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Cristancho C, Mogensen KM, Robinson MK. Malnutrition in patients with obesity: An overview perspective. Nutr Clin Pract 2024. [PMID: 39439423 DOI: 10.1002/ncp.11228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 09/21/2024] [Accepted: 09/23/2024] [Indexed: 10/25/2024] Open
Abstract
Malnutrition in patients with obesity presents a complex and often overlooked clinical challenge. Although obesity is traditionally associated with overnutrition and excessive caloric intake, it can also coincide with varying degrees of malnutrition. The etiopathogenesis of obesity is multifaceted and may arise from several factors such as poor diet quality, nutrient deficiencies despite excess calorie consumption, genetics, and metabolic abnormalities affecting nutrient absorption and utilization. Moreover, a chronic low-grade inflammatory state resulting from excess adipose tissue, commonly observed in obesity, can further exacerbate malnutrition by altering nutrient metabolism and increasing metabolic demands. The dual burden of obesity and malnutrition poses significant risks, including immune dysfunction, delayed wound healing, anemia, metabolic disturbances, and deficiencies in micronutrients such as vitamin D, iron, magnesium, and zinc, among others. Malnutrition is often neglected or not given enough attention in individuals with obesity undergoing rapid weight loss through aggressive caloric restriction, pharmacological therapies, and/or surgical interventions. These factors often exacerbate vulnerability to nutrition deficiencies. We advocate for healthcare practitioners to prioritize nutrition assessment and initiate medical intervention strategies tailored to address both excessive caloric intake and insufficient consumption of essential nutrients. Raising awareness among healthcare professionals and the general population about the critical role of adequate nutrition in caring for patients with obesity is vital for mitigating the adverse health effects associated with malnutrition in this population.
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Affiliation(s)
- Cagney Cristancho
- Department of Surgery, Nutrition Support Service, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Kris M Mogensen
- Department of Nutrition, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Malcolm K Robinson
- Department of Surgery, Nutrition Support Service, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Mete B, Sadıkoğlu HM, Demirhindi H, Melekoglu E, Barutcu A, Makca T, Atun Utuk F. The association between ultra-processed food consumption and low-grade inflammation in childhood: A cross-sectional study. NUTR BULL 2024. [PMID: 39397283 DOI: 10.1111/nbu.12711] [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: 04/24/2024] [Revised: 09/05/2024] [Accepted: 09/19/2024] [Indexed: 10/15/2024]
Abstract
This study aimed to investigate the relationship between the amount of ultra-processed food (UPF) in the diet and low-grade inflammation in children. This cross-sectional study was conducted in 50 healthy children recruited from children attending the Social Paediatrics Outpatient Clinic for follow-up of normal developmental stages. Low-grade inflammation was calculated by INFLA-score, dietary intake by three 24-h dietary recalls and dietary content analyses by BeBiS™ software. The mean age of the 50 children included in our study was 10.18 ± 3.98 years (5-17 years). UPF accounted for 24.5% of the total daily energy intake of children. In children with higher inflammation scores (INFLA-score ≥ 2), the amount in grams of UPF and the percentage of total energy from UPF were found to be significantly higher (p = 0.030 and p = 0.015, respectively). A weak positive correlation was found between the INFLA-score and the percentage of daily dietary energy intake coming from UPFs (r = 0.350, p < 0.01), the average daily energy intake from UPFs (r = 0.313, p < 0.05), and the average daily amount of UPF consumed (r = 0.260, p < 0.05). The linear regression model revealed that every one-unit increase (1%) in the percentage of total daily energy intake coming from UPF caused an increase in β = 0.154-unit in the INFLA-score. It was found that obesity was not a mediator in the association between the percentages of total energy intake from UPF on the INFLA-score, instead, the energy intake from UPF had a significant direct association with the INFLA-score. The average amount of UPF consumed daily showed an increasing pattern in parallel with inflammation-score quartile classes (Q1 to Q4) with 33.3% in Q1, 38.5% in Q2, 53.8% in Q3 and 66.7% in Q4 (p = 0.049). In conclusion, a positive association was found between low-grade inflammation and UPF consumption in children, independent of obesity.
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Affiliation(s)
- Burak Mete
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey
| | | | - Hakan Demirhindi
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ebru Melekoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Adnan Barutcu
- Department of Child Health and Diseases, Department of Social Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Tuba Makca
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Fatma Atun Utuk
- Department of Family Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey
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Zhao H, Bai Y, Liu Y, Xing Y, Yan Y, Chen G, Chen J, Wang X, Chen C, Zhang Z. Association of ultraprocessed food consumption with risk of rheumatoid arthritis: a retrospective cohort study in the UK Biobank. Am J Clin Nutr 2024; 120:927-935. [PMID: 39163975 DOI: 10.1016/j.ajcnut.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/02/2024] [Accepted: 08/16/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Limited studies explored the association between consumption of ultraprocessed food (UPF) and rheumatoid arthritis (RA). OBJECTIVES This study aimed to examine the association between UPF consumption and RA risk and explore the potential mediating effects of RA-related biomarkers. METHODS This retrospective cohort study included 207,012 participants without RA at recruitment and completed 24-h dietary recalls. UPF was defined based on the NOVA food classification system. Incident RA was ascertained using the International Classification of Diseases version 10. Cox regression models were used to examine the association between UPF consumption and the incidence of RA. Additionally, mediation analyses were conducted to evaluate the contribution of biomarkers related to the lipid profile, systemic inflammatory factors, serum liver enzymes, and glucose metabolism to the observed associations. RESULTS The participants' mean (standard deviation [SD]) age at recruitment was 56.08 (7.95) y. During a median follow-up of 12.24 (interquartile range: 11.66-13.03) y, 1869 RA events were recorded. Compared with the lowest quintile of UPF consumption (weight percentage of the UPF), the adjusted hazard ratio (HR) of RA in the highest quintile was 1.17 (95% confidence interval (CI): 1.01, 1.36). There was a 6% elevated risk of RA incidence per SD increase in UPF intake (HR: 1.06; 95% CI: 1.01, 1.11). In the mediation analyses, the biomarkers explained 3.07%-14.80% of the association between UPF intake and RA. CONCLUSIONS Higher UPF consumption was associated with an increased risk of RA, which may be mediated by inflammation, lipids, and liver enzymes. Lower UPF consumption is recommended to reduce RA incidence.
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Affiliation(s)
- Haodong Zhao
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yujie Bai
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yujie Liu
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yifei Xing
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yilin Yan
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Guochong Chen
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Jingsi Chen
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Xiaodong Wang
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China; Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou, China
| | - Cailong Chen
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
| | - Zheng Zhang
- Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
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Du S, Chen J, Kim H, Lichtenstein AH, Yu B, Appel LJ, Coresh J, Rebholz CM. Protein Biomarkers of Ultra-Processed Food Consumption and Risk of Coronary Heart Disease, Chronic Kidney Disease, and All-Cause Mortality. J Nutr 2024:S0022-3166(24)01016-2. [PMID: 39299474 DOI: 10.1016/j.tjnut.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/01/2024] [Accepted: 08/01/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND There is a need to understand the underlying biological mechanisms through which ultra-processed foods negatively affect health. Proteomics offers a valuable tool with which to examine different aspects of ultra-processed foods and their impact on health. OBJECTIVES The aim of this study was to identify protein biomarkers of usual ultra-processed food consumption and assess their relation to the incidence of coronary heart disease (CHD), chronic kidney disease (CKD), and all-cause mortality risk. METHODS A total of 9361 participants from the Atherosclerosis Risk in Communities visit 3 (1993-1995) were included. Dietary intake was assessed using a 66-item food-frequency questionnaire and the processing levels were categorized on the basis of the Nova classification. Plasma proteins were detected using an aptamer-based proteomic assay. We used multivariable linear regressions to examine the association between ultra-processed food and proteins, and Cox proportional hazard models to identify associations between ultra-processed food-related proteins and health outcomes. Models extensively controlled for sociodemographic characteristics, health behaviors, and clinical factors. RESULTS Eight proteins (6 positive, 2 negative) were identified as significantly associated with ultra-processed food consumption. Over a median follow-up of 22 y, there were 1276, 3084, and 5127 cases of CHD, CKD, and death, respectively. Three, 5, and 3 ultra-processed food-related proteins were associated with each outcome, respectively. One protein (β-glucuronidase) was significantly associated with a higher risk of all 3 outcomes, and 3 proteins (receptor-type tyrosine-protein phosphatase U, C-C motif chemokine 25, and twisted gastrulation protein homolog 1) were associated with a higher risk of 2 outcomes. CONCLUSIONS We identified a panel of protein biomarkers that were significantly associated with ultra-processed food consumption. These proteins may be considered potential biomarkers for ultra-processed food intake and may elucidate the biological processes through which ultra-processed foods impact health outcomes.
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Affiliation(s)
- Shutong Du
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jingsha Chen
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Hyunju Kim
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States
| | - Alice H Lichtenstein
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Bing Yu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Josef Coresh
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States; Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
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Lane MM, Travica N, Gamage E, Marshall S, Trakman GL, Young C, Teasdale SB, Dissanayaka T, Dawson SL, Orr R, Jacka FN, O'Neil A, Lawrence M, Baker P, Rebholz CM, Du S, Marx W. Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies. Annu Rev Nutr 2024; 44:383-404. [PMID: 39207876 DOI: 10.1146/annurev-nutr-062322-020650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classes III and IV), and 11 showed no evidence (class V). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health.
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Affiliation(s)
- Melissa M Lane
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Nikolaj Travica
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Elizabeth Gamage
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Skye Marshall
- Research Institute for Future Health, Gold Coast, Queensland, Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Gina L Trakman
- Department of Food, Nutrition, and Dietetics, Sport, Performance, and Nutrition Research Group, La Trobe University, Melbourne, Victoria, Australia
| | - Claire Young
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Scott B Teasdale
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Mindgardens Neuroscience Network, Randwick, New South Wales, Australia
| | - Thusharika Dissanayaka
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Samantha L Dawson
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Rebecca Orr
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Felice N Jacka
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Immunology, Therapeutics, and Vaccines, James Cook University, Townsville, Queensland, Australia
| | - Adrienne O'Neil
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Phillip Baker
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shutong Du
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wolfgang Marx
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia;
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Wiss DA, LaFata EM. Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle? Nutrients 2024; 16:1955. [PMID: 38931309 PMCID: PMC11206753 DOI: 10.3390/nu16121955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.
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Affiliation(s)
- David A. Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
- Nutrition in Recovery LLC, 1902 Westwood Blvd. #201, Los Angeles, CA 90025, USA
| | - Erica M. LaFata
- Center for Weight Eating and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA 19104, USA;
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Werneck AO, Steele EM, Delpino FM, Lane MM, Marx W, Jacka FN, Stubbs B, Touvier M, Srour B, Louzada ML, Levy RB, Monteiro CA. Adherence to the ultra-processed dietary pattern and risk of depressive outcomes: Findings from the NutriNet Brasil cohort study and an updated systematic review and meta-analysis. Clin Nutr 2024; 43:1190-1199. [PMID: 38613906 DOI: 10.1016/j.clnu.2024.03.028] [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: 12/21/2023] [Revised: 02/24/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND & AIMS We aimed to analyze the prospective association between adherence to the ultra-processed dietary pattern and risk of depressive outcomes using original data from the NutriNet Brasil cohort and via a systematic review and meta-analysis of observational studies that have investigated the same association. METHODS In our original research analysis, we used data from 15,960 adults (≥18 y) participating in the NutriNet Brasil cohort study, free of depression or depressive symptoms during the baseline (77.5% women, 45.8 ± 13.0 y). The mean dietary share of ultra-processed foods (%Kcal/d), calculated from two baseline 24-h dietary recalls, was used to measure the adherence to the ultra-processed dietary pattern. New cases of depressive symptoms were assessed using the Patient Health Questionnaire-9 over the follow-up period (mean: 18.3 months). Cox proportional hazards models were used for the main analyses. In our systematic review and meta-analysis, we incorporated effect estimates from six prospective cohort studies that have examined the same association, including ours. RESULTS In the adjusted model, each 10% increase in the dietary share of ultra-processed foods was associated with a 10% increase in the hazard of incident cases of depressive symptoms (HR:1.10; 95%CI: 1.07-1.14). This association was slightly attenuated in the models including potential mediators. In our meta-analysis of six prospective studies, high versus low exposure to ultra-processed foods was associated with a summary hazard ratio of depressive outcomes of 1.32; 95%CI: 1.19-1.46; I2: 71%. CONCLUSION A higher adherence to the ultra-processed dietary pattern was associated with a higher risk of developing depressive outcomes in the NutriNet Brasil cohort and in the meta-analysis.
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Affiliation(s)
- André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Euridice M Steele
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Felipe M Delpino
- Postgraduate in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Melissa M Lane
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice N Jacka
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Maria Lc Louzada
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Renata B Levy
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Carlos A Monteiro
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil.
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Price EJ, Du M, McKeown NM, Batterham MJ, Beck EJ. Excluding whole grain-containing foods from the Nova ultraprocessed food category: a cross-sectional analysis of the impact on associations with cardiometabolic risk measures. Am J Clin Nutr 2024; 119:1133-1142. [PMID: 38417577 DOI: 10.1016/j.ajcnut.2024.02.017] [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: 12/22/2023] [Revised: 02/08/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Whole grain (WG) consumption is linked with a reduced risk of chronic disease. However, the recommendations of the Nova classification system tend to contradict this evidence as high WG-containing foods, such as bread and cereals, are considered ultraprocessed, and intake is discouraged. OBJECTIVES This study aimed to explore associations of cardiometabolic risk measures with ultraprocessed food (UPF) intake as classified by Nova compared with when foods with ≥25% and ≥50% WG are removed from the Nova UPF category. METHODS A cross-sectional analysis of the 2015-18 National Health and Nutrition Examination Survey. Nova was used to identify UPFs, and the WG Initiative's definition of a WG food and front-of-pack labeling requirements was used to identify high WG foods. Regression models were used to explore impacts on the association of UPF intake (quintiles) and cardiometabolic risk measures when high WG foods were excluded from the Nova UPF category. RESULTS Participants in the highest quintile of UPF intake had significantly higher weight [83.6 kg (0.8)], BMI (in kg/m2) [30.6 (0.3)], waist circumference [103.1 cm (0.6)], and weight-to-height ratio [0.63 (0.003)] compared to those in the lowest quintile (P < 0.0001 for all). The same was found when foods with ≥25% and ≥50% WG were removed. Positive associations for C-reactive protein were found when ≥25% and ≥50% WG-containing foods were removed only [2.32 mg/L (0.1), P = 0.0209; 2.37 mg/L (0.1), P = 0.0179, respectively]. Participants in the highest quintile had significantly lower total cholesterol after adjustment when foods with ≥50% WG were removed [4.98 mmol/L (0.04), P = 0.0292]. Adjusted R2 values remained relatively unchanged across each approach for all outcomes. CONCLUSIONS Foods high in WG may not significantly contribute to the deleterious associations previously observed between UPF intake and cardiometabolic risk factors. Consideration of their contribution to healthful dietary patterns and diet quality in the United States population should be made prior to the endorsement of Nova.
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Affiliation(s)
- Elissa J Price
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Mengxi Du
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicola M McKeown
- Programs in Nutrition, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Marijka J Batterham
- National Institute for Applied Statistics Research Australia and Statistical Consulting Centre, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Eleanor J Beck
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Medical, Indigenous, and Health Sciences, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, NSW, Australia.
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9
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Goldstein MR, Mascitelli L. Inflammation, infection, and cardiovascular risk. Lancet 2024; 403:1023-1024. [PMID: 38492938 DOI: 10.1016/s0140-6736(23)02875-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 12/21/2023] [Indexed: 03/18/2024]
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Warren M, O'Connor C, Lee JE, Burton J, Walton D, Keathley J, Wammes M, Osuch E. Predispose, precipitate, perpetuate, and protect: how diet and the gut influence mental health in emerging adulthood. Front Nutr 2024; 11:1339269. [PMID: 38505265 PMCID: PMC10948435 DOI: 10.3389/fnut.2024.1339269] [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: 11/15/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024] Open
Abstract
Medicine often employs the 4Ps of predisposing, precipitating, perpetuating, and protective factors to identify salient influences on illness states, and to help guide patient care. Mental illness is a significant cause of morbidity and mortality worldwide. Mental health is a complex combination of biological, psychological, environmental, and social factors. There is growing interest in the gut-brain-microbiome (GBM) axis and its impact on mental health. We use the medical model of the 4Ps to explore factors involving the connection between nutrition and the GBM axis and their associated risks with mental health problems in emerging adults (EAs), a life stage when mental illness onset is the most common. We review the impact of current dietary trends on the GBM and on mental health, and the role that gut microbiome-based interventions can have in modulating the GBM axis of EAs. We discuss the implications of gut health on the GBM and areas for clinical intervention.
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Affiliation(s)
- Michael Warren
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Ju Eun Lee
- Geriatrics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeremy Burton
- Department of Surgery, Microbiology and Immunology, Lawson Health Research Institute, Western University, London, ON, Canada
| | - David Walton
- School of Physical Therapy, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Justine Keathley
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Michael Wammes
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Elizabeth Osuch
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- London Health Sciences Centre, Lawson Health Research Institute, London, ON, Canada
- First Episode Mood and Anxiety Program, London Health Sciences Centre, London, ON, Canada
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11
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Prescott SL, Logan AC, D’Adamo CR, Holton KF, Lowry CA, Marks J, Moodie R, Poland B. Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:120. [PMID: 38397611 PMCID: PMC10888116 DOI: 10.3390/ijerph21020120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.
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Affiliation(s)
- Susan L. Prescott
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia;
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- The ORIGINS Project, Telethon Kids Institute, Perth, WA 6009, Australia
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA;
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Christopher A. Lowry
- Department of Psychology and Neuroscience, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - John Marks
- Department of Criminal Justice, Louisiana State University of Alexandria, Alexandria, LA 71302, USA;
| | - Rob Moodie
- School of Population and Global Health (MSPGH), University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5R 0A3, Canada;
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12
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Zhao L, Clay-Gilmour A, Zhang J, Zhang X, Steck SE. Higher ultra-processed food intake is associated with adverse liver outcomes: a prospective cohort study of UK Biobank participants. Am J Clin Nutr 2024; 119:49-57. [PMID: 37871746 DOI: 10.1016/j.ajcnut.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) intake has been positively associated with obesity and diabetes. The relationship between UPF intake and liver health has been scarcely studied. OBJECTIVES We aimed to evaluate the association of UPF intake with risk of adverse liver outcomes including nonalcoholic fatty liver disease (NAFLD), liver fibrosis/cirrhosis, liver cancer, severe liver disease, and serum biomarkers of liver health. METHODS A total of 173,889 participants aged 40 to 69 y from the UK Biobank were included. UPF intake was defined using 24-h dietary recalls and NOVA classification. Liver outcome data were obtained from cancer registry, in-hospital records, and death registries. Serum biomarkers were measured at baseline. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between UPF and adverse liver outcomes adjusting for demographics, lifestyle factors, body mass index, and diabetes. We used multinomial logistic regression to evaluate associations between UPF and liver function biomarkers. RESULTS After a median follow-up of 8.9 y, we documented 1108 NAFLD, 350 liver fibrosis/cirrhosis, 134 liver cancer, and 550 severe liver disease cases. Higher UPF intake was associated with increased risk of NAFLD (HRQuartile 4 vs. Quartile 1: 1.43; 95% CI: 1.21, 1.70; Ptrend < 0.001), liver fibrosis/cirrhosis (HR: 1.18; 95% CI: 0.87, 1.59; Ptrend = 0.009), and severe liver disease (HR: 1.50; 95% CI: 1.19, 1.90; Ptrend < 0.001) but not with liver cancer (HR: 1.00; 95% CI: 0.63, 1.58; Ptrend = 0.88). Higher UPF intake was associated with elevated levels of C-reactive protein, alkaline phosphatase, aspartate aminotransferase, γ-glutamyltransferase, and triglycerides and lower cholesterols (all Ptrend < 0.001). CONCLUSIONS Higher UPF intake is associated with an increased risk of NAFLD, liver fibrosis and cirrhosis, and severe liver disease and adverse levels of multiple clinical biomarkers, suggesting the potential importance of reducing UPF intake to improve liver health.
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Affiliation(s)
- Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Alyssa Clay-Gilmour
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xuehong Zhang
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
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13
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Zhao L, Zhang X, Martinez Steele E, Lo CH, Zhang FF, Zhang X. Higher ultra-processed food intake was positively associated with odds of NAFLD in both US adolescents and adults: A national survey. Hepatol Commun 2023; 7:e0240. [PMID: 37655983 PMCID: PMC10476803 DOI: 10.1097/hc9.0000000000000240] [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: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The effect of ultra-processed foods (UPF) on NAFLD remains unclear. Related evidence for adult NAFLD is limited and no study has yet evaluated UPF's impact on NAFLD in adolescence. METHODS We used data from the National Health and Nutrition Examination Survey (2017-2018) with 806 adolescents and 2734 adults. UPF intake was estimated using dietary data from two 24-hour dietary recalls. NAFLD was defined by transient elastography. Logistic regression was used to estimate the multivariable OR and 95% CI for associations between UPF and NAFLD with survey weight adjustments. RESULTS The mean UPF intake was 812 g/d in adolescents and 823 g/d in adults. A total of 12.4% of the adolescents and 35.6% of the adults had NAFLD. Higher UPF intake was associated with higher odds of NAFLD in both adolescents (OR Quintile 5 vs. Quartile 1 = 2.34, 95% CI, 1.01, 5.41; ptrend = 0.15) and adults (OR Quintile 5 vs. Quintile 1 = 1.72, 95% CI, 1.01, 2.93; ptrend = 0.002). In adults, ~68% and 71% of the association between UPF intake and NAFLD was mediated by body mass index and waist circumference (all p-values < 0.001), respectively. The results were similar for adolescents but not statistically significant. A higher UPF intake was associated with lower levels of serum albumin and higher levels of C-reactive protein in adults. CONCLUSIONS Higher UPF intake was linked to higher NAFLD odds in both adolescents and adults, mainly because of elevated body fatness. If confirmed, reducing UPF intake may help prevent NAFLD in both adolescents and adults.
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Affiliation(s)
- Longgang Zhao
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Euridice Martinez Steele
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Chun-Han Lo
- Internal Medicine and Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Nevada, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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14
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Yuan S, Chen J, Fu T, Li X, Bruzelius M, Åkesson A, Larsson SC. Ultra-processed food intake and incident venous thromboembolism risk: Prospective cohort study. Clin Nutr 2023; 42:1268-1275. [PMID: 37348154 DOI: 10.1016/j.clnu.2023.06.016] [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: 03/02/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND & AIMS Ultra-processed food (UPF) intake has been associated with multiple health outcomes, but data on the association between UPF intake and venous thromboembolism (VTE) risk are lacking. We conducted this study to examine the association between UPF intake and the risk of incident VTE. METHODS This prospective cohort study was based on 186,323 participants free of baseline VTE from the UK Biobank. UPF intake was assessed by 24-h recall questionnaires. Data on incident VTE came from the nationwide inpatient and primary care datasets and the death registry. Cox proportional hazards regression was used to estimate the association between UPF intake and incident VTE risk. Multiplicative interactions and stratified analyses by age, sex, and body mass index were performed. RESULTS During a 10.5-year (median) follow-up, 4235 incident VTE cases were diagnosed. After adjusting for covariates, the hazard ratio of VTE among individuals with the highest quintile of UPF intake was 1.05 (95% confidence interval [CI] 0.94, 1.17) for UPF in servings, 1.12 (95% CI 1.01, 1.24) in grams, 1.10 (95% CI 1.00, 1.22) in grams %, 1.21 (95% CI 1.10, 1.33) in energy, and 1.15 (95% CI 1.05, 1.27) in energy % compared to those in the lowest quintile. Age, sex, and body mass index did not modify the associations (Pinteraction > 0.05). CONCLUSIONS Higher UPF intake was associated with a moderately increased risk of VTE.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Jie Chen
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tian Fu
- Department of Gastroenterology, Central South University, Changsha, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Maria Bruzelius
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Coagulation Unit, Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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15
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Ebrahimi Z, Shojaeian Z, Amiri F, Esmaillzadeh A, Sadeghi O, Esteghamati A, Jahed SA, Sedaghat S. Association of major dietary patterns with advanced glycation end products and high-sensitivity C-reactive protein in people with type 1 diabetes mellitus. Nutr J 2023; 22:37. [PMID: 37496018 PMCID: PMC10369805 DOI: 10.1186/s12937-023-00860-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/22/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The associations of diet with serum levels of advanced glycation end products (AGEs) and high-sensitivity C-reactive protein (hs-CRP) have been examined in patients with type 2 diabetes mellitus (T2DM). However, data on patients with type 1 diabetes mellitus (T1DM) are limited. Therefore, this study was conducted to investigate the associations of major dietary patterns with serum levels of AGEs and hs-CRP among patients with T1DM. METHODS A total of 229 patients with T1DM participated in this current cross-sectional study. We collected dietary data using a validated food frequency questionnaire (FFQ). The factor analysis approach was used to determine major dietary patterns. A fasting blood sample was collected from each participant to assess serum levels of AGEs and hs-CRP. The associations of dietary patterns with elevated levels of AGEs and hs-CRP were assessed using binary logistic regression. RESULTS Patients with T1DM in the highest tertile of a Western dietary pattern had 4.32 times higher odds of having elevated AGEs than those in the lowest tertile (OR: 4.32, 95% CI: 1.86-10.05). Additionally, adherence to the Western diet was associated with 2.97 times greater odds of having elevated hs-CRP (> 3 mg/L) (OR: 2.97, 95% CI: 1.22-7.24) in these patients. Such positive associations were not observed for unhealthy and traditional dietary patterns. Moreover, higher adherence to a semi-healthy diet (characterized by high consumption of white meat, whole grains, processed meat, and a low salt intake) was associated with 87% lower odds of having elevated hs-CRP (OR: 0.13, 95% CI: 0.05-0.35). However, we found no significant association between the semi-healthy diet and AGEs levels. CONCLUSION We found that adherence to a Western dietary pattern was associated with elevated levels of AGEs/hs-CRP in patients with T1DM. Also, we discovered a significant inverse association between adherence to a semi-healthy diet and hs-CRP levels.
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Affiliation(s)
- Zohreh Ebrahimi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Shojaeian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Sadeghi
- Nutrition and Food Security Research Center, Department of Community Nutrition, Student Research Committee, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Internal Medicine Department, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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16
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Dinu M, Martini D. Ultra-Processed Foods, Diet Quality and Human Health. Nutrients 2023; 15:2890. [PMID: 37447216 DOI: 10.3390/nu15132890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
The increase in the volume of industrially processed products in the global food supply has coincided with an increasing prevalence of obesity and non-communicable diseases in many countries, suggesting that ultra-processed foods (UPF) consumption may be detrimental to human health [...].
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20122 Milan, Italy
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17
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Lian Y, Wang GP, Chen GQ, Chen HN, Zhang GY. Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis. Front Nutr 2023; 10:1175994. [PMID: 37360305 PMCID: PMC10285062 DOI: 10.3389/fnut.2023.1175994] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Despite increasing evidence that has shown the association of ultra-processed foods (UPFs) with cancer risk, the results remain inconclusive. We, therefore, conducted the meta-analysis to clarify the association by including recently published studies. Methods A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies from inception to January 2023. To pool data, fixed-effects or random-effects models were used where appropriate. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. Results A total of 13 studies (4 cohort studies and 9 case-control studies) were included in the analysis, with a total of 625,738 participants. The highest UPFs consumption was associated with increased risk of colorectal cancer (OR = 1.23, 95% CI: 1.10-1.38), colon cancer (OR = 1.25, 95% CI: 1.14-1.36), and breast cancer (OR = 1.10, 95% CI: 1.00-1.20) but not rectal cancer (OR = 1.18, 95% CI: 0.97-1.43) and prostate cancer (OR = 1.03, 95% CI: 0.93-1.12). In addition, the subgroup analyses showed that a positive association between UPFs consumption and colorectal cancer was observed among men (OR = 1.31, 95% CI: 1.15-1.50), whereas no significant association was observed among women (OR = 1.10, 95% CI: 0.94-1.29). Conclusion The present meta-analysis suggests that high UPFs consumption is associated with a significantly increased risk of certain site-specific cancers, especially the digestive tract and some hormone-related cancers. However, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.
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Affiliation(s)
- Ying Lian
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Gang-Pu Wang
- Department of General Surgery, The Fourth People's Hospital of Jinan City, Jinan, China
| | - Guo-Qiang Chen
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Hua-Nan Chen
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Guang-Yong Zhang
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
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18
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Lane MM, Lotfalian M, Hodge A, O'Neil A, Travica N, Jacka FN, Rocks T, Machado P, Forbes M, Ashtree DN, Marx W. High ultra-processed food consumption is associated with elevated psychological distress as an indicator of depression in adults from the Melbourne Collaborative Cohort Study. J Affect Disord 2023; 335:57-66. [PMID: 37149054 DOI: 10.1016/j.jad.2023.04.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 04/14/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Few studies have tested longitudinal associations between ultra-processed food consumption and depressive outcomes. As such, further investigation and replication are necessary. The aim of this study is to examine associations of ultra-processed food intake with elevated psychological distress as a marker for depression after 15 years. METHOD Data from the Melbourne Collaborative Cohort Study (MCCS) were analysed (n = 23,299). We applied the NOVA food classification system to a food frequency questionnaire (FFQ) to determine ultra-processed food intake at baseline. We categorised energy-adjusted ultra-processed food consumption into quartiles by using the distribution of the dataset. Psychological distress was measured by the ten-item Kessler Psychological Distress Scale (K10). We fitted unadjusted and adjusted logistic regression models to assess the association of ultra-processed food consumption (exposure) with significant psychological distress (outcome and defined as K10 ≥ 20). We fitted additional logistic regression models to determine whether these associations were modified by sex, age and body mass index. RESULTS After adjusting for sociodemographic characteristics and lifestyle and health-related behaviours, participants with the highest relative intake of ultra-processed food were at increased odds of significant psychological distress compared to participants with the lowest intake (aOR: 1.23; 95%CI: 1.10, 1.38, p for trend = 0.001). We found no evidence for an interaction of sex, age and body mass index with ultra-processed food intake. CONCLUSION Higher ultra-processed food intake at baseline was associated with subsequent elevated psychological distress as an indicator of depression at follow-up. Further prospective and intervention studies are necessary to identify possible underlying pathways, specify the precise attributes of ultra-processed food that confer harm, and optimise nutrition-related and public health strategies for common mental disorders.
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Affiliation(s)
- Melissa M Lane
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia.
| | - Mojtaba Lotfalian
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Adrienne O'Neil
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Nikolaj Travica
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice N Jacka
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, VIC, Australia; Black Dog Institute, NSW, Australia; James Cook University, QLD, Australia
| | - Tetyana Rocks
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia; Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Sao Paulo 01246-904, Brazil
| | - Malcolm Forbes
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia; Mental Health, Drugs & Alcohol Service, University Hospital Geelong, Barwon Health, VIC 3220, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC 3050, Australia
| | - Deborah N Ashtree
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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19
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Lee S, Choi M. Ultra-Processed Food Intakes Are Associated with Depression in the General Population: The Korea National Health and Nutrition Examination Survey. Nutrients 2023; 15:2169. [PMID: 37432323 DOI: 10.3390/nu15092169] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
Depression is the most common mental illnesses worldwide. The consumption of ultra-processed food (UPF) has increased globally due to its affordability and convenience; however, only a few studies have investigated the link between UPF intake and depression in the general population. We investigated the associations between UPF and depression using the Korea National Health and Nutrition Examination Survey. A total of 9463 individuals (4200 males and 5263 females) aged above 19 years old participated in this study. The prevalence of depression was identified using the Patient Health Questionnaire-9. Dietary intake was assessed through a 24-h recall interview. The percentage of energy from UPFs was ascertained based on the NOVA classification. The associations between the quartile ranges of UPF intake and depression were estimated using logistic regression models. Individuals in the highest quartile had a 1.40 times higher likelihood of having depression, with marginal significance (95% confidence intervals (CIs) = 1.00-1.96). In a sex-specific stratification, only females demonstrated a significant association (odds ratio (OR) = 1.51, 95% CI 1.04-2.21), even after adjusting for confounders (p-value for trend = 0.023). Our findings revealed a significant association between higher UPF intake and depression among females but not among males in the Korean general population.
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Affiliation(s)
- Sunghee Lee
- Department of Food and Nutrition, College of Health Science, Kangwon National University, Samcheok 25949, Republic of Korea
| | - Myungjin Choi
- Department of Food and Nutrition, College of Health Science, Kangwon National University, Samcheok 25949, Republic of Korea
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Tristan Asensi M, Napoletano A, Sofi F, Dinu M. Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review. Nutrients 2023; 15:1546. [PMID: 36986276 PMCID: PMC10058108 DOI: 10.3390/nu15061546] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Low-grade inflammation alters the homeostasis of the organism and favors the onset of many chronic diseases. The global growth in the prevalence of noncommunicable diseases in recent years has been accompanied by an increase in the consumption of ultra-processed foods (UPF). Known to be hyperpalatable, economic and ready-to-eat, increased consumption of UPF has already been recognized as a risk factor for several chronic diseases. Different research groups have tried to investigate whether UPF consumption could promote low-grade inflammation and thus favor the development of noncommunicable diseases. Current evidence highlights the adverse health effects of UPF characteristics, not only due to the nutrients provided by a diet rich in UPF, but also due to the non-nutritive components present in UPF and the effect they may have on gut health. This review aims to summarize the available evidence on the possible relationship between excessive UPF consumption and modulation of low-grade inflammation, as potential promoters of chronic disease.
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Affiliation(s)
- Marta Tristan Asensi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Antonia Napoletano
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, 50134 Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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Ultra-Processed Food Consumption and Depressive Symptoms in a Mediterranean Cohort. Nutrients 2023; 15:nu15030504. [PMID: 36771211 PMCID: PMC9919031 DOI: 10.3390/nu15030504] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/10/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of this study was to investigate the relationship between the consumption of UPFs and depressive symptoms in a sample of younger Italian adults. A cross-sectional study was conducted on 596 individuals (age 18-35 y) recruited in southern Italy. Food frequency questionnaires and the NOVA classification were used to assess dietary factors; the Center for the Epidemiological Studies of Depression Short Form (CES-D-10) was used to assess presence of depressive symptoms. Individuals in the highest quartile of UPF consumption had higher odds of having depressive symptoms in the energy-adjusted model (odds ratio (OR) = 1.89, 95% confidence interval (CI): 1.06, 3.28); the association remained significant after adjusting for potential confounding factors (OR = 2.04, 95% CI: 1.04, 4.01) and became even stronger after further adjustment for adherence to the Mediterranean diet as a proxy of diet quality (OR = 2.70, 95% CI: 1.32, 5.51). In conclusion, a positive association between UPF consumption and likelihood of having depressive symptoms was found in younger Italian individuals. Given the consistency of the findings after adjustment for diet quality, further studies are needed to understand whether non-nutritional factors may play a role in human neurobiology.
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