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Dicken SJ, Batterham RL, Brown A. Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling. Br J Nutr 2024; 131:1619-1632. [PMID: 38220223 PMCID: PMC11043912 DOI: 10.1017/s0007114524000096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024]
Abstract
UK front of package labelling (FOPL) informs consumers on the nutrient content of food. However, FOPL does not consider food processing, and with the UK government being urged to act on ultra-processed food (UPF), whether UPF should be added to FOPL is unclear. This study compared food and drink in the UK National Diet and Nutrition Survey (NDNS) Intake24 database based on FOPL, nutrient content and NOVA classification, to understand whether UPF are covered by dietary recommendations for foods high in fat, salt and sugar. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients, processed food and UPF according to the NOVA classification and FOPL traffic lights. UPF contained greater energy, fat, saturated fat (SF), total sugar (TS) and salt than MPF. UPF had a greater odds of containing red FOPL and an unhealthier overall FOPL score (OR:4·59 (95 % CI: 3·79, 5·57); OR:7·0 (95 % CI: 6·1, 8·2), respectively) and lower odds of containing green FOPL (OR:0·05 (95 % CI: 0·03, 0·10)), compared with MPFs. For items with no red FOPL, UPF still contained greater energy, fat, SF, TS and salt than MPF. However, several UPF have healthier FOPL scores. UPF had an unhealthier nutritional profile and FOPL score than MPF. For items with no red FOPL, UPF still had an unhealthier profile than MPF, with a higher energy density. Importantly, not all UPF were unhealthy according to FOPL. These results indicate partial overlap between FOPL, nutrient content and NOVA classification of UK food and drink products, with implications for UK food and drink labelling.
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Affiliation(s)
- Samuel J. Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
| | - Rachel L. Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
| | - Adrian Brown
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), LondonW1T 7DN, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), LondonNW1 2BU, UK
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Hosseininasab D, Shiraseb F, Bahrampour N, da Silva A, Hajinasab MM, Bressan J, Mirzaei K. Ultra-processed food consumption and quality of life: a cross-sectional study in Iranian women. Front Public Health 2024; 12:1351510. [PMID: 38665244 PMCID: PMC11043594 DOI: 10.3389/fpubh.2024.1351510] [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: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background Ultra-processed foods (UPFs) have been associated with a higher intake of added sugars, sodium, and unhealthy fats; however, the relationship between UPFs and quality of life (QoL) is not well understood. Methods The present cross-sectional study included 193 Iranian women aged 18-48 years with a body mass index (BMI) of ≥25 kg/m2. UPFs were identified using the NOVA classification. QoL was evaluated using the SF-36 questionnaire. Anthropometric measurements and body composition were assessed using an appropriate method. Results The mean BMI and fat-free mass (FFM) of the subjects were 30.90 kg/m2 and 46.69 kg, respectively. At first, a significant difference was observed in the height of women across tertiles of UPF consumption. The mean score of the total QoL scale was 66.90. Women who were in the tertile 3 of UPFs intake had 23.59 units lower the scale of limitation in physical capabilities and activity (score of role-physical) (β = -23.59, 95% CI: -37.77-9.40, p = 0.001). Among those with the highest adherence to UPF intake, there was an 8.76 unit reduction in addressing feelings of energy and fatigue (vitality domain) in model 2 (β = -8.76, 95% CI: -16.42-1.11, p = 0.02). Finally, a reduction of 15.78 units was observed in the mental health scale, specifically in the mental states of anxiety and depression, among participants in the third tertile of UPF intake (β = -15.78, 95% CI: -24.11-7.45, p < 0.001). Conclusion Increased UPF consumption was associated with lower QoL in Iranian women. Further studies are needed to confirm these findings and develop effective strategies to promote healthy food choices.
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Affiliation(s)
- Dorsa Hosseininasab
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Niki Bahrampour
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Alessandra da Silva
- Laboratory of Energy Metabolism and Body Composition, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Mohammad Mahdi Hajinasab
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Josefina Bressan
- Laboratory of Energy Metabolism and Body Composition, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Aceves-Martins M, Bates RL, Craig LCA, Chalmers N, Horgan G, Boskamp B, de Roos B. Consumption of foods with the highest nutritional quality, and the lowest greenhouse gas emissions and price, differs between socio-economic groups in the UK population. Public Health Nutr 2023; 26:3370-3378. [PMID: 37905562 PMCID: PMC10755419 DOI: 10.1017/s1368980023002355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/29/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To establish a baseline understanding of whether consuming food with the highest nutritional quality, lowest greenhouse gas emissions (GHGE) and cost differs between different UK demographic and socio-economic population groups. DESIGN Multiple linear regression models were fitted to evaluate the relationship between predictor socio-demographic variables in this study (i.e. sex, ethnic group, age, BMI and level of deprivation) and the response variables (i.e. consumption of items considered most nutritious, with a low GHGE and price, as a proportion of total items consumed). SETTING The UK. PARTICIPANTS 1374 adult (18-65 years) participants from the National Diet and Nutrition Survey latest waves 9-11 (2016-2017 and 2018-2019). RESULTS Based on the total energy consumption in a day, the average diet-based GHGE was significantly higher for participants with a higher BMI. Non-white and most deprived participants spent significantly (P < 0·001) less money per total energy consumption. Participants with a BMI between 18·6 and 39·9 kg/m2 and those living in the least deprived areas consumed a significantly (P < 0·001) higher amount of those items considered the most nutritious, with the lowest GHGE and cost per 100 kcal. CONCLUSIONS Consumption of food with the highest nutritional quality, lowest GHGE and cost in the UK varies among those with different socio-demographic characteristics, especially the deprivation level of participants. Our analysis endorses the consideration of environmental sustainability and affordability, in addition to the consideration of nutritional quality from a health perspective, to make current dietary guidelines more encompassing and equitable.
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Affiliation(s)
| | - Ruth L Bates
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
| | - Leone CA Craig
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Neil Chalmers
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
| | - Graham Horgan
- Biomathematics & Statistics Scotland, Rowett Institute, Aberdeen, UK
| | - Bram Boskamp
- Biomathematics & Statistics Scotland, The King’s Buildings, Edinburgh, UK
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
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Zhang Q, Liu Y, He C, Zhu R, Li M, Lam HM, Wong WT. Nutritional Assessment of Plant-Based Meat Products Available on Hong Kong Market: A Cross-Sectional Survey. Nutrients 2023; 15:3684. [PMID: 37686716 PMCID: PMC10489762 DOI: 10.3390/nu15173684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Plant-based meat (PBM) takes up ever-increasing market shares and draws great attention from both customers and retailers these days. However, little is known about the nutritional quality of PBM products. OBJECTIVE This study intended to profile and evaluate the overview nutrition of PBM with equivalent meat products on the Hong Kong market. METHODS We conducted a cross-sectional survey of 274 PBM and 151 meat products from 27 different brands on the Hong Kong market in October 2022. The nutritional differences between PBM and meat products were assessed using analysis of covariance (ANCOVA) and two independent sample t-test. The nutritional quality of PBMs was evaluated according to nutrient reference value, front-of-package (FoP) criteria and nutritional score. RESULTS PBM had relatively lower energy density, total fat, saturated fat, protein, and salt compared to meat. According to the FoP criteria, 91.36%, 17.88%, and 99.34% of PBMs were labeled as medium to high in fat, salt, and sugar, respectively. Through ingredient analysis of 81 PBM products, soy and canola were the main source of protein and fat. CONCLUSIONS PBM products have a roughly better nutrient quality compared to muscle-based meat, though there is still potential for further refinement in terms of production, consumption, and regulation.
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Affiliation(s)
- Qile Zhang
- School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China; (Q.Z.); (C.H.); (R.Z.)
| | - Yilin Liu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Chufeng He
- School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China; (Q.Z.); (C.H.); (R.Z.)
| | - Ruiwen Zhu
- School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China; (Q.Z.); (C.H.); (R.Z.)
| | - Minghui Li
- School of Pharmacy, University College London, London WC1N 1AX, UK;
| | - Hon-Ming Lam
- School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China; (Q.Z.); (C.H.); (R.Z.)
- State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Tak Wong
- School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China; (Q.Z.); (C.H.); (R.Z.)
- State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Hong Kong, China
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Vellinga RE, van den Boomgaard I, Boer JM, van der Schouw YT, Harbers MC, Verschuren WMM, van 't Veer P, Temme EH, Biesbroek S. Different levels of ultra-processed food and beverage consumption and associations with environmental sustainability and all-cause mortality in EPIC-NL. Am J Clin Nutr 2023:S0002-9165(23)62420-7. [PMID: 37207984 DOI: 10.1016/j.ajcnut.2023.05.021] [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: 08/17/2022] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The adverse health effects of high ultra-processed food and drink consumption (UPFD) are well documented. However, its environmental impact remains unclear and the separate effects of ultra-processed foods (UPF) and drinks (UPD) on all-cause mortality are not previously studied. OBJECTIVES To assess the association between levels of UPFD, UPF and UPD consumption with diet-related environmental impacts and all-cause mortality in Dutch adults. METHODS Habitual diets were assessed by FFQ in 1993-1997 among 38,261 participants of the EPIC-NL cohort. The mean follow-up time was 18.2 years (SD 4.1), 4,697 deaths occurred. FFQ-items were categorized according to the NOVA classification. Associations with quartiles of UPFD, UPF, and UPD consumption and environmental impact indicators were analyzed using general linear models and with all-cause mortality by Cox proportional hazard models. The lowest UPFD, UPF, UPD consumption quartiles were used as comparator. RESULTS The average UPFD consumption was 181 (SD 88) g per 1000 kcal. High UPF consumption was statistically significantly inversely associated with all environmental impact indicators (Q4vsQ1: -13.6% to -3.0%) whereas high UPD consumption was, except for land use, statistically significant positively associated with all environmental impact indicators (Q4vsQ1: 5.9% to 1.2%). High UPFD consumption was heterogeneously associated with environmental impacts (Q4vsQ1: 2.6% to -4.0% ). After multivariable adjustment, the highest quartiles of UPFD and UPD consumption were significantly associated with all-cause mortality (HRQ4vsQ1 1.20, 95%CI 1.10,1.30 and HRQ4vsQ1 1.19, 95%CI 1.09,1.29, respectively). UPF consumption of Q2 and Q3 were associated with a borderline significant lower risk of all-cause mortality (HRQ2vsQ1 0.93, 95% CI 0.85,1.00; HRQ3vsQ1 0.91, 95% CI 0.84,0.99), while Q4 was not statistically significant (HRQ4vsQ1 1.05, 95% CI 0.96,1.15). CONCLUSIONS Reducing UPD consumption could lower environmental impact and all-cause mortality risk, however this was not shown for UPF. When categorizing foods consumption by their degree of processing trade-offs are observed for human and planetary health aspects.
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Affiliation(s)
- Reina E Vellinga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
| | - Iris van den Boomgaard
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Jolanda Ma Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein C Harbers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pieter van 't Veer
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Elisabeth Hm Temme
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
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Aceves-Martins M, Denton P, de Roos B. Ready meals, especially those that are animal-based and cooked in an oven, have lower nutritional quality and higher greenhouse gas emissions and are more expensive than equivalent home-cooked meals. Public Health Nutr 2023; 26:1-9. [PMID: 36647605 PMCID: PMC9989702 DOI: 10.1017/s1368980023000034] [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: 03/31/2022] [Revised: 11/04/2022] [Accepted: 12/07/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine whether ready meals and equivalent home-cooked meals differ in nutritional quality indicators, greenhouse gas emissions (GHGE) and cost. DESIGN We performed a cross-sectional analysis of meal data from the National Diet and Nutrition Survey (NDNS) nutrient databank (2018/19). Additional data on nutrient composition, cost and cooking-related GHGE were calculated and compared between fifty-four ready meals and equivalent home-cooked meals. SETTING The UK. PARTICIPANTS Not applicable. RESULTS Ready meals, overall and those that were animal-based, had significantly higher levels of free sugar compared with equivalent home-cooked meals (P < 0·0001 and P < 0·0004, respectively). Animal-based ready meals had significantly higher levels of GHGE (P < 0·001), whereas the cost of ready meals, overall, was significantly higher (P < 0·001), compared with equivalent home-cooked meals. Animal-based meals, whether ready meals or equivalent homemade meals, had significantly higher levels of protein (P < 0·0001), contained significantly more kilocalories (P = 0·001), had significantly higher levels of GHGE (P < 0·0001) and were significantly more expensive (P < 0·0001), compared with plant-based meals. Overall, plant-based meals home-cooked on the gas or electric stove had the lowest GHGE and cost, whereas animal-based oven-cooked ready meals had the highest levels of GHGE and were most expensive. CONCLUSIONS Ready meals have lower nutritional quality and higher GHGE and are more expensive than equivalent home-cooked meals, especially those meals that are animal-based and prepared in an oven.
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Affiliation(s)
| | - Philippa Denton
- The Rowett Institute, University of Aberdeen, AberdeenAB25 2ZD, UK
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, AberdeenAB25 2ZD, UK
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