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Shinozaki N, Murakami K, Kimoto N, Masayasu S, Sasaki S. Highly Processed Food Consumption and its Association With Overall Diet Quality in a Nationwide Sample of 1,318 Japanese Children and Adolescents: A Cross-Sectional Analysis Based on 8-Day Weighed Dietary Records. J Acad Nutr Diet 2024:S2212-2672(24)00267-3. [PMID: 38852670 DOI: 10.1016/j.jand.2024.06.001] [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: 09/18/2023] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND There is limited evidence regarding the association between consumption of highly processed foods (HPFs) and overall diet quality in children and adolescents from Asian countries. OBJECTIVE This study aimed to examine the association between HPF consumption and overall diet quality in Japanese children and adolescents. DESIGN A cross-sectional analysis was conducted based on 8-day dietary record data collected from volunteers in 32 of 47 prefectures throughout Japan in 2016 to 2020. Foods were categorized into 1 of 4 processing levels using the framework developed by the University of North Carolina at Chapel Hill. Food classification was performed under a low-estimate scenario (classifying mixed dishes consumed outside the home after disaggregation into ingredients) and high-estimate scenario (classifying them into HPFs without food disaggregation). PARTICIPANTS/SETTING A total of 1318 Japanese children and adolescents aged 3 to 17 years participated in the study. MAIN OUTCOME MEASURES Diet quality was assessed using the Healthy Eating Index-2020 and Nutrient-Rich Food Index 9.3. STATISTICAL ANALYSIS Multiple regression models adjusted for sociodemographic and anthropometric characteristics and the survey cycle were used to examine the association between tertiles of the energy contribution of HPFs and diet quality. RESULTS The mean energy contribution of HPFs was 27.3% and 44.3% in the low- and high-estimate scenarios, respectively. The top contributors to total energy intake from HPFs were confectioneries in the low-estimate scenario and cereals and starchy foods in the high-estimate scenario. Irrespective of the scenarios, participants in higher tertiles of energy contribution of HPFs had lower total scores for Healthy Eating Index-2020 and Nutrient-Rich Food Index 9.3 (P for trend < .0001). CONCLUSIONS HPFs accounted for more than one-quarter of the energy intake of Japanese children and adolescents surveyed, and higher consumption of HPFs was associated with lower diet quality. Therefore, reducing HPF consumption may increase overall diet quality among Japanese children and adolescents. Further research is needed to explore the causal nature of this association.
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Affiliation(s)
- Nana Shinozaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Nana Kimoto
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | | | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-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: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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3
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Hu G, Flexner N, Tiscornia MV, L’Abbé MR. Accelerating the Classification of NOVA Food Processing Levels Using a Fine-Tuned Language Model: A Multi-Country Study. Nutrients 2023; 15:4167. [PMID: 37836451 PMCID: PMC10574618 DOI: 10.3390/nu15194167] [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: 09/01/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
The consumption and availability of ultra-processed foods (UPFs), which are associated with an increased risk of noncommunicable diseases, have increased in most countries. While many countries have or are planning to incorporate UPF recommendations in their national dietary guidelines, the classification of food processing levels relies on expertise-based manual categorization, which is labor-intensive and time-consuming. Our study utilized transformer-based language models to automate the classification of food processing levels according to the NOVA classification system in the Canada, Argentina, and US national food databases. We showed that fine-tuned language models using the ingredient list text found on food labels as inputs achieved a high overall accuracy (F1 score of 0.979) in predicting the food processing levels of Canadian food products, outperforming traditional machine learning models using structured nutrient data and bag-of-words. Most of the food categories reached a prediction accuracy of 0.98 using a fined-tuned language model, especially for predicting processed foods and ultra-processed foods. Our automation strategy was also effective and generalizable for classifying food products in the Argentina and US databases, providing a cost-effective approach for policymakers to monitor and regulate the UPFs in the global food supply.
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Affiliation(s)
- Guanlan Hu
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (G.H.); (N.F.)
| | - Nadia Flexner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (G.H.); (N.F.)
| | | | - Mary R. L’Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (G.H.); (N.F.)
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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:nu15051295. [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] [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
- Correspondence: ; Tel.: +81-3-5841-7872; Fax: +81-3-5841-7873
| | | | - 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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5
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Mulligan C, Lee JJ, Vergeer L, Ahmed M, L'Abbé MR. Evaluating the potential implications of canadian front-of-pack labelling regulations in generic and branded food composition databases. BMC Public Health 2022; 22:1866. [PMID: 36203128 PMCID: PMC9535871 DOI: 10.1186/s12889-022-14269-4] [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: 12/16/2021] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Canada proposed the implementation of mandatory front-of-pack (FOP) labelling regulations, whereby foods meeting or exceeding thresholds for nutrients-of-concern (i.e., total sugars, saturated fat, sodium) must display a ‘high-in’ FOP symbol (FOP). The objective of the study was to evaluate the potential implications of the proposed regulations using Canadian generic and branded food composition databases. Methods A generic food composition database of products consumed by Canadians, Canadian Nutrient File (CNF) 2015 (n = 3,677), and a branded food composition database of packaged foods and beverages, Food Label Information Program (FLIP) 2017 (n = 17,521), were used to evaluate the number and proportion of foods that would display a FOP symbol based on the details of the proposed FOP labelling regulations published in 2018. Results Overall, 35.5% (n = 1,306) of products in CNF 2015 and 63.9% (n = 11,193) of products in FLIP 2017 would display a FOP symbol for at least one nutrient-of-concern exceeding proposed thresholds. Soups, Combination Dishes, and Desserts categories in CNF 2015 and Combination dishes, Soups, and Meats categories in FLIP 2017 would have the highest proportion of products that would display a FOP symbol. Although displaying a FOP symbol for one nutrient was most common in both CNF 2015 (n = 992; 27.0%) and FLIP 2017 (n = 7,296, 41.6%), the number (i.e., 0–3) and type (i.e., saturated fat, sodium, total sugar) of nutrients displayed varied by food category. Conclusion While the generic database, containing both packaged and unpackaged foods, revealed a low prevalence of foods that would display a FOP symbol, the branded database showed that the proposed FOP labelling regulations would identify over 60% of packaged foods with excess contents of nutrients-of-concern. Considering the high prevalence of packaged foods in Canada that would meet or exceed the thresholds of nutrients-of-concern, the proposed FOP labelling regulations should be implemented in a timely manner to help consumers easily identify foods high in nutrients-of-concern and encourage manufacturer-driven product reformulations. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14269-4.
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Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, Room 5368, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada
| | - Jennifer J Lee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, Room 5368, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, Room 5368, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, Room 5368, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, University of Toronto, University of Toronto, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, Room 5368, 1 King's College Circle, M5S 1A8, Toronto, ON, Canada.
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6
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Panahi S, Jones W, Duncan AM, Ferland G, Keller HH, Grantham A, House JD. Guidance and perspectives on highly processed foods. Appl Physiol Nutr Metab 2022; 47:1038-1044. [PMID: 35926234 DOI: 10.1139/apnm-2022-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Guidance from Health Canada to limit highly processed foods (HPF) seeks to ensure that Canadians remain within intake recommendations for nutrients of concern. However, HPF can contribute to dietary requirements of specific populations. The Canadian Nutrition Society and Institute for the Advancement of Food and Nutritional Sciences convened speakers for a Food for Health workshop in 2021 to provide evidence and perspectives from government, industry, and healthcare on reasons for advocating limits and potential unintended consequences of limiting HPF, and implications and necessity of HPF in clinical settings. This paper discusses advantages and disadvantages of HPF explored at this workshop.
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Affiliation(s)
- Shirin Panahi
- Laval University, 4440, 2300 rue de la Terrasse, PEPS, Quebec, Quebec, Canada;
| | - Wendelyn Jones
- Institute for the Advancement of Food and Nutrition Sciences, Washington, D.C., United States;
| | | | - Guylaine Ferland
- Université de Montréal, 5622, Département de Nutrition, Montréal, Quebec, Canada;
| | | | | | - James D House
- University of Manitoba, Food and Human Nutritional Sciences, Winnipeg, Manitoba, Canada;
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7
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Rego RA. Ultra-Processed: The Search of Positioning From the Food Industry Regulatory Authorities. Front Nutr 2022; 9:906561. [PMID: 35734375 PMCID: PMC9207195 DOI: 10.3389/fnut.2022.906561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
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Vergeer L, Ahmed M, Vanderlee L, Mulligan C, Weippert M, Franco-Arellano B, Dickinson K, Bernstein JT, Labonté MÈ, L'Abbé MR. The relationship between voluntary product (re) formulation commitments and changes in the nutritional quality of products offered by the top packaged food and beverage companies in Canada from 2013 to 2017. BMC Public Health 2022; 22:271. [PMID: 35144589 PMCID: PMC8832833 DOI: 10.1186/s12889-022-12683-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Food companies shape Canada’s food supply through voluntary actions and commitments concerning product (re)formulation; however, the extent that these initiatives translate into actual improvements in nutritional quality is unclear. This study examined changes in the nutritional quality of products offered by the top 22 packaged food and beverage companies in Canada from 2013 to 2017, in relation to the strength of their product (re) formulation actions and commitments. Methods The Food Company Reformulation (FCR) scoring tool was used to quantify the strength of companies’ reported recent actions and commitments to reduce energy and nutrients of concern in their products, with higher scores signifying stronger voluntary actions/commitments. Nutritional information for products was sourced from the University of Toronto FLIP 2013 (n = 6490) and 2017 (n = 8277) databases (n = 4074 matched products). Changes in product healthfulness were assessed using the Health Star Rating (HSR) system (with higher HSRs denoting healthier products) and calories, sodium, saturated fat, trans fat, and total and free sugar levels per 100 g/mL. Generalized estimating equations examined changes in nutritional quality in relation to FCR scores. Results Overall, mean HSRs increased significantly for 5 companies’ product portfolios and were reduced in 1 company’s product portfolio. There were significant reductions in calories, sodium, saturated fat in 2 companies’ portfolios and increases in 4, 3, and 8 companies’ portfolios, respectively. Trans fats increased significantly in 2 companies’ portfolios. Total and free sugars decreased significantly in 4 and 5 companies’ portfolios, respectively, and increased in 1 company’s portfolio. There was little change in the healthfulness of matched products. Higher FCR scores were not associated with greater increases in HSRs, or reductions in calories or nutrient amounts. FCR scores were negatively associated with HSRs and positively associated with total and free sugars. No relationship was observed between FCR scores and calories, sodium, saturated fat or trans fat. Conclusions Reporting stronger voluntary product (re) formulation actions and commitments was not associated with greater improvements in the healthfulness of products offered by Canada’s leading packaged food and beverage companies from 2013 to 2017, suggesting a need for stronger industry initiatives or mandatory government interventions to improve the healthfulness of the food supply. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12683-2.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Centre nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels, École de nutrition, Université Laval, Pavillon des Services, 2440 boul. Hochelaga, Québec, Québec, G1V 0A6, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Faculty of Health Science, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, G.P.O. Box 2100, Adelaide, SA, 5001, Australia
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Centre nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels, École de nutrition, Université Laval, Pavillon des Services, 2440 boul. Hochelaga, Québec, Québec, G1V 0A6, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
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Dicken SJ, Batterham RL. The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake, Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies. Nutrients 2021; 14:23. [PMID: 35010898 PMCID: PMC8747015 DOI: 10.3390/nu14010023] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 12/11/2022] Open
Abstract
Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional quality, is debated. Higher UPF intakes are inversely associated with fruit, vegetables, legumes and seafood consumption. Therefore, the association between UPFs and poor health could simply be from excess nutrient intake or from a less healthful dietary pattern. If so, adjustment for dietary quality or pattern should explain or greatly reduce the size of the significant associations between UPFs and health-related outcomes. Here, we provide an overview of the literature and by using a novel approach, review the relative impact of adjusting for diet quality/patterns on the reported associations between UPF intake and health-related outcomes in prospective cohort studies. We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern. Our findings suggest that the adverse consequences of UPFs are independent of dietary quality or pattern, questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.
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Affiliation(s)
- Samuel J. Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK;
| | - Rachel L. Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK;
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), London NW1 2BU, UK
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), London W1T 7DN, UK
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10
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Food Waste and Nutrition Quality in the Context of Public Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105379. [PMID: 34070070 PMCID: PMC8158126 DOI: 10.3390/ijerph18105379] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023]
Abstract
Food waste and nutrition are intrinsically linked in terms of environmental health and public health. Despite this, it is unknown whether these topics have been previously synthesized into a review. The aim was to identify the interdisciplinary parameters that exist in public health and nutrition literature in terms of food waste and plastic waste associated with food, and to identify how these parameters currently contribute to food sustainability messaging and interventions. A rapid scoping review was conducted. Data were mapped into concepts and synthesized in a narrative review. Four main concepts were identified: (1) food waste and diet quality, nutrient losses, and environmental health, (2) food waste reduction interventions and diet quality, (3) food banks/pantries and diet/nutritional quality, and (4) food and plastic waste messaging in nutrition or dietary guidelines. Food waste is associated with nutrient wastage, and interventions to reduce food waste can successfully address food sustainability and nutrition quality. Food redistribution systems do not currently address access to sustainably sourced foods that are also nutrient-dense for lower-income communities. Opportunities for future research and practice include aligning food waste, plastic waste, and nutrition priorities together and developing better food redistribution systems to limit wastage of high-quality foods.
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Griffin J, Albaloul A, Kopytek A, Elliott P, Frost G. Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study. BMJ Nutr Prev Health 2021; 4:174-180. [PMID: 34308125 PMCID: PMC8258022 DOI: 10.1136/bmjnph-2020-000225] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort. DESIGN Cross-sectional. SETTING Occupational cohort. PARTICIPANTS 53 163 British police force employees enrolled (2004-2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study. MAIN OUTCOME MEASURES A CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake. RESULTS In this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=-0.32, p<0.001), fibre (r=-0.20, p<0.001) and protein (r = -0.40, p<0.001) and positively correlated with fat (r=0.18, p<0.001), saturated fat (r=0.14, p<0.001) and nmes (r=0.10, p<0.001) intake. Multivariable analysis suggests a positive association between ultraprocessed food (NOVA 4) consumption and CMR. However, this main effect was no longer observed after adjustment for diet quality (p=0.209). Findings from mediation analysis indicate that the effect of ultraprocessed food (NOVA 4) intake on CMR is mediated by diet quality (p<0.001). CONCLUSIONS Ultraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.
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Affiliation(s)
- Jennifer Griffin
- Nutrition and Dietetics Research Group, Imperial College London, London, London, UK
| | - Anwar Albaloul
- Nutrition and Dietetics Research Group, Imperial College London, London, London, UK
| | - Alexandra Kopytek
- Nutrition and Dietetics Research Group, Imperial College London, London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Gary Frost
- Nutrition and Dietetics Research Group, Imperial College London, London, London, UK
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Vergeer L, Franco-Arellano B, Tjong GB, Bernstein JT, L’Abbé MR. The Level of Processing, Nutritional Composition and Prices of Canadian Packaged Foods and Beverages with and without Gluten-Free Claims. Nutrients 2021; 13:nu13041183. [PMID: 33918418 PMCID: PMC8066194 DOI: 10.3390/nu13041183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 12/27/2022] Open
Abstract
Little is known about the healthfulness and cost of gluten-free (GF) foods, relative to non-GF alternatives, in Canada. This study compared the extent of processing, nutritional composition and prices of Canadian products with and without GF claims. Data were sourced from the University of Toronto Food Label Information Program (FLIP) 2013 (n = 15,285) and 2017 (n = 17,337) databases. Logistic regression models examined the association of NOVA processing category with GF claims. Calorie/nutrient contents per 100 g (or mL) were compared between GF and non-GF products. Generalized linear models compared adjusted mean prices per 100 g (or mL) of products with and without GF claims. The prevalence of GF claims increased from 7.1% in 2013 to 15.0% in 2017. GF claims appeared on 17.0% of ultra-processed foods, which were more likely to bear GF claims products than less-processed categories. Median calories and sodium were significantly higher in GF products; no significant differences were observed for saturated fat or sugars. Compared to non-GF products, adjusted mean prices of GF products were higher for 10 food categories, lower for six categories and not significantly different for six categories. Overall, GF claims are becoming increasingly prevalent in Canada; however, they are often less healthful and more expensive than non-GF alternatives, disadvantaging consumers following GF diets.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada
| | - Gabriel B. Tjong
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Jodi T. Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Mary R. L’Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
- Correspondence: ; Tel.: +1-416-946-7545
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13
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Mulligan C, Franco-Arellano B, Ahmed M, Vergeer L, Dickinson K, L'Abbé MR. Comparing how Canadian packaged food products align with the 2007 and 2019 versions of Canada's Food Guide. Appl Physiol Nutr Metab 2021; 46:934-944. [PMID: 33596121 DOI: 10.1139/apnm-2020-0620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In 2019, Canada's Food Guide (CFG) was updated from the 2007 version. This study developed a food-based nutrient profile model (NPM) to evaluate the alignment of packaged food and beverage products with CFG 2019 and compared it with CFG 2007. Packaged products from the University of Toronto's Food Label Information Program 2017 database were evaluated in terms of their alignment with CFG 2007 (using the Health Canada Surveillance Tool (HCST)) and CFG 2019 (using our newly developed CFG 2019 NPM). Agreement in alignment (e.g., products "in line" according to CFG 2019 NPM and in Tiers 1 or 2 according to the HCST) was calculated and differences in alignment and reasons for differences were quantified and described. Overall agreement in product alignment between CFG 2007 and 2019 was 81.9%, with fewer products aligned with CFG 2019: 16.4% vs. 31.8%, (χ2 = 189.12, p < 0.001). Differences in alignment varied across food categories (0.0-73.8%), explained by differences in CFG 2019, reflected in the CFG 2019 NPM (e.g., emphasis on avoiding processed foods, encouraging whole grains and low-fat dairy). This study presents a first step in assessing packaged foods' alignment with CFG 2019; future work is needed to evaluate broader dietary adherence to the updated recommendations. Novelty: A food-based nutrient profile model was developed based on the 2019 CFG and tested on packaged foods by comparing it with the nutrient-based HCST, based on CFG 2007. Most (82%) packaged products were "not in line" with either CFG version.
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Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, Australia
| | - Mary R L'Abbé
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
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Vergeer L, Vanderlee L, Sacks G, Robinson E, Mackay S, Young L, Mulligan C, L'Abbé MR. The Development and Application of a Tool for Quantifying the Strength of Voluntary Actions and Commitments of Major Canadian Food Companies to Improve the Nutritional Quality of Their Products. Curr Dev Nutr 2020; 4:nzaa151. [PMID: 33134791 PMCID: PMC7580911 DOI: 10.1093/cdn/nzaa151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Canada's food supply is high in nutrients of public health concern, contributing to poor diet quality and increased noncommunicable disease risk. Food companies shape the healthfulness of the food supply, yet little is known about companies' voluntary actions and commitments concerning product (re)formulation. OBJECTIVE This study aimed to develop and apply a tool for quantifying the strength of voluntary actions and commitments of major food companies in Canada to improve the healthfulness of their products. METHODS Twenty-two top packaged food and beverage companies were selected based on Canadian market share. Recent actions and/or commitments to reduce energy/portion sizes, sodium, saturated fat, trans fat, and sugars were identified from company websites and public documents, verified by company representatives (where possible), and scored based on breadth of application across the product portfolio, magnitude(s) of reduction, measurability, nutritional significance, national/global applicability, and transparency using the Food Company Reformulation scoring tool. Companies offering beverages only (n = 4) were not assessed for sodium, saturated fat, or trans fat (re)formulation. RESULTS Seventeen of 22 companies reported reductions and/or commitments concerning sodium (72.2%, n = 13/18), trans fat (61.1%, n = 11/18), sugars (59.1%, n = 13/22), saturated fat (55.6%, n = 10/18), and/or energy/portion sizes (50.0%, n = 11/22). Scores ranged from 0/155 to 122/155 for food companies (median = 49/155) and 0/65 to 42/65 for beverage companies (median = 17/65). Companies generally performed best for sodium reduction (median = 21/32; range = 0-32) and poorest for energy/portion-size reductions (median = 2/30; range = 0-24). Multinational companies had significantly higher total scores than domestic companies (P = 0.004). Higher total scores were associated with greater market shares in the beverage manufacturing sector (P = 0.04), but not packaged food (P = 0.50). CONCLUSIONS Many of Canada's leading food companies report limited or no action to reduce nutrients of concern in their products, suggesting a need for government intervention and strengthened accountability mechanisms to encourage alignment of reformulation efforts with government and expert recommendations.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- École de Nutrition, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Pavillon des Services, Quebec City, Quebec, Canada
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Deakin University, Burwood, Victoria, Australia
| | - Ella Robinson
- Global Obesity Centre (GLOBE), Deakin University, Burwood, Victoria, Australia
| | - Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Grafton, Auckland, New Zealand
| | - Leanne Young
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Grafton, Auckland, New Zealand
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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