Reliability of the Turkish Version of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). Nutrients 2024; 16:2552. [PMID: 39125430 PMCID: PMC11314031 DOI: 10.3390/nu16152552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
The global consumption of highly (ultra) processed foods (HPFs) is increasing, and it is associated with non-communicable diseases. This study aimed to assess the validity and reliability of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). This study included 94 adults. Sociodemographic data were collected, and anthropometric and blood pressure measurements were performed. The sQ-HPF was translated into Turkish and culturally adapted. Dietary intake was assessed using three-day dietary records. Factor analysis and Cronbach's alpha were used to evaluate the validity and consistency of the sQ-HPF. Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Three items from the original sQ-HPF were excluded due to low factor loadings. The Kaiser-Meyer Olkin (KMO) coefficient for the measure of sample adequacy was found to be 0.642 and Bartlett's test of sphericity was found to be significant (p < 0.001). A significant correlation was found between the sQ-HPF score and HPF consumption derived from the 3-day dietary records (p < 0.05). Cronbach's alpha was found to be 0.65. Individuals with higher sQ-HPF scores consumed a significantly greater percentage of energy from HPFs (kcal/day) (p < 0.001). The sQ-HPF demonstrated good test-retest reliability (ICC = 0.76). The Turkish version of the sQ-HPF is a valid and reliable tool for assessing HPF consumption patterns and can be used in epidemiological and clinical studies.
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Affiliation(s)
- Nazlıcan Erdoğan Gövez
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara 06490, Turkey;
| | - Eda Köksal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara 06490, Turkey;
| | - Celia Martinez-Perez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
| | - Lidia Daimiel
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
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4
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Pries AM, Bassetti E, Badham J, Baker P, Blankenship J, Dunford EK, Kupka R. Ultraprocessing and presence of additives in commercially produced complementary foods in seven Southeast Asian countries: a cross-sectional study. Am J Clin Nutr 2024; 120:310-319. [PMID: 38816268 PMCID: PMC11347792 DOI: 10.1016/j.ajcnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND There has been a dramatic shift in food systems, and the consumption of commercially processed and packaged foods has grown globally, including among older infants and young children. Many of these products are ultraprocessed and contain additives, with concerning implications for the health and nutrition of children. OBJECTIVES The study objectives were as follows: 1) to assess the levels of processing among different commercially produced complementary food product (CPCF) categories marketed in the Southeast Asia region, 2) to compare the nutrient content of CPCF products across levels of processing, and 3) to assess the types of additives present in different CPCF categories. METHODS This cross-sectional study involved secondary analysis of a cross-sectional dataset of product label information from CPCF purchased in 2021 in Cambodia, Indonesia, Lao People's Democratic Republic, Malaysia, Philippines, Thailand, and Viet Nam. Ingredient lists were reviewed to determine the level of processing-based on the Nova classification-and the presence of additives. Nutrient declaration panels were reviewed to determine total sugar, sodium, and total fat. RESULTS Nearly half of all CPCF were ultraprocessed, with total sugar and sodium content significantly higher among ultraprocessed CPCF than unprocessed/minimally processed products. Almost half of CPCF contained additives, with a median of 6 per product. More than 30% of all CPCF made use of cosmetic additives to enhance the products' appearance, flavor, or texture, with emulsifiers, colors, and thickeners the most prevalent. Almost one-third of products contained additives not permitted in Codex Alimentarius standards and guidelines for CPCF. CONCLUSIONS Findings from this study should alert national governments to both adopt and ensure enforcement of Codex guidance on additives and regulations enacted to encourage lower levels of processing for CPCF.
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Affiliation(s)
- Alissa M Pries
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand.
| | | | | | - Philip Baker
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Elizabeth K Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Roland Kupka
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand
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Liddiard E, Hamshaw RJT. Body dissatisfaction and beyond: Investigating attitudes towards calorie labels on UK food menus. Appetite 2024; 199:107418. [PMID: 38754766 DOI: 10.1016/j.appet.2024.107418] [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: 12/20/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
In 2022 the British government made calorie labels on menus a legal requirement to encourage healthier food choices while dining out. Yet, little research has explored perceptions of calorie labels on menus in the United Kingdom or tested whether there may be groups of people vulnerable to potential negative effects of calorie labels, such as those with body dissatisfaction. This between-subjects, convergent mixed-methods study addressed these enquiries. Participants were 562 adults who completed an online survey where hypothetical food orders were made from a menu. The study found that participants who viewed a menu with calorie labels ordered fewer calories. Quantitative results did not find that participants with higher levels of body dissatisfaction were at significantly greater odds of using calorie labels to order fewer calories. However, our qualitative (thematic) analysis revealed that experiences of calorie labels could be shaped by body image concerns. Themes further drew on how calorie labels were empowering, but there were also concerns about their oversimplicity. Findings are discussed in relation to implications for future calorie labelling policies. Given the inconsistent findings amongst the limited amount of literature investigating the role of body dissatisfaction in how calorie labels are used, future research is crucial. In the meantime, as a cautionary measure, clinicians involved in supporting individuals with body or food-related concerns should be aware of the challenges their clients may experience in facing calorie labels on menus when dining out.
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Affiliation(s)
- Emma Liddiard
- Department of Psychology, University of Bath, Bath, UK
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González-Cantero JO, López-Torres LP, Alvarado-Avalos IR, López-Alcaraz F, Gasca-Suarez E, Cisneros-Hernández AA, Valadez A, Macías-Espinoza F, Dominguez-Rodriguez A. An internet-based self-help intervention for the reduction of consumption of ultra-processed products and increase of physical activity in Mexican university population: study protocol for a randomized controlled trial. Front Nutr 2024; 11:1325528. [PMID: 39221160 PMCID: PMC11363904 DOI: 10.3389/fnut.2024.1325528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 06/19/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction The consumption of ultra-processed products has been associated with the etiology of various diseases, mainly metabolic diseases. On the other hand, physical activity acts as a protective factor that helps prevent the appearance of this type of disease. In addition to the physical effects, both the consumption of ultra-processed products (UPPs) and sedentary behaviors have been associated with a significant impact on people's mental health. These problems occur significantly in university students. Online internet interventions are an alternative that has the advantage of reaching a broader sample size and adapting to various problems. Methods A randomized controlled clinical superiority trial with two independent groups will be developed with 176 participants. Participants in both groups will be evaluated in 5 steps: (1) pretest, (2) middle of the intervention, (3) post-test, (4) follow-up at 3 months, and (5) follow-up at 6 months. In the experimental group ("UNISALUD"), participants will receive an intervention composed of 11 sessions with interactive elements such as videos, audio, and infographics created through the user experience (UX) principles and based on the health action process approach (HAPA). The participants in the control group will be on the waiting list and will receive treatment 27 days after fulfilling the inclusion criteria. Thus, participants will not receive the treatment immediately. Discussion The study is expected to establish the feasibility of a self-help internet-based intervention created based on the user experience methodology and the health action process model, leading to a significant decrease and increase in the consumption of UPPs, ultra-healthy products, and physical activity, respectively. Conclusion Internet-based interventions are scarce in Latin America. Due to their potential, this study will provide data about consumption of UPPs, physical activity, and mental health of the Mexican population, which will influence the reduction of health-related complications through prevention strategies or measures.Clinical Trial Registration:ClinicalTrials.gov, NCT05834842.
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Affiliation(s)
- Joel Omar González-Cantero
- Departamento de Ciencias del Comportamiento, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca, Mexico
| | - Leyna Priscila López-Torres
- Departamento de Ciencias Sociales, Maestría en Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Itzel Refugio Alvarado-Avalos
- Maestría en Psicología de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Estefania Gasca-Suarez
- Maestría en Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Adrian Antonio Cisneros-Hernández
- Departamento de Proyectos de Comunicación, Centro Universitario de Arte, Arquitectura y Diseño, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alexandra Valadez
- Departamento de Transformaciones Sociales, Centro Universitario de Tlajomulco, Universidad de Guadalajara, Tlajomulco, Mexico
| | - Fabiola Macías-Espinoza
- Departamento de Psicología Aplicada, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Hosseinpour-Niazi S, Niknam M, Amiri P, Mirmiran P, Einy E, Izadi N, Gaeini Z, Azizi F. The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata. BMC Public Health 2024; 24:1955. [PMID: 39039502 PMCID: PMC11265477 DOI: 10.1186/s12889-024-19351-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. METHODS This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. RESULTS The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods. CONCLUSIONS Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Einy
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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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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9
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Pereira de Araújo T, de Moraes MM, Afonso C, Rodrigues SSP. Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population. Br J Nutr 2024; 131:1600-1607. [PMID: 38174417 DOI: 10.1017/s0007114523003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.
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Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Milena Miranda de Moraes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Sara Simões Pereira Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
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10
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Aljahdali AA, Rossato SL, Baylin A. Ultra-processed foods consumption among a USA representative sample of middle-older adults: a cross-sectional analysis. Br J Nutr 2024; 131:1461-1472. [PMID: 38174358 PMCID: PMC10950447 DOI: 10.1017/s0007114523003033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
The study evaluated the association between ultra-processed foods (UPF) and nutrient intake and identified the socio-demographic characteristics associated with UPF consumption among a nationally representative sample of middle-older adults. Dietary assessment was collected in 2013 using a validated FFQ. The Nova system was used to classify food and drinks into UPF. The percentage of dietary energy from UPF was calculated and used throughout the analyses, and average nutrient intake across quintiles of UPF was evaluated. The determinants associated with the dietary caloric contribution of UPF intake were investigated using linear regression models. A cross-sectional analysis of a nationally representative study of Americans over the age of 50, the Health and Retirement Study, was conducted. The analysis included 6220 participants. The mean age was 65 (se 0·28) years, with 55 % being female. UPF intake accounted for 51 % (se 0·25) of total intake. An increase in the percentage of (%UPF) consumption was correlated with an increase in calories, carbohydrates, saturated fat and sugar, and a decrease in fibre, vitamins and minerals. %UPF intake was inversely associated with being Hispanic, higher income, physical activity, vegetarian diet and Mediterranean diet but positively associated with very low food insecurity. UPF represented half of the calories consumed. A higher %UPF intake was associated with a lower nutrient profile, suggesting decreasing %UPF intake as a strategy to improve the nutritional quality of middle-older adults. A few socio-demographic factors were associated with %UPF, which would help in planning strategies to reduce UPF consumption.
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Affiliation(s)
- Abeer Ali Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Global Public Health, University of Michigan, Ann Arbor, MI, USA
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11
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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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12
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Henney AE, Gillespie CS, Alam U, Hydes TJ, Boyland E, Cuthbertson DJ. Ultra-processed food and non-communicable diseases in the United Kingdom: A narrative review and thematic synthesis of literature. Obes Rev 2024; 25:e13682. [PMID: 38204299 DOI: 10.1111/obr.13682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/27/2023] [Accepted: 11/13/2023] [Indexed: 01/12/2024]
Abstract
The social and economic constructs of the United Kingdom (UK) provide a fertile food environment for the dramatic expansion in the ultra-processed food (UPF) market, driving increased UPF consumption. This has coincided with the significant increase in the incidence and prevalence of non-communicable diseases (NCDs) such as obesity, type 2 diabetes, cardiovascular disease, and cancer, with an inherent impact on morbidity and mortality. Our review aims to assess the current epidemiological and public health trends in the United Kingdom, specifically examining consumption of UPFs and subsequent development of NCDs, summarizing existing meta-analytical and experimental approaches. First, we address important socioeconomic and psychosocial domains that may contribute to increased availability and consumption of UPF. Additionally, we explore the putative mechanistic basis for the association between UPFs and NCDs: partly attributable to their energy density, the macro- and micronutrient composition (including high refined carbohydrate, saturated, and trans fats composition, in addition to low fiber and protein content), and artificially engineered additives and other compounds that adversely affect health in inadequately researched pathophysiological pathways. This review highlights the importance of promoting minimally processed diets to both clinical and political decision makers.
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Affiliation(s)
- Alex E Henney
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism and Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Conor S Gillespie
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism and Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Theresa J Hydes
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism and Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Department of Gastroenterology and Hepatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Emma Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Daniel J Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism and Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
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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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14
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Dittmann A, Werner L, Hörz L, Luft T, Finkbeiner F, Storcksdieck genannt Bonsmann S. Sociodemographic and behavioural differences between frequent and non-frequent users of convenience food in Germany. Front Nutr 2024; 11:1369137. [PMID: 38585611 PMCID: PMC10997035 DOI: 10.3389/fnut.2024.1369137] [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: 01/11/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Convenience foods are a double-edged sword in that they provide quick and easy nutrition but may promote non-communicable diseases related to excess intakes of sugar, fat, and salt. To inform the German national reduction and innovation strategy for less sugar, fat, and salt in processed foods, the present study sought to analyse the consumption frequency of selected convenience foods and to determine sociodemographic and behavioural factors that characterise frequent users. Methods In a representative computer-assisted telephone interview survey in the adult German population (N = 3,997) conducted in 2018, consumption frequency of 21 convenience foods was assessed. To characterise frequent in contrast to non-frequent users, data on sociodemographics and behavioural aspects were compared. Statistical analyses comprised chi-square tests with Bonferroni correction as well as Spearman's rank correlation. Cramer's V was used to determine the strength of an association. Results Overall and among frequent users (7.7% of the sample) sweet convenience foods and savoury cooking aids were consumed most frequently. Around 75% of the participants indicated little-to-no consumption of 19 of the 21 convenience foods. Male gender (p < 0.001), younger age (p < 0.001), and not having a high level of education (p = 0.017) were identified as key characteristics of frequent users. Furthermore, frequent users were more likely than non-frequent users to live in a family household (p = 0.003) or without a partner (p < 0.001), and to work in shifts (p = 0.002). Additionally, they showed significantly lower cooking skills (p < 0.001). Conclusion Public health interventions to limit excess intakes of sugar, fat, and salt from convenience food in Germany should target people of male gender, younger age, and having a lower level of education. On the behavioural side, developing the skills to cook from scratch emerged as major point of focus. Simultaneously, reformulation of the food offer should continue in order to help transition to a more health-promoting food environment.
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15
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Wang FX, Kong XH, Guo Z, Li LX, Zhang S. Global, regional, and national burden of diet high in processed meat from 1990 to 2019: a systematic analysis from the global burden of disease study 2019. Front Nutr 2024; 11:1354287. [PMID: 38414489 PMCID: PMC10896824 DOI: 10.3389/fnut.2024.1354287] [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: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/29/2024] Open
Abstract
Objective The objective of this study is to explore the prevalence and attributable burden of diet high in processed meat (DHIPM) in global, regional, and national level due to the burden caused by unhealthy dietary pattern worldwide. Design Cross-sectional study. Materials and design All the data involved in this research were obtained from Global Burden of Diseases Study 2019. DisMod-MR 2.1, a Bayesian meta-regression tool, was used to estimate the prevalence, which was measured by summary exposure value (SEV) and attributable burden of DHIPM. The Spearman rank order correlation method was performed to measure the correlation between sociodemographic index (SDI) and the prevalence as well as attributable burden. The estimated annual percentage change (EAPC) was calculated to demonstrate the temporal trends. Results Globally, there were 304.28 thousand deaths and 8556.88 disability-adjusted life years (DALYs) caused by DHIPM in 2019 and increased by 34.63 and 68.69%, respectively. The prevalence had decreased slightly from 1990 to 2019, however increased in most regions and countries, especially in middle SDI regions, despite the implicitly high prevalence in high SDI regions. Countries with higher SDI values were facing higher prevalence and attributable burden of DHIPM while developing countries were observed with severer temporal trends. Compared with women, men had suffered from lower exposure level however graver attributable burden of DHIPM in the past three decades. Conclusion The progress of continuous urbanization allowed increasingly severe prevalence and attributable burden of DHIPM, thus the challenge to alleviate this trend was acute. Effective measures such as education on beneficial dietary pattern and supplement on healthy food were urgently required, especially in developing regions and countries.
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Affiliation(s)
- Feng-Xia Wang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Hua Kong
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhe Guo
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Lu-Xia Li
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Shu Zhang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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16
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Argov-Argaman N, Altman H, Janssen JN, Daeem S, Raz C, Mesilati-Stahy R, Penn S, Monsonego-Ornan E. Effect of milk fat globules on growth and metabolism in rats fed an unbalanced diet. Front Nutr 2024; 10:1270171. [PMID: 38274212 PMCID: PMC10808575 DOI: 10.3389/fnut.2023.1270171] [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: 07/31/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
We assessed the effects of supplementing milk fat globules (MFG) on the growth and development of the skeleton in rats fed a Western unbalanced diet (UBD). The UBD is high in sugar and fat, low in protein, fiber, and micronutrients, and negatively impacts health. The MFG-a complex lipid-protein assembly secreted into milk-has a unique structure and composition, which differs significantly from isolated and processed dietary ingredients. Rats consuming the UBD exhibited growth retardation and disrupted bone structural and mechanical parameters; these were improved by supplementation with small MFG. The addition of small MFG increased the efficiency of protein utilization for growth, and improved trabecular and cortical bone parameters. Furthermore, consumption of UBD led to a decreased concentration of saturated fatty acids and increased levels of polyunsaturated fatty acids (PUFA), particularly omega-6 PUFA, in the serum, liver, and adipose tissue. The addition of small MFG restored PUFA concentration and the ratio of omega-6 to omega-3 PUFA in bone marrow and adipose tissue. Finally, large but not small MFG supplementation affected the cecal microbiome in rats. Overall, our results suggest that natural structure MFG supplementation can improve metabolism and bone development in rats fed an UBD, with the effects depending on MFG size. Moreover, the benefits of small MFG to bone development and metabolism were not mediated by the microbiome, as the detrimental effects of an UBD on the microbiome were not mitigated by MFG supplementation.
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Affiliation(s)
- Nurit Argov-Argaman
- Department of Animal Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hodaya Altman
- School of Nutrition Science, Institute of Biochemistry, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Seman Daeem
- Department of Animal Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chen Raz
- Department of Animal Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronit Mesilati-Stahy
- School of Nutrition Science, Institute of Biochemistry, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Svetlana Penn
- School of Nutrition Science, Institute of Biochemistry, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Efrat Monsonego-Ornan
- School of Nutrition Science, Institute of Biochemistry, Hebrew University of Jerusalem, Jerusalem, Israel
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17
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Vitale M, Costabile G, Testa R, D'Abbronzo G, Nettore IC, Macchia PE, Giacco R. Ultra-Processed Foods and Human Health: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2024; 15:100121. [PMID: 38245358 PMCID: PMC10831891 DOI: 10.1016/j.advnut.2023.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 01/22/2024] Open
Abstract
Evidence of associations between ultra-processed foods (UPF) and increased risk of cardiovascular disease is emerging, but it is unclear how much this is influenced by the methodology used to assess the UPF intake or by the level of consumption. We conducted a meta-analysis to evaluate 1) the association between UPF consumption and risk of diabetes, hypertension, dyslipidemia, and obesity, using prospective cohort studies; 2) the differential associations depending on the methodology used to assess UPF intake and the level of UPF consumption and 3) the quality of evidence using the NutriGrade scoring system. A systematic literature search was conducted in PubMed/MEDLINE, ISI Web of Science, and Scopus through 1 April, 2023, on studies conducted in humans providing data for the highest compared with the lowest UPF consumption categories. Summary relative ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random-effects model. Out of 4522 articles retrieved from the literature search, 25 reports met the criteria for inclusion in the meta-analysis, 7 for diabetes, 5 for hypertension, 3 for dyslipidemia, and 13 for obesity. A consistently positive association between high UPF intake and increased risk of developing diabetes (37%), hypertension (32%), hypertriglyceridemia (47%), low HDL cholesterol concentration (43%), and obesity (32%) was observed, even if the quality of evidence was not satisfying. However, these risks varied significantly depending on the methodology used to assess UPF consumption, with a difference of more than 50% between the methods. Based on the level of intake, we did not observe significant differences in the results. These findings show that UPF consumption is associated with higher risk of diabetes, hypertension, dyslipidemia, and obesity, but the level of risk consistently changes depending on the methodology used to assess UPF intake. Therefore, caution should be used when interpreting and extrapolating the results.
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Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Diabetes, Nutrition and Metabolism Unit, Federico II University of Naples, Italy.
| | - Giuseppina Costabile
- Department of Clinical Medicine and Surgery, Diabetes, Nutrition and Metabolism Unit, Federico II University of Naples, Italy
| | - Roberta Testa
- Department of Clinical Medicine and Surgery, Diabetes, Nutrition and Metabolism Unit, Federico II University of Naples, Italy
| | - Giovanna D'Abbronzo
- Department of Clinical Medicine and Surgery, Diabetes, Nutrition and Metabolism Unit, Federico II University of Naples, Italy
| | | | - Paolo Emidio Macchia
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy
| | - Rosalba Giacco
- Department of Clinical Medicine and Surgery, Diabetes, Nutrition and Metabolism Unit, Federico II University of Naples, Italy; Institute of Food Sciences, National Research Council, Avellino, Italy
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18
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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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19
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Pettinger C, Hunt L, Gardiner H, Garg P, Howard L, Wagstaff C. Engaging with 'less affluent' communities for food system transformation: a community food researcher model (FoodSEqual project). Proc Nutr Soc 2023:1-15. [PMID: 38099419 DOI: 10.1017/s0029665123004913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The UK food system is distorted by inequalities in access, failing the people most in need, yet it should provide access to safe, nutritious affordable food for all citizens. Dietary patterns are associated with socio-demographic characteristics, with high levels of diet-related disease mortality attributed to poor dietary habits. Disadvantaged UK communities face urgent public health challenges, yet are often treated as powerless recipients of dietary and health initiatives. The need for food system transformation has been illustrated within recent UK government policy drivers and research funding. The Food Systems Equality project is a research consortium that aims to 'co-produce healthy and sustainable food systems for disadvantaged communities'. The project focusses on innovating food products, supply chains and policies, placing communities at the centre of the change. Tackling the above issues requires new ways of working. Creative approaches in food research are known to empower a wider range of individuals to share their 'lived food experience' narratives, building relationships and corroborating co-production philosophies, thus promoting social justice, and challenging more traditional positivist/reductionist 'biomedical' approaches for nutrition and food studies. This review paper critiques the use of community-centric approaches for food system transformation, focusing on one, a community food researcher model() as an exemplar, to highlight their utility in advocating with rather than for less affluent communities. The potential for creative methods to lead to more equitable and lasting solutions for food system transformation is appraised, consolidating the need for community-driven systemic change to foster more progressive and inclusive approaches to strengthen social capital. The paper closes with practice insights and critical considerations offering recommendations for readers, researchers, and practitioners, enabling them to better understand and apply similar approaches.
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Affiliation(s)
- Clare Pettinger
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Louise Hunt
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Hannah Gardiner
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Paridhi Garg
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Lisa Howard
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
- Food Plymouth CIC The local Sustainable Food Places Food Partnership, Plymouth, UK
| | - Carol Wagstaff
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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20
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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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21
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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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22
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Johnstone AM, Lonnie M. Tackling diet inequalities in the UK food system: is food insecurity driving the obesity epidemic? (The FIO Food project). Proc Nutr Soc 2023:1-9. [PMID: 38058191 DOI: 10.1017/s0029665123004871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
By 2050 the number of adults living with obesity in the UK will rise with approximately one in four in the adult population. This rising trend is not equitable, with higher prevalence in socially disadvantaged groups. There is an apparent paradox of not being able to provide food for the family to eat, a feature of food insecurity and living with obesity. With the current cost-of-living crisis, there is a challenge to afford both food and fuel bills. Environmentally sustainable and healthy diets are proposed to improve public health and reduce the impact of the food system on the environment, while also improving diet quality. However, healthier foods tend to be nearly three times more expensive than unhealthy foods, and this provides a challenge for citizens on low incomes. In this review, we explore some of the evidence for solutions in the retail food environment to support the UK food system to be safe, nutritious, environmentally friendly and fair for all. We highlight the value of co-production in research, to give value and power to the lived experience to address these inequalities. Our multidisciplinary research approach within the FIO Food research grant will generate new insights into modifiable and potentially impactful changes to the UK food system, specifically for the retail food sector. We believe that the co-creation, design and delivery of research with those living with obesity and food insecurity will help to transform the UK food system for health and the environment in this vulnerable group.
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Affiliation(s)
- Alexandra M Johnstone
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Marta Lonnie
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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23
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Meisel JD, Esguerra V, Giraldo JK, Montes F, Stankov I, Meisel CA, Sarmiento OL, Valdivia JA. Understanding the dynamics of the obesity transition associated with physical activity, sedentary lifestyle, and consumption of ultra-processed foods in Colombia. Prev Med 2023; 177:107720. [PMID: 37802196 DOI: 10.1016/j.ypmed.2023.107720] [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: 05/03/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE We investigate the obesity transition at the country- and regional-levels, by age, gender, and socioeconomic status (SES) and its relationship to three health behavior attributes, including physical activity (PA), sedentary activities (ST), and consumption of ultra-processed foods (CUPF) within the urban population of Colombia, from 20,010 to 2050. METHODS The study is informed by cross-sectional data from ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender, and SES. This model also uses a conservative co-flow structure for three health-related behaviors (PA, ST, and CUPF). RESULTS At the national level, our results indicate that the burden of obesity is shifting towards populations with lower SES as the gross domestic product (GDP) increases, particularly women aged 20-59 years with lower SES. Among this group of women, the highest burden of obesity is among those who do not meet the PA, ST and CUPF recommendations. At the regional level, our findings suggest that the regions are at different stages in the obesity transition. CONCLUSIONS The burden of obesity is shifting towards women with lower SES as GDP increases at the national level and across several regions. This obesity transition is paralleled by a high prevalence of women from low SES groups who do not meet the minimum recommendations for PA, CUPF, and ST. Our findings can be used by decision-makers to inform age- and SES- specific policies seeking to tackle the obesity.
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Affiliation(s)
- Jose D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, 730001 Ibagué, Colombia; Social and Health Complexity Center, Bogotá, Colombia.
| | - Valentina Esguerra
- Universidad de Ibagué, Carrera 22 Calle 67, 730001 Ibagué, Colombia; Department of Industrial Engineering, Social and Health Complexity Center, Universidad de los Andes, Carrera 1 Este No. 19A-40, Bogotá, Colombia.
| | - John K Giraldo
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, 730001 Ibagué, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de los Andes, Carrera 1 Este No. 19A-40, Bogotá, Colombia.
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, 7th floor, Philadelphia, PA 19104, USA; UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
| | - Carlos A Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, 730001 Ibagué, Colombia.
| | - Olga L Sarmiento
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 Este No. 19A-40, Bogotá, Colombia.
| | - Juan A Valdivia
- Departamento de Física, Facultad de Ciencias, Universidad de Chile, Las Palmeras 3425, Ñuñoa Santiago, Chile; Centro para el Desarrollo de la Nanociencia y la Nanotecnología, CEDENNA, Santiago, Chile.
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24
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Barrett EM, Gaines A, Coyle DH, Pettigrew S, Shahid M, Maganja D, Jones A, Rayner M, Mozaffarian D, Taylor F, Ghammachi N, Wu JHY. Comparing product healthiness according to the Health Star Rating and the NOVA classification system and implications for food labelling systems: An analysis of 25 486 products in Australia. NUTR BULL 2023; 48:523-534. [PMID: 37897130 DOI: 10.1111/nbu.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023]
Abstract
We investigated the extent of alignment between 'healthiness' defined by a food classification system that classifies foods and beverages primarily by their nutrient composition, the Health Star Rating (HSR) and a system that considers only the degree of processing of the product, the NOVA classification system. We used data for 25 486 products contained within the George Institute for Global Health's Australian 2022 FoodSwitch Dataset. Agreement between the two systems in the proportion of products classified as 'healthier' (HSR ≥3.5 or NOVA group 1-3) or 'less healthy' (HSR <3.5 or NOVA group 4) was assessed using the κ statistic. There was 'fair' agreement (κ = 0.30, 95%CI: 0.29-0.31) between both systems in the proportion of all products classified as healthier or less healthy. Approximately one-third (n = 8729) of all products were defined as 'discordant', including 34.3% (n = 5620) of NOVA group 4 products with HSR ≥3.5 (commonly convenience foods, sports/diet foods, meat alternatives, as well as products containing non-sugar sweeteners) and 34.1% (n = 3109) of NOVA group 1-3 products with HSR <3.5 (commonly single-ingredient foods such as sugars/syrups, full-fat dairy and products specially produced to contain no ultra-processed ingredients). Our analysis strengthens the evidence for the similarities and differences in product healthiness according to a nutrient-based classification system and a processing-based classification system. Although the systems' classifications align for the majority of food and beverage products, the discordance found for some product categories indicates potential for confusion if systems are deployed alongside each other within food policies.
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Affiliation(s)
- Eden M Barrett
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, USA
| | - Allison Gaines
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Daisy H Coyle
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Simone Pettigrew
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria Shahid
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Damian Maganja
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Jones
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, USA
- Division of Cardiology, Tufts School of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Fraser Taylor
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nadine Ghammachi
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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25
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Rego MLM, Leslie E, Capra BT, Helder M, Yu W, Katz B, Davy KP, Hedrick VE, Davy BM, DiFeliceantonio AG. The influence of ultra-processed food consumption on reward processing and energy intake: Background, design, and methods of a controlled feeding trial in adolescents and young adults. Contemp Clin Trials 2023; 135:107381. [PMID: 37935307 PMCID: PMC10872704 DOI: 10.1016/j.cct.2023.107381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/18/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The greatest age-related weight gain occurs in the early/mid-20s. Overall dietary quality among adolescents and emerging adults (age 18-25) is poor, with ultra-processed foods (UPF) representing more than two-thirds of adolescents' total energy intake (i.e., 68%). UPF consumption may impact cognitive and neurobiological factors that influence dietary decision-making and energy intake (EI). To date, no research has addressed this in this population. METHODS Participants aged 18-25 will undergo two 14-day controlled feeding periods (81% UPF, 0% UPF) using a randomly assigned crossover design, with a 4-week washout between conditions. Brain response to a UPF-rich milkshake, as well as behavioral measures of executive function, will be evaluated before and after each diet. Following each diet, measurements include ad libitum buffet meal EI, food selection, eating rate, and eating in the absence of hunger (EAH). Prior to initiating recruitment, controlled diet menus, buffet, and EAH snacks were developed and evaluated for palatability. Sensory and texture attributes of buffet and EAH snack foods were also evaluated. RESULTS Overall diet palatability was rated "like very much" (8)/"like moderately"(7) (UPF: 7.6 ± 1.0; Non-UPF: 6.8 ± 1.5). Subjective hardness rating (range = 1-9 [1 = soft, 9 = hard] was similar between UPF and Non-UPF buffet and snack items (UPF:4.22 ± 2.19, Non-UPF: 4.70 ± 2.03), as was the objective measure of hardness (UPF: 2874.33 ± 2497.06 g, Non-UPF: 2243.32 ± 1700.51 g). CONCLUSIONS Findings could contribute to an emerging neurobiological understanding of the effects of UPF consumption including energy overconsumption and weight gain among individuals at a critical developmental stage.
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Affiliation(s)
- Maria L M Rego
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA.
| | - Emma Leslie
- Fralin Biomedical Research Institute, Virginia Tech, USA
| | - Bailey T Capra
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA
| | - Mckenna Helder
- Department of Food Science and Technology, Virginia Tech, USA
| | - Wenjing Yu
- Fralin Biomedical Research Institute, Virginia Tech, USA
| | - Benjamin Katz
- Department of Human Development and Family Science, Virginia Tech, USA
| | - Kevin P Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA
| | - Brenda M Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA
| | - Alexandra G DiFeliceantonio
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, USA; Fralin Biomedical Research Institute, Virginia Tech, USA
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26
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Dicken SJ, Qamar S, Batterham RL. Who consumes ultra-processed food? A systematic review of sociodemographic determinants of ultra-processed food consumption from nationally representative samples. Nutr Res Rev 2023:1-41. [PMID: 37905428 DOI: 10.1017/s0954422423000240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Ultra-processed food (UPF) intake is associated with increased non-communicable disease risks. However, systematic reports on sociodemographic predictors of UPF intake are lacking. This review aimed to understand UPF consumption based on sociodemographic factors, using nationally representative cohorts. The systematic review was pre-registered (PROSPERO:CRD42022360199), following PRISMA guidelines. PubMed/MEDLINE searches (‘ultra-processed/ultraprocessed’ and ‘ultra-processing/ultraprocessing’) until 7 September 2022 retrieved 1131 results. Inclusion criteria included: observational, nationally representative adult samples, in English, in peer-reviewed journals, assessing the association between sociodemographics and individual-level UPF intake defined by the NOVA classification. Exclusion criteria included: not nationally representative, no assessment of sociodemographics and individual-level UPF intake defined by NOVA. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Fifty-five papers were included, spanning thirty-two countries. All thirteen sociodemographic variables identified were significantly associated with UPF intake in one or more studies. Significant differences in UPF intake were seen across age, race/ethnicity, rural/urbanisation, food insecurity, income and region, with up to 10–20% differences in UPF intake (% total energy). Higher UPF intakes were associated with younger age, urbanisation and being unmarried, single, separated or divorced. Education, income and socioeconomic status showed varying associations, depending on country. Multivariate analyses indicated that associations were independent of other sociodemographics. Household status and gender were generally not associated with UPF intake. NOS averaged 5·7/10. Several characteristics are independently associated with high UPF intake, indicating large sociodemographic variation in non-communicable disease risk. These findings highlight significant public health inequalities associated with UPF intake, and the urgent need for policy action to minimise social injustice-related health inequalities.
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Affiliation(s)
- Samuel J Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK
| | - Sulmaaz Qamar
- 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
| | - 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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27
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Pan F, Zhang T, Mao W, Zhao F, Luan D, Li J. Ultra-Processed Food Consumption and Risk of Overweight or Obesity in Chinese Adults: Chinese Food Consumption Survey 2017-2020. Nutrients 2023; 15:4005. [PMID: 37764788 PMCID: PMC10537323 DOI: 10.3390/nu15184005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Overweight and obesity have increased rapidly in the past few decades in China, and less research has focused on the association between the consumption of ultra-processed foods (UPFs) and overweight or obesity in Chinese adults. The objective of this study was to determine the relationship of UPF consumption with the risk of overweight or obesity in Chinese adults. Residents aged 18 years and above who participated in the nationally representative survey Chinese Food Consumption Survey in 2017-2020 were included in this study. Dietary intake data were collected via non-consecutive three-day 24 h dietary recalls and weighing household foods and condiments. According to the NOVA food classification system, UPFs were classified depending on the purpose and extent of food processing. Multiple logistic regression and multivariate-adjusted restricted cubic spline (RCS) regressions were performed to estimate the association between UPF consumption (categorized into quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4)) and risk of overweight or obesity. A total of 38,658 adults aged 18 years and above participated in the present study. The prevalence of overweight and obesity in adults was 33.0% (95% CI: 32.91-33.10) and 9.6% (95% CI 9.55-9.67), respectively. After a multivariable adjustment, the risk of overweight or obesity was increased by 10% in Q3 (OR: 1.10, 95% CI: 1.04-1.17) compared to Q1 as a reference. Women (OR: 1.10, 95% CI: 1.01-1.20) and adults living in small and medium-sized cities (OR: 1.13, 95% CI: 1.01-1.26) with higher UPF consumption had higher odds of overweight or obesity. Nevertheless, the effect of higher UPF consumption on the risk of overweight or obesity was relatively weak for overall adults in China. The top three categories of subgroups consumption of UPFs were 1: sugar-sweetened beverages; 2: sauces, cheeses, spreads, and gravies; and 3: ultra-processed breads and breakfast cereals. These findings provide evidence that higher UPF consumption was positively associated with overweight or obesity, which was defined based on Chinese criteria among women and adults living in small and medium-sized cities in China. Further studies, such as intervention trials, are needed to identify the mechanism of correlation between the consumption of UPFs and health-related outcomes in Chinese adults. From a public health perspective, with the prevalence of overweight and obesity growing and the increase in UPF consumption in Chinese adults, it is necessary to promote healthy food intake and a balanced diet through active nutritional education actions for overweight and obesity prevention and control.
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Affiliation(s)
- Feng Pan
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Tongwei Zhang
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Weifeng Mao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Fanglei Zhao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Dechun Luan
- Liaoning Center for Disease Control and Prevention, Shenyang 110005, China
| | - Jianwen Li
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
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Pang T, Gray HL, Alman AC, Buro AW, Basu A, Lu S, Snell-Bergeon JK. Ultra-processed food consumption and obesity indicators in individuals with and without type 1 diabetes mellitus: a longitudinal analysis of the prospective Coronary Artery Calcification in Type 1 Diabetes (CACTI) cohort study. Public Health Nutr 2023; 26:1626-1633. [PMID: 37129091 PMCID: PMC10410376 DOI: 10.1017/s1368980023000848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/23/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate the associations of ultra-processed food (UPF) consumption and obesity indicators among individuals with and without type 1 diabetes mellitus (T1DM) from the Coronary Artery Calcification in Type 1 Diabetes cohort study. DESIGN A secondary analysis. The consumption of UPF was assessed using the dietary data collected with the Harvard FFQ, and each food item was categorised according to the NOVA food processing classification. Height, weight and waist circumference were measured at baseline and after a mean of 14·6-year follow-up. Generalised estimating equations stratified by diabetes status were used to assess the associations between UPF intake and obesity indicators over 14 years of follow-up. SETTING USA. PARTICIPANTS A total of 600 adults (256 T1DM and 344 non-diabetic controls) aged 39 ± 9·1 years at baseline and followed up for over 14 years were included. RESULTS Participants with T1DM consumed significantly more UPF than non-diabetic controls at baseline: 7·6 ± 3·8 v. 6·6 ± 3·4 servings per day of UPF, respectively (P < 0·01). Participants with T1DM and with the highest UPF intake had the highest weight (βQ4 v. Q1 = 3·07) and BMI (βQ4 v. Q1 = 1·02, all P < 0·05) compared with those with the lowest UPF intake. Similar positive associations were observed in non-diabetic controls. CONCLUSIONS Individuals with T1DM may consume more UPF than non-diabetic controls. Positive associations between UPF consumption and obesity indicators suggest that limiting UPF can be recommended for obesity prevention and management. Further research is needed to confirm these findings.
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Affiliation(s)
- Tiantian Pang
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | | | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Shi Lu
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Fraga ACSA, Theme Filha MM, Bastos MP. Factors associated with ultra-processed foods consumption in a cohort of Brazilian pregnant women. CAD SAUDE PUBLICA 2023; 39:e00177022. [PMID: 37436189 PMCID: PMC10494692 DOI: 10.1590/0102-311xen177022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 07/13/2023] Open
Abstract
Nutrition during pregnancy is essential for the health of the pregnant woman, the development of the fetus, and the prevention of complications related to pregnancy and the postpartum period. This study described the factors associated with high consumption of ultra-processed foods among pregnant women. This prospective cohort study was performed from February 2016 to November 2019 in two health units in the city of Rio de Janeiro, Brazil, with data from 344 pregnant women. The first interview was conducted in the prenatal visit at less than 20 gestational weeks, the second at 34 gestational weeks, and the third at two months postpartum. Diet was assessed in the last interview using a food frequency questionnaire, and food items were classified according to NOVA. The percentage of ultra-processed foods consumption was estimated by tertile distribution, and the third tertile represented the highest consumption. Based on the hierarchical analysis model, the associations between ultra-processed foods consumption and sociodemographic, reproductive health, pregestational, behavioral, and pregnancy variables were assessed using a multinomial logistic regression model. Older women had lower ultra-processed foods consumption (OR = 0.33; 95%CI: 0.15-0.71). Few years of schooling (up to 7 years; OR = 5.58; 95%CI: 1.62-19.23), history of a previous childbirth (OR = 2.48; 95%CI: 1.22-5.04), history of two or more previous childbirths (OR = 7.53; 95%CI: 3.02-18.76), and no history of regular physical activity before pregnancy (OR = 2.40; 95%CI: 1.31-4.38) were risk factors. The identification of risk and protection factors allows for the establishment of control measures and encouragement of healthy practices during prenatal care.
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Affiliation(s)
- Ana Claudia Santos Amaral Fraga
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Al Shuwaysh AI, Fabella EL, Al Hassan M, Al Hassan YT, Al Hassan A, Al Majed H, Al Nahwi A, Al Howayshel H, Al Abdi A. Association Between Risk for Prediabetes and Type 2 Diabetes Mellitus Prevention Among Faculty Members and Administrative Staff of a Saudi University. Cureus 2023; 15:e41926. [PMID: 37583750 PMCID: PMC10424706 DOI: 10.7759/cureus.41926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Diabetes mellitus prevalence continues to rise globally, causing disability and decreased productivity among patients, a significant strain on healthcare systems, and a burden on national economies. In 2021, diabetes will affect approximately 537 million adults. The rising prevalence of prediabetes worldwide also poses a significant public health threat, as it is estimated that by 2030, more than 470 million individuals will be prediabetic. OBJECTIVE This study aimed to determine the association between the risk of prediabetes and the level of Type 2 Diabetes Mellitus (T2DM) prevention among faculty members and administrative staff of a Saudi university. METHODS An analytic cross-sectional study design was utilized. The prediabetes risk of respondents was assessed using a risk test developed by the CDC, while the participants' diabetes prevention practices were determined using a researcher-developed questionnaire. Data were collected from 360 selected faculty members and administrative staff of three randomly selected health colleges and three non-health colleges at King Faisal University, Hofuf, Al-Ahsa, Saudi Arabia, between September 25 and October 13, 2022. The collected data were subjected to estimation of proportion and logistic regression analyses using Epi InfoTM version 7. RESULTS Nearly 40% of respondents (39.72%, 95% CI: 34.80, 44.86) were found to be at high risk for prediabetes. The majority of university faculty and administrative staff consistently practiced T2DM preventive measures related to the limitation of processed food consumption, smoking cessation, and regular checking of weight and the nutritional value of food. However, there was poor T2DM prevention practice in terms of exercise, consumption of sweetened beverages, and stress reduction. Those who had a high prediabetes risk were 1.17 times more likely to engage in T2DM prevention practices. However, they were found to be 19% less likely to perform T2DM prevention practices when sociodemographic variables were held constant. CONCLUSION Prediabetes risk was prevalent among Saudi university faculty and administrative staff. T2DM prevention was not consistently practiced by those who had a high risk for prediabetes. High prediabetes risk was negatively associated with the level of T2DM prevention.
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Affiliation(s)
- Abdullah I Al Shuwaysh
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Eduardo L Fabella
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Mohammed Al Hassan
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Yasser Taher Al Hassan
- Health Programs Department, Public Health Directorate, Al-Ahsa Directorate for Health Affairs, Ministry of Health, Al-Ahsa, SAU
| | - Abdullah Al Hassan
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Hussam Al Majed
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Ahmad Al Nahwi
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Hassan Al Howayshel
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
| | - Ali Al Abdi
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 PMCID: PMC10251611 DOI: 10.1186/s13098-023-01037-6] [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: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 – cj 1711, Sao Paulo, SP 01239-040 Brazil
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica – CELN – University of Campinas, Campinas, SP Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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Dunford EK, Miles DR, Popkin B. Food Additives in Ultra-Processed Packaged Foods: An Examination of US Household Grocery Store Purchases. J Acad Nutr Diet 2023; 123:889-901. [PMID: 36931919 PMCID: PMC10200736 DOI: 10.1016/j.jand.2022.11.007] [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: 04/12/2022] [Revised: 09/18/2022] [Accepted: 11/18/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Food additives have been used mainly in the past century to perform specific functions in foods. Some types of food additives have been linked to adverse health outcomes, yet there is little research examining food additives in the US food supply. OBJECTIVE To examine the proportion of products purchased by US households containing four common technical food additives using time-specific food composition data and examine whether purchases have changed over time. PARTICIPANTS/SETTING Nielsen Homescan Consumer Panels, 2001 and 2019. MAIN OUTCOME MEASURES The proportion of packaged food products containing common types of food additives purchased by US households was determined overall and by food category. STATISTICAL ANALYSIS PERFORMED Differences were examined using Student t test; P value < 0.001 was considered significant. RESULTS Between 2001 and 2019, the proportion of food products purchased by US households that contained additives increased from 49.6% to 59.5% (P < 0.001). The proportion of carbonated soft drinks purchased containing flavors decreased, with a subsequent increase in purchases containing nonnutritive sweeteners. Baby foods showed a 20% increase in the proportion of purchases containing additives and >15% increase in the proportion of purchases containing three or more additives. CONCLUSIONS There is convincing evidence that US household purchases of common types of technical food additives are increasing. Despite some positive changes such as a decrease in the use of added flavors in carbonated soft drinks, across most food categories an increase in purchases of all types of products containing additives was observed. In particular the finding that purchases of baby food products containing additives have increased substantially is crucial in informing future research in this area and warrants further investigation.
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Affiliation(s)
- Elizabeth K Dunford
- Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Donna R Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Barry Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Harb AA, Shechter A, Koch PA, St-Onge MP. Ultra-processed foods and the development of obesity in adults. Eur J Clin Nutr 2023; 77:619-627. [PMID: 36280730 PMCID: PMC10123172 DOI: 10.1038/s41430-022-01225-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022]
Abstract
Ultra-processed foods (UPF) are ubiquitous in the modern-day food supply and widely consumed. High consumption of these foods has been suggested to contribute to the development of obesity in adults. The purpose of this review is to present and evaluate current literature on the relationship between UPF consumption and adult obesity. Cross-sectional studies (n = 9) among different populations worldwide show a positive association between UPF consumption and obesity. Longitudinal studies (n = 7) further demonstrate a positive association between UPF consumption and development of obesity, suggesting a potential causal influence of UPF consumption on obesity risk. However, only one randomized controlled trial has tested the causality of this association. The study included in this review found greater energy intake and weight gain with consumption of a high UPF diet compared to a high unprocessed food diet. The potential mechanisms by which UPF increase the risk of obesity include increased energy intake due to increased sugar consumption, decreased fiber consumption, and decreased protein density; however, more research is needed. Overall, the evidence identified in the current review consistently support a positive relation between high UPF consumption and obesity. While there is a need for more experimental research to establish causality and elucidate the mechanisms, the sum of the evidence supports a need for research on treatment modalities that include reductions in UPF consumption for the management of adult obesity.
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Affiliation(s)
- Amanda A Harb
- Doctoral Candidate, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA
| | - Ari Shechter
- Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Pamela A Koch
- Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA
| | - Marie-Pierre St-Onge
- Department of Medicine, Columbia University Irving Medical Center, New York, USA.
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Mambrini SP, Menichetti F, Ravella S, Pellizzari M, De Amicis R, Foppiani A, Battezzati A, Bertoli S, Leone A. Ultra-Processed Food Consumption and Incidence of Obesity and Cardiometabolic Risk Factors in Adults: A Systematic Review of Prospective Studies. Nutrients 2023; 15:nu15112583. [PMID: 37299546 DOI: 10.3390/nu15112583] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has increased likewise the incidence of obesity and cardiometabolic diseases. To highlight a possible relationship, we conducted a systematic review of prospective studies from PubMed and Web of Science investigating the association between UPF consumption and the incidence of obesity and cardiometabolic risk factors. Seventeen studies were selected. Eight evaluated the incidence of general and abdominal obesity, one the incidence of impaired fasting blood glucose, four the incidence of diabetes, two the incidence of dyslipidemia, and only one the incidence of metabolic syndrome. Studies' quality was assessed according to the Critical Appraisal Checklist for cohort studies proposed by the Joanna Briggs Institute. Substantial agreement emerged among the studies in defining UPF consumption as being associated with the incident risk of general and abdominal obesity. More limited was the evidence on cardiometabolic risk. Nevertheless, most studies reported that UPF consumption as being associated with an increased risk of hypertension, diabetes, and dyslipidemia. In conclusion, evidence supports the existence of a relationship between UPF consumption and the incidence of obesity and cardiometabolic risk. However, further longitudinal studies considering diet quality and changes over time are needed.
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Affiliation(s)
- Sara Paola Mambrini
- IRCCS Auxologico, Laboratory of Metabolic Research, San Giuseppe Hospital, 28824 Piancavallo, Italy
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
| | - Francesca Menichetti
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
| | - Simone Ravella
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
| | - Marta Pellizzari
- IRCCS Auxologico, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, 20145 Milan, Italy
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
- IRCCS Auxologico, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, 20145 Milan, Italy
| | - Andrea Foppiani
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
- IRCCS Auxologico, Clinical Nutrition Unit, Department of Endocrine and Metabolic Diseases, 20145 Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
- IRCCS Auxologico, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, 20145 Milan, Italy
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
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Dalrymple KV, Vogel C, Flynn AC, Seed PT, Godfrey KM, Poston L, Inskip HM, Crozier SR. Longitudinal dietary trajectories from pregnancy to 3 years post delivery in women with obesity: relationships with adiposity. Obesity (Silver Spring) 2023; 31:1159-1169. [PMID: 36876599 PMCID: PMC10947498 DOI: 10.1002/oby.23706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 03/07/2023]
Abstract
OBJECTIVE The study aim was to examine the relationships between longitudinal dietary trajectories from early pregnancy to 3 years post delivery and adiposity measures in women with obesity. METHODS The diets of 1208 women with obesity in the UPBEAT (UK Pregnancy Better Eating and Activity Trial) study were assessed using a food frequency questionnaire (FFQ) at 15+0 to 18+6 weeks' gestation (baseline), 27+0 to 28+6 weeks' gestation, and 34+0 to 36+0 weeks' gestation, as well as 6 months and 3 years post delivery. Using factor analysis of the baseline FFQ data, four dietary patterns were identified: fruit & vegetable, African/Caribbean, processed, and snacking. The baseline scoring system was applied to the FFQ data at the four subsequent time points. Group-based trajectory modeling was used to extract longitudinal dietary pattern trajectories. Using adjusted regression, associations between dietary trajectories and log-transformed/standardized adiposity measures (BMI and waist and mid-upper arm circumferences) at 3 years post delivery were examined. RESULTS Two trajectories were found to best describe the data for the four individual dietary patterns; these were characterized as high and low adherence. A high adherence to the processed pattern was associated with a higher BMI (β = 0.38 [95% CI: 0.06-0.69]) and higher waist (β = 0.35 [0.03-0.67]) and mid-upper arm circumferences (β = 0.36 [0.04-0.67]) at 3 years post delivery. CONCLUSIONS In women with obesity, a processed dietary pattern across pregnancy and 3 years post delivery is associated with higher adiposity.
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Affiliation(s)
- Kathryn V. Dalrymple
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Christina Vogel
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
| | - Angela C. Flynn
- Department of Nutritional SciencesSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Paul T. Seed
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Lucilla Poston
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
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Bhawra J, Kirkpatrick SI, Hall MG, Vanderlee L, White CM, Hammond D. Patterns and correlates of nutrition knowledge across five countries in the 2018 international food policy study. Nutr J 2023; 22:19. [PMID: 36922823 PMCID: PMC10018957 DOI: 10.1186/s12937-023-00844-x] [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: 05/20/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Nutrition knowledge is an important determinant of diet-related behaviour; however, the use of disparate assessment tools creates challenges for comparing nutrition knowledge levels and correlates across studies, geographic contexts, and populations. Using the Food Processing Knowledge (FoodProK) score - a measure of nutrition knowledge based on consumers' ability to understand and apply the concept of food processing in a functional task - nutrition knowledge levels and associated correlates were assessed in five countries. METHODS Adults, aged ≥18 years, were recruited through the Nielsen Consumer Insights Global Panel in Australia (n = 3997), Canada (n = 4170), Mexico (n = 4044), the United Kingdom (UK) (n = 5363), and the United States (US) (n = 4527). Respondents completed web-based surveys in November-December 2018. Functional nutrition knowledge was measured using the FoodProK score. Linear regression models examined associations between FoodProK score and sociodemographic, dietary behaviours, and knowledge-related characteristics. RESULTS FoodProK scores (maximum, 8 points) were highest in Canada (mean: 5.1) and Australia (5.0), followed by the UK (4.8), Mexico (4.7), and the US (4.6). Health literacy and self-rated nutrition knowledge were positively associated with FoodProK scores (p < .001). FoodProK scores were higher among those who reported vegetarian/other dietary practices (p < .001); made efforts to consume less sodium, trans fats, or sugars (p < .001); ≥60 years (p = 0.002), female (p < .001), and 'majority' ethnic group respondents in their respective countries (p < .001). CONCLUSIONS This study found differences in consumers' ability to distinguish levels of food processing for common foods, with somewhat lower levels of nutrition knowledge in countries with the highest intake of highly processed foods. Nutrition knowledge differences based on consumer characteristics highlight the need for accessible policy interventions that support uptake of healthy eating efforts across populations to avoid exacerbating nutrition-related disparities. Tools such as the FoodProK can be used to evaluate the impact of policies targeting nutrition knowledge across contexts.
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Affiliation(s)
- Jasmin Bhawra
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | | | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Lana Vanderlee
- École de Nutrition, Centre nutrition, santé et société (Centre NUTRISS) and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
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37
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Shinozaki N, Murakami K, Masayasu S, Sasaki S. Highly Processed Food Consumption and Its Association with Anthropometric, Sociodemographic, and Behavioral Characteristics in a Nationwide Sample of 2742 Japanese Adults: An Analysis Based on 8-Day Weighed Dietary Records. Nutrients 2023; 15:1295. [PMID: 36904297 PMCID: PMC10005625 DOI: 10.3390/nu15051295] [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: 01/31/2023] [Revised: 02/24/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
This cross-sectional study assessed highly processed food (HPF) consumption and its association with individual characteristics in a nationwide sample of Japanese adults. Eight-day weighed dietary records were obtained from 2742 free-living adults aged 18-79 years across Japan. HPFs were identified based on a classification method developed by researchers at the University of North Carolina at Chapel Hill. The basic characteristics of the participants were assessed using a questionnaire. On average, HPF contributed to 27.9% of daily energy intake. The contribution of HPF to the daily intake of 31 nutrients ranged from 5.7% for vitamin C to 99.8% for alcohol (median, 19.9%). Cereals and starchy foods were the main food groups that contributed to the total energy intake of HPF. Multiple regression analysis showed that the older group (60-79 years) had a lower HPF energy contribution than the younger group (18-39 y) (regression coefficient (β) = -3.55, p < 0.0001). Compared to current smokers, past and never-smokers had lower HPF energy contributions (β = -1.41, p < 0.02; and -4.20, p < 0.0001, respectively). In conclusion, HPFs account for approximately one-third of energy intake in Japan. Younger age and current smoking status should be considered in future intervention strategies to reduce HPF consumption.
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Affiliation(s)
- Nana Shinozaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | | | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Özdemir A, Hall R, Lovell A, Ellahi B. Nutrition knowledge and influence on diet in the carer-client relationship in residential care settings for people with intellectual disabilities. NUTR BULL 2023; 48:74-90. [PMID: 36647738 DOI: 10.1111/nbu.12600] [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: 04/28/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023]
Abstract
People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition-related non-communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety-seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in 'making everyday food choices' (p = 0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full-fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client-centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health.
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Affiliation(s)
- Aslıhan Özdemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Rebecca Hall
- Department of Mental Health and Learning Disabilities, Faculty of Health and Social Care, University of Chester, Chester, UK.,School of Nursing, Midwifery and Social Work, University of Salford, Salford, UK
| | - Andrew Lovell
- Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care, University of Chester, Chester, UK
| | - Basma Ellahi
- Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care, University of Chester, Chester, UK
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Muñoz-Rosique B, Hernández-Correas N, Abellán A, Bueno E, Gómez R, Tejada L. Influence of Pig Genetic Line and Salt Reduction on Peptide Production and Bioactivity of Dry-Cured Hams. Foods 2023; 12:foods12051022. [PMID: 36900539 PMCID: PMC10000787 DOI: 10.3390/foods12051022] [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: 01/26/2023] [Revised: 02/17/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023] Open
Abstract
Ham (Jamón) is a product of great value in Spanish gastronomy, although experts have recommended reducing its consumption due to its high salt content and its relationship with cardio-vascular diseases due to the increase in blood pressure it may cause. Therefore, the objective of this study was to evaluate how the reduction of salt content and the pig genetic line influence bioactivity in boneless hams. For this purpose, 54 hams were studied, 18 boneless Iberian hams (RIB), 18 boneless white hams from commercial cross-bred pigs (RWC), and 18 salted and traditionally processed Iberian hams (TIB) to check if the pig genetic line (RIB vs. RWC) or the processing (RIB vs. TIB) affect the peptide production and bioactivity of the hams. The pig genetic line significantly affected the activity of ACE-I and DPPH, with RWC having the highest ACE-I activity and RIB having the highest antioxidative activity. This coincides with the results obtained in the identification of the peptides and the bioactivity analysis performed. Salt reduction positively affected the different hams, influencing their proteolysis and increasing their bioactivity in traditionally cured hams.
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Affiliation(s)
- Beatriz Muñoz-Rosique
- Departamento de Calidad, AromaIbérica Serrana, S.L. Ctra. Fuente Álamo, Km 17.4, 30332 Murcia, Spain
| | - Noelia Hernández-Correas
- Departamento de Tecnología de la Alimentación y Nutrición, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
- Correspondence:
| | - Adela Abellán
- Departamento de Tecnología de la Alimentación y Nutrición, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
| | - Estefanía Bueno
- Departamento de Tecnología de la Alimentación y Nutrición, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
| | - Rafael Gómez
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus de Rabanales, Edificio Darwin, 14014 Córdoba, Spain
| | - Luis Tejada
- Departamento de Tecnología de la Alimentación y Nutrición, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
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Association of minimally processed and ultra-processed food daily consumption with obesity in overweight adults: a cross-sectional study. NUTR HOSP 2023. [PMID: 36789961 DOI: 10.20960/nh.04270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects. OBJECTIVE to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. METHODS we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]). RESULTS minimally processed food consumption score quartiles (1st = 1[food-score/day]; 2nd = 6[food-score/day]; 3rd = 7[food-score/day]; 4th = 8[food-score/day]) presented higher values compared to ultra-processed food (1st = 1[food-score/day]; 2nd = 1[food-score/day]; 3rd = 2[food-score/day]; 4th = 4[food-score/day]). For each score of minimally processed food consumed, there was a -5.9 % odds of OB. Thus, the higher quartile (4th) of minimally processed food consumption score represents less odds of OB (OR: -47.2 %; p < 0.001). Each ultra-processed food score consumed presented odds of 3.7 % of OB. Therefore, higher consumption of ultra-processed food (4th quartile) shows higher odds of OB (OR: +14.8 %; p < 0.001). All associations remained significatively even after being adjusted by the confounders. CONCLUSION the consumption scores of minimally processed and ultra-processed foods presented a magnitude capable of impacting OW adults' odds of OB, even when controlled by sociodemographic factors, physical activity, hypertension, and diabetes.
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Jo E, Yoo H, Kim K, Kim S, Kim CK, Lee H, Jeong J, Park S. Who has experienced better or worse health conditions since the outbreak of COVID-19?: results from a representative cross-sectional survey in Seoul. Nutr Res Pract 2023; 17:103-121. [PMID: 36777803 PMCID: PMC9884592 DOI: 10.4162/nrp.2023.17.1.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/15/2022] [Accepted: 04/19/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND/OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population in many ways. This study aimed to analyze the patterns of changes in eating, food purchasing and preparation, physical activity, and subjective health after COVID-19 outbreak by various sociodemographic factors and to understand the factors associated with changes in subjective health. SUBJECTS/METHODS A cross-sectional survey using a representative sample from Seoul was used for the analysis. The data collection was conducted from September to October 2020. A total of 3,833 citizens aged more than 18 years old participated in the Seoul Food Survey. Descriptive statistics and generalized ordinal logistic regression models were used to understand the changes in health behaviors, health indicators, and subjective general health by various socioeconomic status. RESULTS It was shown that the changes in household income, food expenditure, food consumption and physical activities differed significantly by age, education, occupation, income, weight, and food security status. Low-income and food-insecure households were affected more severely by the pandemic. Older age, household food insecurity, income reduction, increased home cooking and frequency of having instant foods, decreased physical activity and weight gain were significant factors explaining worse perceived health during the COVID-19 pandemic. CONCLUSIONS The results suggest that focusing on older populations and low-income families with food insecurity should be prioritized during infectious disease outbreaks. In addition, the role of physical activities and instant food consumption in explaining perceived health should be investigated further in this prolonged battle with the pandemic situation.
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Affiliation(s)
- Eunbin Jo
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea
| | - Hyelim Yoo
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Sunup Kim
- Institute of Social Research, Korea University, Seoul 02841, Korea
| | - Chul-Kyoo Kim
- Department of Sociology, Korea University, Seoul 02841, Korea
| | - Haeyoen Lee
- Food Policy Division, Bureau of Citizens' Health, City Hall, Seoul 04524, Korea
| | - Jinsook Jeong
- Food Policy Division, Bureau of Citizens' Health, City Hall, Seoul 04524, Korea
| | - Sohyun Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.,The Korean Institute of Nutrition, Hallym University, Chuncheon 24252, Korea
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Chang K, Gunter MJ, Rauber F, Levy RB, Huybrechts I, Kliemann N, Millett C, Vamos EP. Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank. EClinicalMedicine 2023; 56:101840. [PMID: 36880051 PMCID: PMC9985039 DOI: 10.1016/j.eclinm.2023.101840] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
Background Global dietary patterns are increasingly dominated by relatively cheap, highly palatable, and ready-to-eat ultra-processed foods (UPFs). However, prospective evidence is limited on cancer development and mortality in relation to UPF consumption. This study examines associations between UPF consumption and risk of cancer and associated mortality for 34 site-specific cancers in a large cohort of British adults. Methods This study included a prospective cohort of UK Biobank participants (aged 40-69 years) who completed 24-h dietary recalls between 2009 and 2012 (N = 197426, 54.6% women) and were followed up until Jan 31, 2021. Food items consumed were categorised according to their degree of food processing using the NOVA food classification system. Individuals' UPF consumption was expressed as a percentage of total food intake (g/day). Prospective associations were assessed using multivariable Cox proportional hazards models adjusted for baseline socio-demographic characteristics, smoking status, physical activity, body mass index, alcohol and total energy intake. Findings The mean UPF consumption was 22.9% (SD 13.3%) in the total diet. During a median follow-up time of 9.8 years, 15,921 individuals developed cancer and 4009 cancer-related deaths occurred. Every 10 percentage points increment in UPF consumption was associated with an increased incidence of overall (hazard ratio, 1.02; 95% CI, 1.01-1.04) and specifically ovarian (1.19; 1.08-1.30) cancer. Furthermore, every 10 percentage points increment in UPF consumption was associated with an increased risk of overall (1.06; 1.03-1.09), ovarian (1.30; 1.13-1.50), and breast (1.16; 1.02-1.32) cancer-related mortality. Interpretation Our UK-based cohort study suggests that higher UPF consumption may be linked to an increased burden and mortality for overall and certain site-specific cancers especially ovarian cancer in women. Funding The Cancer Research UK and World Cancer Research Fund.
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Affiliation(s)
- Kiara Chang
- Public Health Policy Evaluation Unit, Imperial College London, London, W6 8RP, United Kingdom
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 69372, Lyon, France
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, 01246-904, Brazil
| | - Renata B. Levy
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, 01246-904, Brazil
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 69372, Lyon, France
| | - Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 69372, Lyon, France
| | - Christopher Millett
- Public Health Policy Evaluation Unit, Imperial College London, London, W6 8RP, United Kingdom
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Eszter P. Vamos
- Public Health Policy Evaluation Unit, Imperial College London, London, W6 8RP, United Kingdom
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Barbosa LB, Vasconcelos NBR, dos Santos EA, dos Santos TR, Ataide-Silva T, Ferreira HDS. Ultra-processed food consumption and metabolic syndrome: a cross-sectional study in Quilombola communities of Alagoas, Brazil. Int J Equity Health 2023; 22:14. [PMID: 36650595 PMCID: PMC9847020 DOI: 10.1186/s12939-022-01816-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The processing of food can cause changes that turn them into risk factors for chronic diseases. A higher degree of food processing is associated with the development of chronic non-communicable diseases (NCDs), including the metabolic syndrome (MetS). The objective of this study was to analyze the relationship between ultra-processed food (UPF) consumption and the prevalence of MetS and its risk factors, focusing on a population group especially subjected to precarious living conditions and food insecurity. METHOD Cross-sectional population-based study with women (19 to 59 years) from Quilombola communities of Alagoas. The socioeconomic, demographic, anthropometric, health status, lifestyle, and food intake (24-h recall) variables were analyzed. The dependent variable was the MetS, defined using the harmonization criteria of the Joint Interim Statement, and its components. The foods consumed were categorized according to the Nova Classification, assuming the highest UPF consumption as risk exposure. The measure of association was the prevalence ratio (PR) and respective 95%CI, calculated by Poisson regression with robust variance. We also analyzed the association with the Nova score of UPF consumption. RESULTS We investigated 895 women (38.9 ± 11.0 years), of whom 48.3% had MetS. On average, 15.9% of the total energy intake came from UPF. Lower Nova scores were associated with a lower prevalence of diabetes and low HDL. Higher UPF consumption was associated with a 30% higher prevalence of hypertension (PR = 1.30; 95%CI: 1.06-1.61). CONCLUSION The highest UPF consumption was positively associated with the prevalence of hypertension, while a lower Nova score was a protective factor against diabetes and low HDL. UPF consumption in Quilombola communities is important but lower than that observed in the Brazilian population in general. It is suggested that public health programs be implemented to promote healthy eating while valuing the existing eating habits and traditions among the remaining Brazilian Quilombola people.
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Affiliation(s)
- Lídia Bezerra Barbosa
- Postgraduate Program in Health Sciences of the Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970 Brazil
- Faculty of Nutrition of the Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970. Brazil
| | - Nancy Borges Rodrigues Vasconcelos
- Postgraduate Program in Health Sciences of the Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970 Brazil
| | - Ewerton Amorim dos Santos
- Faculty of Medicine of the Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970. Brazil
| | - Tamara Rodrigues dos Santos
- Postgraduate Program in Health Sciences of the Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970 Brazil
| | - Thays Ataide-Silva
- Faculty of Nutrition of the Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970. Brazil
| | - Haroldo da Silva Ferreira
- Faculty of Nutrition of the Federal University of Alagoas, Campus A. C. Simões, BR 104, km 14, Tabuleiro dos Martins, Maceió, Alagoas 57072-970. Brazil
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44
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Maternal sociodemographic factors and their association with ultra-processed foods consumption among children. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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45
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da Silva LSL, de Freitas Batalhão D, dos Santos Carvalho A, Bohn L, Ramos NC, Abdalla PP. Nutritional status, health risk behaviors, and eating habits are correlated with physical activity and exercise of brazilian older hypertensive adults: a cross-sectional study. BMC Public Health 2022; 22:2382. [PMID: 36536331 PMCID: PMC9762644 DOI: 10.1186/s12889-022-14873-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Nutritional status, health risk behaviors, eating habits, and other comorbidities (such as diabetes) may be associated with recommended amounts of physical activity (PA) and exercise (EX) in healthy older adults. However, these associations are still unclear for older hypertensive adults, who require greater care from health professionals. The purpose of this study was to associate the nutritional status, health risk behaviors, eating habits, and the presence of diabetes with recommended amounts of physical activity and exercise practice of older hypertensive adults. METHODS Ten thousand seven hundred eighty-nine older hypertensive adults (70.9 ± 7.4 years) from the VIGITEL telephone survey were classified according to PA levels (insufficiently active/sufficiently active) and EX practice (non-practitioners/practitioners). Binary logistic regression was used to observe the odds ratio (OR) between independent variables (nutritional status [body mass index], sociodemographic characteristics [age/sex/years of study], risk behaviors [screen time/alcohol/tobacco consumption], eating habits [minimally/ultra-processed foods consumption score], and the presence of diabetes) with recommended amounts of PA/EX (dependent variable). RESULTS Highest nutritional status (ORPA = 0.975 [95%-CI: 0.965 - 0.985]; OREX = 0.981[95%-CI: 0.972 - 0.991]), age (ORPA = 0.955 [95%-CI: 0.949 - 0.961]; OREX = 0.980[95%-CI: 0.975 - 0.986]), screen time (ORPA = 0.909[95%-CI: 0.835 - 0.990]), alcohol consumption (ORPA = 0.683[95%-CI: 0.621 - 0.758]; OREX = 0.702[95%-CI: 0.637 - 0.779]), tobacco (ORPA = 0.601 [95%-CI: 0.492 - 0.736]; OREX = 0.464[95%-CI: 0.384 - 0.562]) ultra-processed foods consumption score (ORPA = 0.896[95%-CI: 0.871 - 0.921]; OREX = 0.886[95%-CI: 0.863 - 0.909]) and having diabetes (ORPA = 0.780[95%-CI: 0.708 - 0.859]; OREX = 0.831[95%-CI: 0.759 - 0.909]) reduced the odds of being sufficiently active/practicing exercise (p < 0.05). Male sex (ORPA = 1.633[95%-CI: 1.491 - 1.789]; OREX = 1.247[95%-CI: 1.140 - 1.363]), years of study (ORPA = 1.026[95%-CI: 1.018 - 1.035]; OREX = 1.050[95%-CI: 1.041 - 1.058]), and minimally processed foods consumption score increased the odds of being sufficiently active/practicing exercise (ORPA = 1.132[95%-CI: 1.109 - 1.155]; OREX = 1.167[95%-CI: 1.145 - 1.191], respectively; p < 0.05). CONCLUSION Nutritional status, health risk behaviors, eating habits, and the presence of diabetes were associated with the odds of older hypertensive adults complying with PA and EX recommendations. The results may help health professionals understand how these factors are associated with the changes of older hypertensive adults participating in physical activity and exercise.
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Affiliation(s)
- Leonardo Santos Lopes da Silva
- grid.11899.380000 0004 1937 0722School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Bandeirantes Avenue nº 3900, University Campus - Monte Alegre, Ribeirão Preto-SP, 14030-680 Brazil ,grid.11899.380000 0004 1937 0722Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel de Freitas Batalhão
- grid.412401.20000 0000 8645 7167Physical Education Department, Paulista University, São José Do Rio Preto, Brazil
| | - Anderson dos Santos Carvalho
- grid.412401.20000 0000 8645 7167Physical Education Department, Paulista University, São José Do Rio Preto, Brazil
| | - Lucimere Bohn
- grid.5808.50000 0001 1503 7226Faculty of Sports (FADEUP), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Research Center for Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal ,grid.164242.70000 0000 8484 6281Faculdade de Psicologia, Educação e Desporto, University Lusófona of Porto, Porto, Portugal
| | - Nilo César Ramos
- grid.254313.20000 0000 8738 9661Coastal Carolina University, Conway, SC USA
| | - Pedro Pugliesi Abdalla
- grid.11899.380000 0004 1937 0722Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Huybrechts I, Rauber F, Nicolas G, Casagrande C, Kliemann N, Wedekind R, Biessy C, Scalbert A, Touvier M, Aleksandrova K, Jakszyn P, Skeie G, Bajracharya R, Boer JMA, Borné Y, Chajes V, Dahm CC, Dansero L, Guevara M, Heath AK, Ibsen DB, Papier K, Katzke V, Kyrø C, Masala G, Molina-Montes E, Robinson OJK, Santiuste de Pablos C, Schulze MB, Simeon V, Sonestedt E, Tjønneland A, Tumino R, van der Schouw YT, Verschuren WMM, Vozar B, Winkvist A, Gunter MJ, Monteiro CA, Millett C, Levy RB. Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: Application of the Nova classification and validation using selected biomarkers of food processing. Front Nutr 2022; 9:1035580. [PMID: 36590209 PMCID: PMC9800919 DOI: 10.3389/fnut.2022.1035580] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) "Ultra-processed" foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements. Methods After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25-p75: 58-66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF). Results Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were -0.07 and -0.37 for elaidic acid and 4-methyl syringol sulfate, respectively). Conclusion These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods.
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Affiliation(s)
- Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Geneviève Nicolas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Corinne Casagrande
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Roland Wedekind
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University Paris Cité (CRESS), Paris, France
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | | | - Jolanda M. A. Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Yan Borné
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Veronique Chajes
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Lucia Dansero
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), University of Turin, Turin, Italy
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniel B. Ibsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Esther Molina-Montes
- Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Biomedical Research Centre, Institute of Nutrition and Food Technology (INYTA) “José Mataix”, University of Granada, Granada, Spain
| | - Oliver J. K. Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Carmen Santiuste de Pablos
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Vittorio Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Vanvitelli University, Naples, Italy
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - W. M. Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Beatrice Vozar
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Anna Winkvist
- Sustainable Health, Department Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carlos A. Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
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Coyle DH, Huang L, Shahid M, Gaines A, Di Tanna GL, Louie JCY, Pan X, Marklund M, Neal B, Wu JHY. Socio-economic difference in purchases of ultra-processed foods in Australia: an analysis of a nationally representative household grocery purchasing panel. Int J Behav Nutr Phys Act 2022; 19:148. [PMID: 36503612 PMCID: PMC9742014 DOI: 10.1186/s12966-022-01389-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Consumption of ultra-processed foods is associated with increased risk of obesity and non-communicable diseases. Little is known about current patterns of ultra-processed foods intake in Australia. The aim of this study was to examine the amount and type of ultra-processed foods purchased by Australian households in 2019 and determine whether purchases differed by socio-economic status (SES). We also assessed whether purchases of ultra-processed foods changed between 2015 and 2019. METHODS: We used grocery purchase data from a nationally representative consumer panel in Australia to assess packaged and unpackaged grocery purchases that were brought home between 2015 to 2019. Ultra-processed foods were identified according to the NOVA system, which classifies foods according to the nature, extent and purpose of industrial food processing. Purchases of ultra-processed foods were calculated per capita, using two outcomes: grams/day and percent of total energy. The top food categories contributing to purchases of ultra-processed foods in 2019 were identified, and differences in ultra-processed food purchases by SES (Index of Relative Social Advantage and Disadvantage) were assessed using survey-weighted linear regression. Changes in purchases of ultra-processed foods between 2015 to 2019 were examined overall and by SES using mixed linear models. RESULTS In 2019, the mean ± SD total grocery purchases made by Australian households was 881.1 ± 511.9 g/d per capita. Of this, 424.2 ± 319.0 g/d per capita was attributable to purchases of ultra-processed foods, which represented 56.4% of total energy purchased. The largest food categories contributing to total energy purchased included mass-produced, packaged breads (8.2% of total energy purchased), chocolate and sweets (5.7%), biscuits and crackers (5.7%) and ice-cream and edible ices (4.3%). In 2019, purchases of ultra-processed foods were significantly higher for the lowest SES households compared to all other SES quintiles (P < 0.001). There were no major changes in purchases of ultra-processed foods overall or by SES over the five-year period. CONCLUSIONS Between 2015 and 2019, ultra-processed foods have consistently made up the majority of groceries purchased by Australians, particularly for the lowest SES households. Policies that reduce ultra-processed food consumption may reduce diet-related health inequalities.
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Affiliation(s)
- Daisy H Coyle
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia.
| | - Liping Huang
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Maria Shahid
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Allison Gaines
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Gian Luca Di Tanna
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Jimmy Chun Yu Louie
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
- School of Biological Science, Faculty of Science, The University of Hong Kong, Hong Kong, 999077, China
| | - Xiongfei Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Matti Marklund
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Bruce Neal
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Jason H Y Wu
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
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Abstract
Studies indicate that eating locations can influence food choices. However, the relationship with ultra-processed foods has been little explored. The objective was to assess the association between eating locations and ultra-processed foods consumption in the UK in 2014-2016. Data from 2,449 individuals aged 4 years or older from the NDNS were analysed cross-sectionally. Food consumption information was collected through 4-day food diaries. Recorded foods were classified into NOVA system. The eating locations were grouped into nine categories (home, institutional places, sit-down restaurants, on the go, coffee shops, leisure and sports clubs, fast food, friends and relatives' house, and other places). Linear regression models were carried out. The coefficients represent the increment in the contribution of ultra-processed foods to total energy intake for each percentage point increase in the contribution of each eating location to total energy intake. Among children, consumption at home was inversely associated with ultra-processed foods consumption (β: -0.10; 95% CI -0.17, -0.03), while in leisure and sports places (0.47; 0.20, 0.73) directly associated. For adolescents, eating at home (-0.12; -0.19, -0.05) was inversely associated with the consumption of ultra-processed foods, as well as sit-down restaurants (-0.21; -0.38, -0.03). Fast food (0.29; 0.12, 0.47) were directly associated with the consumption of ultra-processed foods for adolescents. Finally, for adults, sit-down restaurants (-0.13; -0.22, -0.03) showed to be inversely associated with the consumption of ultra-processed foods while in fast food restaurants (0.77; 0.38, 1.17) it was directly associated. Our results showed that the eating locations have different impacts on diet quality.
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Trends in food consumption according to the degree of food processing among the UK population over 11 years. Br J Nutr 2022:1-8. [DOI: 10.1017/s0007114522003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Although ultra-processed foods represent more than half of the total energy consumed by the UK population, little is known about the trend in food consumption considering the degree of food processing. We evaluated the trends of the dietary share of foods categorised according to the NOVA classification in a historical series (2018–2019) among the UK population. Data were acquired from the NDNS, a survey that collects diet information through a 4-d food record. We used adjusted linear regression to estimate the dietary participation of NOVA groups and evaluated the linear trends over the years. From 2008 to 2019, we observed a significant increase in the energy share of culinary ingredients (from 3·7 to 4·9 % of the total energy consumed; P-trend = 0·001), especially for butter and oils; and reduction of processed foods (from 9·6 to 8·6 %; P-trend = 0·002), especially for beer and wine. Unprocessed or minimally processed foods (≅30 %, P-trend = 0·505) and ultra-processed foods (≅56 %, P-trend = 0·580) presented no significant change. However, changes in the consumption of some subgroups are noteworthy, such as the reduction in the energy share of red meat, sausages and other reconstituted meat products as well as the increase of fruits, ready meals, breakfast cereals, cookies, pastries, buns and cakes. Regarding the socio-demographic characteristics, no interaction was observed with the trend of the four NOVA groups. From 2008 to 2019 was observed a significant increase in culinary ingredients and a reduction in processed food. Furthermore, it sheds light on the high share of ultra-processed foods in the contemporary British diet.
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Ultra-processed food consumption and its association with nutritional, functional, and health characteristics in Brazilian elders. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2022. [DOI: 10.15448/2357-9641.2022.1.42968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aims: to estimate the dietary energy contribution of ultra-processed foods and the association on nutritional dietary profile, nutritional status, chronic disease, and functional capacity of Brazilian elders. Methods: we performed an epidemiology cross-sectional study conducted with 332 participants (≥60 years old). Food consumption was measured by three 24-h food recall. Foods were classified according to NOVA classification as in natura/minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Anthropometric variables were used to assess nutritional status, and scales of activities of daily living to assess functional capacity. Chronic diseases were self-reported. Results: the average daily consumption of energy was 2433,96 kcal, being 10.44% from ultra-processed foods. Elders with higher ultra-processed foods intake showed higher consumption of energy, added sugar, total and saturated fat, and fewer consumption of proteins, fibres, potassium, magnesium, iron, zinc, copper, selenium, B6 vitamin e folate. Most participants were independent for functional capacity, overweight, and very high risk for cardiovascular disease, but no statistical significance was observed. No association was found between ultra-processed foods and nutritional dietary profile, nutritional status, chronic disease, and functional capacity. Conclusions: elders who had the highest ultra-processed foods consumption had lower diet quality, although no influences on nutritional status and health variables assessed were observed in this sample.
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