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Rogers PJ, Vural Y, Flynn AN, Brunstrom JM. Nutrient clustering, NOVA classification, and nutrient profiling: How do they overlap, and what do they predict about food palatability? Appetite 2024; 201:107596. [PMID: 38969105 DOI: 10.1016/j.appet.2024.107596] [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: 04/02/2024] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
We compared the performance of three food categorisation metrics in predicting palatability (taste pleasantness) using a dataset of 52 foods, each rated virtually (online) by 72-224 participants familiar with the foods in question, as described in Appetite 193 (2024) 107124. The metrics were nutrient clustering, NOVA, and nutrient profiling. The first two of these metrics were developed to identify, respectively: 'hyper-palatable' foods (HPFs); and ultra-processed foods (UPFs), which are claimed to be 'made to be hyper-palatable'. The third metric categorises foods as high fat, sugar, salt (HFSS) foods versus non-HFSS foods. There were overlaps, but also significant differences, in categorisation of the foods by the three metrics: of the 52 foods, 35 (67%) were categorised as HPF, and/or UPF, and/or HFSS, and 17 (33%) were categorised as none of these. There was no significant difference in measured palatability between HPFs and non-HPFs, nor between UPFs and non-UPFs (p ≥ 0.412). HFSS foods were significantly more palatable than non-HFSS foods (p = 0.049). None of the metrics significantly predicted food reward (desire to eat). These results do not support the use of hypothetical combinations of food ingredients as proxies for palatability, as done explicitly by the nutrient clustering and NOVA metrics. To discover what aspects of food composition predict palatability requires measuring the palatability of a wide range of foods that differ in composition, as we do here.
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Affiliation(s)
- Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom.
| | - Yeliz Vural
- Karadeniz Technical University, Faculty of Letters, Psychology Department, Kanuni Campus, Ortahisar, Trabzon, Turkiye, 61080
| | - Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
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Heaney D, Padilla-Zakour OI, Chen C. Processing and preservation technologies to enhance indigenous food sovereignty, nutrition security and health equity in North America. Front Nutr 2024; 11:1395962. [PMID: 38962432 PMCID: PMC11221487 DOI: 10.3389/fnut.2024.1395962] [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: 03/04/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Indigenous foods are carriers of traditional native North American food culture and living philosophy. They are featured by the wide varieties in fresh and processed forms, richness in nutrition, flavor, health benefits and diversity in origins, but are usually misunderstood or underrepresented in the modern food systems. Conventional processing and cooking methods are sometimes labor-intensive, less efficient and lack science-based guidelines to prevent unseen safety risks and food loss. Global and regional climate change have caused additional challenges to conventional cooking/processing, and increased native communities' reliance on externally produced foods, which have resulted in increasing nutritional unbalance and prevalence of diet-related health issues. Current and emerging technologies, such as storage and packaging, drying, safety processing, canning, pickling, and fermentation, which treat foods under optimized conditions to improve the safety and extend the shelf-life, are increasingly used in current food systems. Therefore, exploring these technologies for indigenous foods offers opportunities to better preserve their nutrition, safety, and accessibility, and is critical for the sovereignty and independence of indigenous food systems, and sustainability of indigenous food culture. This mini-review focuses on identifying adoptable processing and preservation technologies for selected traditional indigenous foods in North America, summarizing education, extension, and outreach resources and discussing the current challenges and future needs critical to expanding knowledge about indigenous foods and improving food sovereignty, nutrition security, and health equity.
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Affiliation(s)
| | - Olga I. Padilla-Zakour
- Department of Food Science, Cornell AgriTech, Cornell University, Geneva, NY, United States
| | - Chang Chen
- Department of Food Science, Cornell AgriTech, Cornell University, Geneva, NY, United States
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Medina-Meza IG, Vaidya Y, Barnaba C. FooDOxS: a database of oxidized sterols content in foods. Food Funct 2024; 15:6324-6334. [PMID: 38726678 DOI: 10.1039/d4fo00678j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Dietary oxidized sterols (DOxS) are cholesterol-like molecules known to exert pro-inflammatory, pro-oxidant, and pro-apoptotic effects, among others. We present the FooDOxS database, a comprehensive compilation of DOxS content in over 1680 food items from 120 publications across 25 countries, augmented by data generated by our group. This database reports DOxS content in foods classified under the NOVA and What We Eat in America (WWEIA) systems, allowing a comprehensive and statistically robust summary of DOxS content in foods. Notably, we evaluated the efficacy of using NOVA and WWEIA classifications in capturing DOxS variations across food categories. Our findings provide insights into the strengths and limitations of these classification systems, enhancing their utility for assessing dietary components. This research contributes to the understanding of DOxS in food processing and suggests refinements for classification systems, holding promise for improved food safety and public health assessments.
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Affiliation(s)
- Ilce Gabriela Medina-Meza
- Department of Biosystems and Agricultural Engineering, Michigan State University, 469 Wilson Rd. | Room 302C, East Lansing, MI, USA.
| | - Yashasvi Vaidya
- Department of Biosystems and Agricultural Engineering, Michigan State University, 469 Wilson Rd. | Room 302C, East Lansing, MI, USA.
| | - Carlo Barnaba
- Department of Pharmaceutical Chemistry, University of Kansas, 2030 Becker Dr. | Room 320D, Lawrence, KS, USA.
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Kermani-Alghoraishi M, Behrouzi A, Hassannejad R, Sarrafzadegan N, Nouri F, Boshatam M, Roohafza H, Haghighatdoost F, Sadeghi M. Ultra-processed food consumption and cardiovascular events rate: An analysis from Isfahan Cohort Study (ICS). Nutr Metab Cardiovasc Dis 2024; 34:1438-1447. [PMID: 38555244 DOI: 10.1016/j.numecd.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND AIMS The contribution of ultra-processed foods (UPFs) to daily energy intake and, therefore, their health effects may vary between countries. We aimed to investigate the association between UPFs and the incidence risk of cardiovascular events (CVEs) and cardiovascular mortality in the Isfahan cohort study. METHODS AND RESULTS In 2001, 6504 participants aged ≥35 years were enrolled and followed until 2017. Dietary intake was assessed using a validated food frequency questionnaire, and the NOVA system was applied for UPF classification. Any new case of CVE, including fatal and non-fatal myocardial infarction (MI) or stroke, unstable angina (UA), and CVD death, was recorded. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through Cox proportional hazards regression models. A total number of 819 CVE, 164 MI, 348 UA, 172 strokes, and 181 cardiovascular deaths were recorded during 61352.5 person-years of follow-up. The median (IQR) of UPF consumption was 2.47 (1.00-5.23) times/week. In the fully adjusted model, individuals in the fourth quartile of UPFs had no higher risk for incident MI and UA (HR = 1.12, 95% CI: 0.87, 1.46; P for trend = 0.364), stroke (HR = 0.93, 95% CI: 0.58, 1.46; P for trend = 0.601), cardiovascular mortality (HR = 0.95, 95% CI: 0.61, 1.47; P for trend = 0.596), and CVE (HR = 1.08, 95% CI: 0.88,1.34; P for trend = 0.515) in comparison with those in the first quartile. CONCLUSION This mid-term prospective cohort study provides no evidence for a significant association between UPF and CVE risk. Longer studies are required to confirm this association.
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Affiliation(s)
- Mohammad Kermani-Alghoraishi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Behrouzi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoureh Boshatam
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Menon A, Patel N, Arulprasad R, Mouttoulatchoumy D, Lakshminarayanan S. Influence of ultra-processed food in the diet of South Indian young adults: an explanatory mixed method study. Eur J Nutr 2024:10.1007/s00394-024-03429-4. [PMID: 38795126 DOI: 10.1007/s00394-024-03429-4] [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: 06/24/2023] [Accepted: 04/17/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India. METHODS This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling. RESULTS Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework. CONCLUSION UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage.
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Affiliation(s)
- Athira Menon
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - Namita Patel
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - R Arulprasad
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - D Mouttoulatchoumy
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - Subitha Lakshminarayanan
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
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Juul F, Bere E. Ultra-processed foods - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10616. [PMID: 38720949 PMCID: PMC11077402 DOI: 10.29219/fnr.v68.10616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/05/2024] [Accepted: 02/22/2024] [Indexed: 05/12/2024] Open
Abstract
Ultra-processed foods (UPFs) are increasingly consumed worldwide and have been linked to several chronic diseases. This paper aims to describe the totality of the available evidence regarding UPFs in relation to health-related outcomes as a basis for setting food-based dietary guidelines for the Nordic Nutrition Recommendations 2023. Systematic literature searches were conducted to identify systematic reviews, meta-analyses, randomized controlled trials (RCTs), and prospective cohort studies examining the association between UPF intake and non-communicable diseases or mortality. A total of 12 systematic reviews (including five meta-analyses) and 44 original research studies (43 prospective cohort studies and one RCT) were included. All original research studies were deemed to be of good methodological quality. The current evidence supports that greater consumption of UPFs is associated with weight gain and increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. The available literature also supports an association between UPFs and hypertension, cancer, and depression; however, the limited number of studies and subjects investigated preclude strong conclusions. Due to the highly diverse nature of UPFs, additional studies are warranted, with special emphasis on disentangling mediating mechanisms, whether nutritional or non-nutrient based. Nevertheless, the available evidence regarding UPFs in relation to weight gain, CVD, type 2 diabetes, and all-cause mortality is considered strong enough to support dietary recommendations to limit their consumption.
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Affiliation(s)
- Filippa Juul
- School of Global Public Health, New York University, New York, NY, USA
- Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Elling Bere
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
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Rusobya H, Mashili F, Ebrahim AA, Kimera Z. Evaluating compliance with local and International Food Labelling Standards in urban Tanzania: a cross-sectional study of pre-packaged snacks in Dar Es Salaam. BMC Public Health 2024; 24:1062. [PMID: 38627643 PMCID: PMC11022405 DOI: 10.1186/s12889-024-18488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Urbanization influences food culture, particularly in low- and middle-income countries where there is an increasing consumption of processed and pre-packaged foods. This shift is contributing to a rise in non-communicable diseases. Food labelling standards are crucial for regulating manufacturing practices and helping consumers make healthy food choices. We aimed to assess the compliance of local and imported pre-packaged snacks with Tanzanian and international labelling standards in Dar es Salaam, Tanzania. METHODOLOGY A cross-sectional study was conducted on 180 snack products. A checklist based on Tanzanian and Codex labelling standards was used to evaluate adherence. We also examined factors influencing adherence, such as product origin, price, category, purchase location, and package size. RESULTS The majority of the snacks demonstrated partial adherence to Tanzania (n = 97; 54%) and International (Codex) (n = 120; 67%) labelling standards. Imported products showed significantly better adherence to both Tanzanian (n = 46; 53%) and international (n = 42; 48%) standards. Notably, more than half (n = 110; 66.7%) of the products used English for labelling, and infrequently (n = 74; 41.4%) used the recommended World Health Organization Front-of-Pack Nutrition Labelling. Product category, origin, and package size were significantly associated with higher levels of international standard adherence (p < 0.05). CONCLUSION The inadequate adherence to mandatory labelling standards and the scarce use of Swahili and FoPL highlight the need to strengthen labelling practices and potential challenges faced by consumers in understanding nutritional information. Thus, strengthening and emphasizing good labelling practices are urgently needed as we seek to address diet-related noncommunicable diseases.
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Affiliation(s)
- Hassan Rusobya
- School of Public Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga West, Dar es Salaam, Tanzania.
| | - Fredirick Mashili
- Department of Physiology, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam, Tanzania
| | - Ashabilan A Ebrahim
- Department of Physiology, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam, Tanzania
| | - Zuhura Kimera
- Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam, Tanzania
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Gonzales Santos M, Rosenthal A, Beatriz Araujo Martins I, de Alcantara M, Almeida Lima M, de Assis Carvalho R, Deliza R. Exploring the role of the general interest in health on the perceptions of Healthy, Industrialized, and Ultra-processed foods among Brazilians. Food Res Int 2024; 181:113992. [PMID: 38448090 DOI: 10.1016/j.foodres.2024.113992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/08/2024]
Abstract
Food processing includes operations that transform raw materials into new products, ensuring the preservation and supply of safe food; however, this view is not always understood by consumers who tend to associate any type of processing with something negative and harmful to health. Given this, the objective of this study was to explore the associations of Brazilian consumers in relation to healthy foods, industrialized foods, and ultra-processed foods, as well as to evaluate the role of socio-demographic characteristics and interest in health in these associations. To this end, 512 Brazilians completed a word association task on these three concepts and then answered a questionnaire about interest in health and socio-demographic issues. In general, participants associated "Healthy food" mainly with "Unprocessed products." Conversely, "Industrialized foods" and "Ultra-processed foods" were associated with "Processed products," "Negative perceptions," "Health harm," and "Industry". Despite this, it was found that "Industrialized foods" were also perceived positively, mainly due to convenience. Consumer associations were influenced (p ≤ 0.05) both by interest in health and by socio-demographic profile. Individuals with a high interest in health mainly associated "Industrialized foods" and "Ultra-processed foods" with the presence of preservatives, additives, and pesticides, and with diseases. As for those with low interest in health, there was a greater lack of knowledge of the concepts. Doubts and lack of knowledge were observed for "Industrialized foods" and "Ultra-processed foods," mainly among consumers with low educational level. The results indicate the need to develop communication strategies that reach consumers to facilitate understanding and, in this way, help them to make more conscious food choices.
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Affiliation(s)
- Mario Gonzales Santos
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil; Faculty of Technological Sciences, Universidad Nacional de Agricultura, Carretera a Dulce Nombre de Culmí, km 215, Barrio El Espino, Catacamas, Honduras.
| | - Amauri Rosenthal
- Embrapa Agroindústria de Alimentos, Av. das Américas 29501, CEP 23.020-470 Rio de Janeiro, RJ, Brazil
| | | | - Marcela de Alcantara
- PDJ/Faperj/Embrapa Agroindústria de Alimentos, Av. das Américas 29501 CEP 23.020-470 Rio de Janeiro, RJ, Brazil
| | - Mariah Almeida Lima
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil
| | - Raíssa de Assis Carvalho
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil
| | - Rosires Deliza
- Embrapa Agroindústria de Alimentos, Av. das Américas 29501, CEP 23.020-470 Rio de Janeiro, RJ, Brazil
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Wang Z, Lu C, Wang Y, E F, Mentis AFA, Li X, Yang K. Association between ultra-processed foods consumption and the risk of hypertension: An umbrella review of systematic reviews. Hellenic J Cardiol 2024; 76:99-109. [PMID: 37543089 DOI: 10.1016/j.hjc.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Several systematic reviews (SRs) have investigated the association between ultra-processed foods (UPFs) and the risk of hypertension in various populations. However, the quality of the evidence remains unclear. This umbrella review was thus conducted to fill this gap. METHODS We searched for SRs with and without meta-analyses comparing high UPF versus low UPF consumption on the risk of hypertension in the Cochrane Library, Embase, PubMed, and Web of Science from inception to August 2022. This study was registered in PROSPERO (No. CRD42022352934). The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis 2009 (PRISMA 2009) statement were used to evaluate the methodological and reporting quality of the included SRs. Stata 15/SE was used to reanalyse the data using the random-effects model, and the risk of bias of observational studies from included SRs was reassessed using the Newcastle-Ottawa Scale (NOS) tool. The certainty of the evidence body was assessed using the GRADE recommendation. RESULTS Seven SRs were included in the umbrella review. Among them, nine observational studies (5 cross-sectional and 4 cohort studies), whose available data were resynthesised using meta-analysis. The methodological and reporting quality of the included SRs were relatively poor. The meta-analysis results revealed suggestive evidence of an association between high UPF consumption and the incidence of hypertension (odds ratio: 1.23, 95% confidence interval: 1.11 to 1.37, p < 0.001, 95% prediction interval: 0.92 to 1.64, critically low certainty) compared to low UPF consumption. CONCLUSION High UPF consumption is associated with an increased risk of hypertension. However, well-conducted SRs, including high-quality prospective cohort studies, are needed to further verify these findings.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yongsheng Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Fenfen E
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | | | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
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Jung S, Kim JY, Park S. Eating patterns in Korean adults, 1998-2018: increased energy contribution of ultra-processed foods in main meals and snacks. Eur J Nutr 2024; 63:279-289. [PMID: 37999737 PMCID: PMC10799128 DOI: 10.1007/s00394-023-03258-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: 01/25/2023] [Accepted: 09/27/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE Unfavorable changes in eating patterns over time may contribute to upward trends in chronic diseases, such as obesity. We examined 20-year trends in the percentage of energy from main meals and snacks and the food sources of each eating occasion among Korean adults. METHODS This study used nationally representative data from the 1st, 4th, and 7th Korea National Health and Nutrition Examination Surveys (1998, 2007-2009, and 2016-2018) among adults aged 20-69 years (n = 29,389). Each eating occasion (breakfast, lunch, dinner, and snacks) was defined by respondents during a 24-h dietary recall interview. To identify the food sources of each eating occasion, we used the NOVA system. The percentage of energy at each eating occasion and that from each NOVA group across survey cycles were estimated, and tests for linear trends were conducted using orthogonal polynomial contrasts in linear regression models. All analyses accounted for the complex survey design. RESULTS After adjusting for age and sex, the percentage of energy from breakfast decreased from 25.0% in 1998 to 16.7% in 2018 (difference, - 8.2%; standard error [SE], 0.3), whereas that from dinner and snacks increased from 31.1 to 33.8% (difference, + 2.7%; SE, 0.4) and from 14.0 to 19.0% (difference, + 5.0%; SE, 0.5), respectively (all P < 0.001). At all eating occasions, the percentage of energy from minimally processed foods declined (difference, - 18.6% for breakfast; - 13.1% for lunch; - 21.1% for dinner; - 20.7% for snacks), while that from ultra-processed foods increased (difference, + 17.0% for breakfast; + 11.3% for lunch; + 18.0% for dinner; + 30.7% for snacks). When stratified by age, the given trends were shown to a greater extent in younger adults (< 50 years old) than in older adults (≥ 50 years old). CONCLUSIONS The eating patterns of Korean adults changed from 1998 to 2018, with the greatest decrease in energy intake from breakfast and the greatest increase from snacking. At all eating occasions, the contribution of minimally processed foods declined, while that of ultra-processed foods increased, especially among younger adults.
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Affiliation(s)
- Sukyoung Jung
- Chungnam National University Hospital Biomedical Research Institute, Daejeon, South Korea
| | - Jee Young Kim
- National Food Safety Information Service, Seoul, South Korea.
| | - Sohyun Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Gangwon, 24252, South Korea.
- The Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea.
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Rogers PJ, Vural Y, Berridge-Burley N, Butcher C, Cawley E, Gao Z, Sutcliffe A, Tinker L, Zeng X, Flynn AN, Brunstrom JM, Brand-Miller JC. Evidence that carbohydrate-to-fat ratio and taste, but not energy density or NOVA level of processing, are determinants of food liking and food reward. Appetite 2024; 193:107124. [PMID: 37980953 DOI: 10.1016/j.appet.2023.107124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
This virtual (online) study tested the common but largely untested assumptions that food energy density, level of processing (NOVA categories), and carbohydrate-to-fat (CF) ratio are key determinants of food reward. Individual participants (224 women and men, mean age 35 y, 53% with healthy weight, 43% with overweight or obesity) were randomised to one of three, within-subjects, study arms: energy density (32 foods), or level of processing (24 foods), or CF ratio (24 foods). They rated the foods for taste pleasantness (liking), desire to eat (food reward), and sweetness, saltiness, and flavour intensity (for analysis averaged as taste intensity). Against our hypotheses, there was not a positive relationship between liking or food reward and either energy density or level of processing. As hypothesised, foods combining more equal energy amounts of carbohydrate and fat (combo foods), and foods tasting more intense, scored higher on both liking and food reward. Further results were that CF ratio, taste intensity, and food fibre content (negatively), independent of energy density, accounted for 56% and 43% of the variance in liking and food reward, respectively. We interpret the results for CF ratio and fibre in terms of food energy-to-satiety ratio (ESR), where ESR for combo foods is high, and ESR for high-fibre foods is low. We suggest that the metric of ESR should be considered when designing future studies of effects of food composition on food reward, preference, and intake.
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Affiliation(s)
- Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom.
| | - Yeliz Vural
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom; Karadeniz Technical University, Faculty of Letters, Psychology Department, Kanuni Campus, Ortahisar, Trabzon, 61080, Türkiye
| | - Niamh Berridge-Burley
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Chloe Butcher
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Elin Cawley
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Ziwei Gao
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Abigail Sutcliffe
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Lucy Tinker
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Xiting Zeng
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - J C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Australia
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12
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Buzcu B, Tessa M, Tchappi I, Najjar A, Hulstijn J, Calvaresi D, Aydoğan R. Towards interactive explanation-based nutrition virtual coaching systems. AUTONOMOUS AGENTS AND MULTI-AGENT SYSTEMS 2024; 38:5. [PMID: 38261966 PMCID: PMC10798935 DOI: 10.1007/s10458-023-09634-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/25/2024]
Abstract
The awareness about healthy lifestyles is increasing, opening to personalized intelligent health coaching applications. A demand for more than mere suggestions and mechanistic interactions has driven attention to nutrition virtual coaching systems (NVC) as a bridge between human-machine interaction and recommender, informative, persuasive, and argumentation systems. NVC can rely on data-driven opaque mechanisms. Therefore, it is crucial to enable NVC to explain their doing (i.e., engaging the user in discussions (via arguments) about dietary solutions/alternatives). By doing so, transparency, user acceptance, and engagement are expected to be boosted. This study focuses on NVC agents generating personalized food recommendations based on user-specific factors such as allergies, eating habits, lifestyles, and ingredient preferences. In particular, we propose a user-agent negotiation process entailing run-time feedback mechanisms to react to both recommendations and related explanations. Lastly, the study presents the findings obtained by the experiments conducted with multi-background participants to evaluate the acceptability and effectiveness of the proposed system. The results indicate that most participants value the opportunity to provide feedback and receive explanations for recommendations. Additionally, the users are fond of receiving information tailored to their needs. Furthermore, our interactive recommendation system performed better than the corresponding traditional recommendation system in terms of effectiveness regarding the number of agreements and rounds.
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Affiliation(s)
- Berk Buzcu
- Computer Science, Özyeğin University, Istanbul, Turkey
- University of Applied Sciences and Arts Western Switzerland (HES-SO Valais-Wallis), Sierre, Switzerland
| | - Melissa Tessa
- Computer Science, High National School of Computer Science ESI ex-INI, Algiers, Algeria
| | - Igor Tchappi
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Amro Najjar
- Luxembourg Institute of Science and Technology, Esch-sur-Alzette, Luxembourg
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Davide Calvaresi
- University of Applied Sciences and Arts Western Switzerland (HES-SO Valais-Wallis), Sierre, Switzerland
| | - Reyhan Aydoğan
- Computer Science, Özyeğin University, Istanbul, Turkey
- Interactive Intelligence, Delft University of Technology, Delft, The Netherlands
- University of Alcala, Alcala de Henares, Spain
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13
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Dobersek U, Bender M, Etienne A, Fernandez Gil GE, Hostetter C. Meat consumption & positive mental health: A scoping review. Prev Med Rep 2024; 37:102556. [PMID: 38186660 PMCID: PMC10770626 DOI: 10.1016/j.pmedr.2023.102556] [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: 08/29/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
The objective of this scoping review was to examine the breadth of the existing literature on the relation between meat consumption or meat abstention and positive psychological functioning. In April 2022, we conducted a systematic search of online databases (PubMed, PsycINFO, CINAHL Plus, Medline, Cochrane Library, and Web of Science) for primary research examining positive psychological functioning in meat consumers and those who abstain from meat. Thirteen studies met the inclusion/exclusion criteria, representing 89,138 participants (54,413 females and 33,863 males) with 78,562 meat consumers and 10,148 meat abstainers (13-102 years) from multiple geographic regions. The primary outcomes were life satisfaction, "positive mental health", self-esteem, and vigor. The secondary outcomes were "meaning in life", optimism, positive emotions, and psychological well-being. Eight of the 13 studies demonstrated no differences between the groups on positive psychological functioning, three studies showed mixed results, and two studies showed that compared to meat abstainers, meat consumers had greater self-esteem, "positive mental health", and "meaning in life". Studies varied substantially in methods and outcomes. Although a small minority of studies showed that meat consumers had more positive psychological functioning, no studies suggested that meat abstainers did. There was mixed evidence for temporal relations, but study designs precluded causal inferences. Our review demonstrates the need for future research given the equivocal nature of the extant literature on the relation between meat consumption and meat abstention and positive psychological functioning.
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Affiliation(s)
- Urska Dobersek
- Department of Psychology, University of Southern Indiana, Evansville, IN, USA
| | - Mary Bender
- Department of Psychology, University of Southern Indiana, Evansville, IN, USA
| | - Alexandria Etienne
- Department of Psychology, University of Southern Indiana, Evansville, IN, USA
| | | | - Claire Hostetter
- Department of Psychology, University of Southern Indiana, Evansville, IN, USA
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14
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Pries AM, Bassetti E, White JM, Mulder A, Threapleton D, Blankenship J. Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries. MATERNAL & CHILD NUTRITION 2023; 19 Suppl 2:e13598. [PMID: 38092380 PMCID: PMC10719055 DOI: 10.1111/mcn.13598] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/13/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023]
Abstract
Ensuring consumption of nutrient-dense, safe and appropriate complementary foods among older infants and young children (IYC) 6-36 months of age is critical for enabling optimal growth and development. The ubiquitous availability of and high demand for commercially packaged snack foods has culminated in a growing trend of snack food products specifically produced and promoted for older IYC. Commercially produced complementary foods (CPCF) that are finger foods/snacks often contain added sugars, excessive sodium content and high total sugar content, making them inappropriate for this young population. This study benchmarked the nutrient composition and labelling practices of CPCF finger foods/snacks available for purchase in seven countries in Southeast Asia. The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. Of the total 606 products identified, 8.2% were automatically categorized as not suitable because they were confectionery items. Of the remaining 556 products assessed, over 85% failed to meet all nutrient composition requirements, with the presence of added sugars/sweeteners and excessive sodium and total sugar contents the primary reasons for failure. Products also demonstrated concerning labelling practices, with all of the products (98.6%) displaying an inappropriate claim on the label. These findings reveal major concerns with the nutrient composition and labelling practices of CPCF finger foods/snacks in the SEA region and should serve as an alarm bell for regulatory action. National binding legal measures, such as mandatory standards for composition and labelling are urgently needed.
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15
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Mulrooney SL, Lyng JG, O'Hara C, O'Sullivan A, O'Riordan ED, Gibney ER. Examination of the interrelationships between nutrition, environmental sustainability and food-processing: A concept study using model diets. Curr Res Food Sci 2023; 7:100627. [PMID: 38034944 PMCID: PMC10681926 DOI: 10.1016/j.crfs.2023.100627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Recent work has focused on understanding the link between diet quality and environmental impact, however it is also important to consider the role food processing plays in this relationship. Using model meal plans, this paper examines the link between nutrient content, environmental impact, and processing. Four distinct meal plans were considered - 'Healthy', 'Unhealthy', 'Healthy (plant-based)', 'Healthy (plant-based, processed)'. For each a variety of environmental impact, processing and nutritional composition metrics were compared. Alternative healthy eating index (AHEI) score for the Unhealthy diet was significantly lower than the other three diets. The 'Healthy (plant-based)' diet had the highest AHEI score but was not significantly different to the 'Healthy (plant-based, processed)' and 'Healthy' diet scores. The greenhouse gas emissions for the two plant based diets were not significantly different to each other or to the 'Healthy' diet but were significantly lower than the 'Unhealthy' diet. The 'Healthy', 'Unhealthy', and 'Healthy (plant-based)' diets had similar processing specific energy consumption values however, the 'Healthy (plant-based, processed)' diets had significantly greater specific energy consumption. There was no clear link between diet quality and food processing when considered using processing specific energy value. When the number of processes in each diet was estimated, the unhealthier diet had considerably more processes associated with it. Examining the interaction of nutritional quality, environmental impact and processing of diets in this way highlights the complexity of the inter-relationships. Understanding these interactions is necessary to support the transition to healthy diets from sustainable sources.
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Affiliation(s)
| | - James G. Lyng
- Institute of Food and Health, University College Dublin, Ireland
| | - Cathal O'Hara
- Institute of Food and Health, University College Dublin, Ireland
| | | | | | - Eileen R. Gibney
- Institute of Food and Health, University College Dublin, Ireland
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16
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Durán-Agüero S, Valdés-Badilla P, Valladares M, Espinoza V, Mena F, Oñate G, Fernandez M, Godoy-Cumillaf A, Crovetto M. Consumption of ultra-processed food and its association with obesity in Chilean university students: A multi-center study Ultra-processed food and obesity in Chilean university students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2356-2362. [PMID: 34469253 DOI: 10.1080/07448481.2021.1967960] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/07/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To explore the associations between the consumption of three categories of ultra-processed food (sugary beverages, sweet, and salty snacks) and body mass index (BMI) among Chilean university students. METHODS We conducted a multi-center, descriptive study among 2,039 students from 6 Chilean universities. Food consumption was surveyed using a validate food survey. That height and body weight were objectively measured to calculate BMI for determining weight status, and also, tobacco use and physical activity were measured. RESULTS An intake equal to or higher than 1 serving of sugary beverage a day was associated with greater odds of obesity in university students (OR:1.32 [95% CI: 1.00, 1.74]), 2 servings/day (OR: 1.30 [95% CI: 1.04, 1.50]), and 3 servings/day (OR: 1.39 [95% CI: 1.05, 1.80]). Neither consumption of sweet nor salty snacks (≥1 servings/day) related to differential odds of obesity: (OR: 0.83 [95% CI: 0.42, 1.64]) and (OR: 1.79 [95% CI: 0.93, 3.41]), respectively. CONCLUSION In a sample of Chilean university students, consumption of sugary beverages, and not consumption of sweet or salty snacks, was associated with obesity.
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Affiliation(s)
- Samuel Durán-Agüero
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Sede Los Leones, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences. Faculty of Education Sciences, Universidad Católica del Maule. Talca, Talca, Chile
- Carrera de Entrenador Deportivo. Escuela de Educación, Universidad Viña del Mar, Viña del Mar, Chile
| | - Macarena Valladares
- Centro Integrativo de Biología y Química Aplicada (CIBQA), Universidad Bernardo ÓHiggins, Santiago, Chile
| | - Valentina Espinoza
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Francisco Mena
- Estudiante Doctorado en Nutrición y Alimentos, Universidad de Chile, Santiago, Chile
| | - Gloria Oñate
- Carrera Nutrición y Dietética, Universidad Autónoma de Chile, Santiago, Chile
| | - Macarena Fernandez
- Carrera Nutrición y Dietética, Universidad Autónoma de Chile, Santiago, Chile
| | - Andres Godoy-Cumillaf
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Santiago, Chile
| | - Mirta Crovetto
- Centro de Estudios Avanzados, Facultad de Ciencias de la Salud, Universidad Playa Ancha, Valparaíso, Chile
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17
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Disdier AC, Etilé F, Rotunno L. The international diffusion of food innovations and the nutrition transition: retrospective longitudinal evidence from country-level data, 1970-2010. BMJ Glob Health 2023; 8:e012062. [PMID: 37967902 PMCID: PMC10660632 DOI: 10.1136/bmjgh-2023-012062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/10/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION There is a lack of quantitative evidence on the role of food innovations-new food ingredients and processing techniques-in the nutrition transition. OBJECTIVE Document the distribution of food innovations across 67 high-income (HIC) and middle-income (MIC) countries between 1970 and 2010, and its association with the nutritional composition of food supply. METHODS We used all available data on food patents, as compiled by the European Patent Office, to measure food innovations. We considered innovations directly received by countries from inventors seeking protection in their territories, and those embedded in processed food imports. Food and Agricultural Organization data were used to estimate the associations between international diffusion of food innovations and trends in total food supply and its macronutrient composition, after adjusting for confounding trends in demand-side factors. We identified the role of trade by simulating the changes in average diet due to innovations embedded in food imports. RESULTS Trends in food innovations were positively and significantly associated with changes in daily per capita calorie supply available for human consumption in MIC between 1990 and 2010 (elasticity of 0.027, 95% CI 0.019 to 0.036). Food innovations were positively correlated with the share of animal and free fats in total food supply (elasticities of 0.044, 95% CI 0.030 to 0.058 for MIC between 1970 and 1989 and 0.023, 95% CI 0.003 to 0.043 for HIC between 1990 and 2010). Food innovations were associated with substitutions from complex carbohydrates towards sugars in total food supply for MIC after 1990 (elasticities of -0.037, 95% CI -0.045 to -0.029 for complex carbs, 0.082, 95% CI 0.066 to 0.098 for sugars). For these countries, the trade channel capturing access to innovations through imports of processed food played a key role. CONCLUSION Policy-makers should consider the impacts of the international diffusion of food innovations in assessing the costs and benefits of international trade regulations.
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Affiliation(s)
- Anne-Célia Disdier
- Paris School of Economics, Paris, France
- UMR 1393, Paris-Jourdan Sciences Economiques, INRAE, Paris, France
| | - Fabrice Etilé
- Paris School of Economics, Paris, France
- UMR 1393, Paris-Jourdan Sciences Economiques, INRAE, Paris, France
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18
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Boise S, Crossa A, Etheredge AJ, McCulley EM, Lovasi GS. Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement. THE OPEN PUBLIC HEALTH JOURNAL 2023; 16:e187494452308210. [PMID: 38179222 PMCID: PMC10766432 DOI: 10.2174/18749445-v16-230821-2023-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/13/2023] [Accepted: 07/30/2023] [Indexed: 01/06/2024]
Abstract
Background There is no singular approach to measuring the food environment suitable for all studies. Understanding terminology, methodology, and common issues is crucial to choosing the best approach. Objective This review is designed to support a shared understanding so diverse multi-institutional teams engaged in food environment measurement can justify their measurement choices and have informed discussions about reasons for measurement strategies to vary across projects. Methods This guide defines key terms and provides annotated resources identified as a useful starting point for exploring the food environment literature. The writing team was an academic-practice collaboration, reflecting on the experience of a multi-institutional team focused on retail environments across the US relevant to cardiovascular disease. Results Terms and annotated resources are divided into three sections: food environment constructs, classification and measures, and errors and strategies to reduce error. Two examples of methods and challenges encountered while measuring the food environment in the context of a US health department are provided. Researchers and practice professionals are directed to the Food Environment Electronic Database Directory (https://www.foodenvironmentdirectory.com/) for comparing available data resources for food environment measurement, focused on the US; this resource incorporates updates informed by user input and literature reviews. Discussion Measuring the food environment is complex and risks oversimplification. This guide serves as a starting point but only partially captures some aspects of neighborhood food environment measurement. Conclusions No single food environment measure or data source meets all research and practice objectives. This shared starting point can facilitate theoretically grounded food environment measurement.
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Affiliation(s)
- Sarah Boise
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia PA
- Penn Medicine Medical Group, University of Pennsylvania Health System, Penn Medicine
| | - Aldo Crossa
- Department of Health and Mental Hygiene, New York, NY
| | | | - Edwin M. McCulley
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia PA
| | - Gina S. Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia PA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia PA
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19
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Passeri A, Municchi D, Cavalieri G, Babicola L, Ventura R, Di Segni M. Linking drug and food addiction: an overview of the shared neural circuits and behavioral phenotype. Front Behav Neurosci 2023; 17:1240748. [PMID: 37767338 PMCID: PMC10520727 DOI: 10.3389/fnbeh.2023.1240748] [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: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Despite a lack of agreement on its definition and inclusion as a specific diagnosable disturbance, the food addiction construct is supported by several neurobiological and behavioral clinical and preclinical findings. Recognizing food addiction is critical to understanding how and why it manifests. In this overview, we focused on those as follows: 1. the hyperpalatable food effects in food addiction development; 2. specific brain regions involved in both food and drug addiction; and 3. animal models highlighting commonalities between substance use disorders and food addiction. Although results collected through animal studies emerged from protocols differing in several ways, they clearly highlight commonalities in behavioral manifestations and neurobiological alterations between substance use disorders and food addiction characteristics. To develop improved food addiction models, this heterogeneity should be acknowledged and embraced so that research can systematically investigate the role of specific variables in the development of the different behavioral features of addiction-like behavior in preclinical models.
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Affiliation(s)
- Alice Passeri
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | - Diana Municchi
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | - Giulia Cavalieri
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | | | - Rossella Ventura
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
- IRCCS San Raffaele, Rome, Italy
| | - Matteo Di Segni
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
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20
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Hall KD. From dearth to excess: the rise of obesity in an ultra-processed food system. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220214. [PMID: 37482782 PMCID: PMC10363698 DOI: 10.1098/rstb.2022.0214] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/23/2023] [Indexed: 07/25/2023] Open
Abstract
More people now have obesity than suffer from starvation thanks to our modern food system. Agriculture was transformed over the 20th century by a variety of technological advancements that relied heavily on fossil fuels. In the United States, government policies and economic incentives led to surplus production of cheap inputs to processed food industries that produced a wide variety of heavily marketed, convenient, rewarding, timesaving, and relatively inexpensive ultra-processed foods. The energy available in the food supply increased by much more than the population needs, albeit with large inequities in nutrition security. While most of the rise in per capita food availability during the late 20th and early 21st centuries in the United States resulted in increased food waste, a variety of mechanisms have been proposed by which changes in the increasingly ultra-processed food environment resulted in excess energy intake disproportionately in people genetically susceptible to obesity. As populations continue to grow, substantial investments in coordinated nutrition and agricultural research are needed to transform our current food system to one that relies less on fossil fuels, preserves biodiversity, ensures environmental health, and provides equitable access to affordable, safe and nutritious food that reduces the prevalence of chronic diet-related diseases like obesity. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
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Affiliation(s)
- Kevin D. Hall
- Integrative Physiology Section Chief, Laboratory of Biological Modeling, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 12A South Drive, Room 4007, Bethesda, MD 20892-4007, USA
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21
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Flint M, Bowles S, Lynn A, Paxman JR. Novel plant-based meat alternatives: future opportunities and health considerations. Proc Nutr Soc 2023; 82:370-385. [PMID: 36603854 DOI: 10.1017/s0029665123000034] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Present food systems threaten population and environmental health. Evidence suggests reduced meat and increased plant-based food consumption would align with climate change and health promotion priorities. Accelerating this transition requires greater understanding of determinants of plant-based food choice. A thriving plant-based food industry has emerged to meet consumer demand and support dietary shift towards plant-based eating. 'Traditional' plant-based diets are low-energy density, nutrient dense, low in saturated fat and purportedly associated with health benefits. However, fast-paced contemporary lifestyles continue to fuel growing demand for meat-mimicking plant-based convenience foods which are typically ultra-processed. Processing can improve product safety and palatability and enable fortification and enrichment. However, deleterious health consequences have been associated with ultra-processing, though there is a paucity of equivocal evidence regarding the health value of novel plant-based meat alternatives (PBMAs) and their capacity to replicate the nutritional profile of meat-equivalents. Thus, despite the health halo often associated with plant-based eating, there is a strong rationale to improve consumer literacy of PBMAs. Understanding the impact of extensive processing on health effects may help to justify the use of innovative methods designed to maintain health benefits associated with particular foods and ingredients. Furthering knowledge regarding the nutritional value of novel PBMAs will increase consumer awareness and thus support informed choice. Finally, knowledge of factors influencing engagement of target consumer subgroups with such products may facilitate production of desirable, healthier PBMAs. Such evidence-based food manufacturing practice has the potential to positively influence future individual and planetary health.
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Affiliation(s)
- Megan Flint
- Food and Nutrition Subject Group, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Simon Bowles
- Food and Nutrition Subject Group, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Anthony Lynn
- Food and Nutrition Subject Group, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Jenny R Paxman
- Food and Nutrition Subject Group, Sheffield Hallam University, Sheffield S1 1WB, UK
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22
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Abstract
Food-based dietary guidelines have been the basis of public health recommendations for over half a century, but more recently, there has been a trend to classify the health properties of food not by its nutrient composition, but by the degree to which it has been processed. This concept has been supported by many association studies, narrative reviews and the findings from one randomised controlled feeding trial, which demonstrated the sustained effect of ultra-processed diets on increasing both energy intake and body weight. This has led to widespread speculation as to specific features of ultra-processed foods that promote increased energy intakes. Rising interest in the ultra-processed topic has led to proposals to include guidance and restrictions on the consumption of processed foods in national dietary guidelines, with some countries encouraging consumers to avoid highly processed foods completely, and only choose minimally processed foods. However, there remains a lack of consensus on the role of processed foods in human health when faced with the challenges of securing the food supply for a growing global population, that is, healthy, affordable and sustainable. There has also been criticism of the subjective nature of definitions used to differentiate foods by their degree of processing, and there is currently a lack of empirical data to support a clear mechanism by which highly processed foods promote greater energy intakes. Recommendations to avoid all highly processed foods are potentially harmful if they remove affordable sources of nutrients and will be impractical for most when an estimated two-thirds of current energy purchased are from processed or ultra-processed foods. The current review highlights some considerations when interpreting the dietary association studies that link processed food intake to health and offers a critique on some of the mechanisms proposed to explain the link between ultra-processed food and poor health. Recent research suggests a combination of higher energy density and faster meal eating rates are likely to influence meal size and energy intakes from processed foods and offers new perspectives on how to manage this in the future. In going beyond the ultra-processed debate, the aim is to summarise some important considerations when interpreting existing data and identify the important gaps for future research on the role of processed food in health.
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Affiliation(s)
- Ciarán G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
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23
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Calvo MS, Dunford EK, Uribarri J. Industrial Use of Phosphate Food Additives: A Mechanism Linking Ultra-Processed Food Intake to Cardiorenal Disease Risk? Nutrients 2023; 15:3510. [PMID: 37630701 PMCID: PMC10459924 DOI: 10.3390/nu15163510] [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: 07/24/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
The consumption of ultra-processed food (UPF) keeps rising, and at the same time, an increasing number of epidemiological studies are linking high rates of consumption of UPF with serious health outcomes, such as cardiovascular disease, in the general population. Many potential mechanisms, either in isolation or in combination, can explain the negative effects of UPF. In this review, we have addressed the potential role of inorganic phosphate additives, commonly added to a wide variety of foods, as factors contributing to the negative effects of UPF on cardiorenal disease. Inorganic phosphates are rapidly and efficiently absorbed, and elevated serum phosphate can lead to negative cardiorenal effects, either directly through tissue/vessel calcification or indirectly through the release of mineral-regulating hormones, parathyroid hormone, and fibroblast growth factor-23. An association between serum phosphate and cardiovascular and bone disease among patients with chronic kidney disease is well-accepted by nephrologists. Epidemiological studies have demonstrated an association between serum phosphate and dietary phosphate intake and mortality, even in the general American population. The magnitude of the role of inorganic phosphate additives in these associations remains to be determined, and the initial step should be to determine precise estimates of population exposure to inorganic phosphate additives in the food supply.
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Affiliation(s)
- Mona S. Calvo
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Elizabeth K. Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia;
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jaime Uribarri
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
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24
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Monteles Nascimento L, de Carvalho Lavôr LC, Mendes Rodrigues BG, da Costa Campos F, de Almeida Fonseca Viola PC, Lucarini M, Durazzo A, Arcanjo DDR, de Carvalho E Martins MDC, de Macêdo Gonçalves Frota K. Association between Consumption of Ultra-Processed Food and Body Composition of Adults in a Capital City of a Brazilian Region. Nutrients 2023; 15:3157. [PMID: 37513575 PMCID: PMC10383416 DOI: 10.3390/nu15143157] [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: 06/20/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The present study investigates the relationship between the consumption of ultra-processed foods (UPF) and anthropometric indices of body composition in adults and seniors living in Teresina, the state capital of an area in northeastern Brazil. The article seeks to address two questions: Is UPF consumption linked to worsening body composition in different age groups? Do anthropometric indicators of body composition change with the increasing consumption of UPF? The study is a cross-sectional, household, population study, carried out with 490 adults and seniors. The food consumption was obtained with a 24 h food recall, and the foods were classified using NOVA. Anthropometric indicators evaluated were waist-to-height ratio, triceps skinfold thickness, arm circumference, corrected arm muscle area, subscapular skinfold thickness, and calf circumference. The association between energy contribution of UPF with anthropometric indicators was verified with a simple and multiple linear regression analysis. Individuals aged 20 to 35 years showed a significant association between UPF consumption and skinfold thickness (ß: 0.04; CI: 0.03/0.09), demonstrating an increase in this subcutaneous body fat marker with higher UPF consumption. Moreover, in participants aged 36 to 59 years, an inverse correlation between UPF intake and muscle mass markers, arm circumference (ß: -0.02; confidence interval: -0.03/-0.01), and corrected arm muscle area (ß: -0.07; confidence interval: -0.12/-0.02) were observed. Such results suggest there is decreased muscle mass with increasing UPF consumption. This is the first study that verified an association between UPF consumption and low-cost body composition indicators in different age groups.
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Affiliation(s)
- Larisse Monteles Nascimento
- Food and Nutrition Postgraduate Program, Department of Nutrition, Federal University of Piauí, Teresina 64049-550, PI, Brazil
| | | | | | | | | | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178 Rome, Italy
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178 Rome, Italy
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25
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Valicente VM, Peng CH, Pacheco KN, Lin L, Kielb EI, Dawoodani E, Abdollahi A, Mattes RD. Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms. Adv Nutr 2023; 14:718-738. [PMID: 37080461 PMCID: PMC10334162 DOI: 10.1016/j.advnut.2023.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Epidemiologic evidence supports a positive association between ultraprocessed food (UPF) consumption and body mass index. This has led to recommendations to avoid UPFs despite very limited evidence establishing causality. Many mechanisms have been proposed, and this review critically aimed to evaluate selected possibilities for specificity, clarity, and consistency related to food choice (i.e., low cost, shelf-life, food packaging, hyperpalatability, and stimulation of hunger/suppression of fullness); food composition (i.e., macronutrients, food texture, added sugar, fat and salt, energy density, low-calorie sweeteners, and additives); and digestive processes (i.e., oral processing/eating rate, gastric emptying time, gastrointestinal transit time, and microbiome). For some purported mechanisms (e.g., fiber content, texture, gastric emptying, and intestinal transit time), data directly contrasting the effects of UPF and non-UPF intake on the indices of appetite, food intake, and adiposity are available and do not support a unique contribution of UPFs. In other instances, data are not available (e.g., microbiome and food additives) or are insufficient (e.g., packaging, food cost, shelf-life, macronutrient intake, and appetite stimulation) to judge the benefits versus the risks of UPF avoidance. There are yet other evoked mechanisms in which the preponderance of evidence indicates ingredients in UPFs actually moderate body weight (e.g., low-calorie sweetener use for weight management; beverage consumption as it dilutes energy density; and higher fat content because it reduces glycemic responses). Because avoidance of UPFs holds potential adverse effects (e.g., reduced diet quality, increased risk of food poisoning, and food wastage), it is imprudent to make recommendations regarding their role in diets before causality and plausible mechanisms have been verified.
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Affiliation(s)
- Vinicius M Valicente
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Ching-Hsuan Peng
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States
| | - Kathryn N Pacheco
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Luotao Lin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Elizabeth I Kielb
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States
| | - Elina Dawoodani
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
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26
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Martini D, da Costa Ribeiro H, Gately P, Mattes R, Re R, Bier D. Positive nutrition: shifting the focus from nutrients to diet for a healthy lifestyle. Eat Weight Disord 2023; 28:51. [PMID: 37341796 DOI: 10.1007/s40519-023-01580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE AND METHODS This summary is based on a scientific symposium organized by the Mediterranean Diet Roundtable and the American Italian Food Coalition titled, 'Positive Nutrition: shifting focus from nutrients to diet for a healthy lifestyle.' It was held at the Embassy of Italy in Washington DC in September of 2022. The panel of experts discussed how science can inform policy, what insights may be gleaned from different countries' approaches to healthy eating and what principles of the Mediterranean diet will inform strategies for a healthy future. Recognizing that isolated actions have limited impact on the complex relationship between diet and obesity, the panel discussed the importance of a system approach. In particular, the panel emphasized that focusing on single ingredients, isolated food categories and narrow approaches to policy have had limited success across the globe. RESULTS AND CONCLUSION The panel agreed that there is a need for change of perspective that embraces complexity and emphasizes more positive nutrition messaging and policies. LEVEL OF EVIDENCE V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20122, Milan, Italy.
| | - Hugo da Costa Ribeiro
- Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Bahia, 40110-060, Brazil
| | - Paul Gately
- Carnegie Research Institute, Leeds Metropolitan University, Leeds, LS6 3QS, UK
| | - Richard Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN, 47907, USA
| | - Roberta Re
- Cambridge Food Science, Cambridge, CB23 5AB, UK
| | - Dennis Bier
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, 77030, USA
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27
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Ketelings L, Benerink E, Havermans RC, Kremers SPJ, de Boer A. Fake meat or meat with benefits? How Dutch consumers perceive health and nutritional value of plant-based meat alternatives. Appetite 2023:106616. [PMID: 37286170 DOI: 10.1016/j.appet.2023.106616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023]
Abstract
Animal agriculture has a large impact on the environment. Hence, there is an increasing demand for meat alternatives - more sustainably produced plant-based products that replace meat as meal component. Demands for meat alternatives also seem to be fuelled by consumers' belief that meat alternatives are healthier than meat products. In an online questionnaire study, we examined whether consumers indeed perceived meat alternatives to be healthier, to what degree consumers adequately estimated the nutritional value of meat (alternatives), and whether a nutrition claim could misguide consumers. In a panel of 120 Dutch consumers, it was found that meat alternatives were generally perceived as being healthier than meat products. According to supermarket data, meat alternatives contained less protein and saturated fat, higher levels of fibre and salt compared to meat. Consumers were found to overestimate the protein content of meat alternatives relative to meat products, especially when meat alternatives carry a 'high in protein' claim. The current beliefs about the healthiness and nutritional content of meat and meat alternatives are precarious and a fair, transparent, and understandable environment should be created for the conscious consumer.
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Affiliation(s)
- Linsay Ketelings
- Food Claims Centre Venlo, Campus Venlo, Maastricht University, Venlo, the Netherlands.
| | - Eline Benerink
- Food Claims Centre Venlo, Campus Venlo, Maastricht University, Venlo, the Netherlands
| | - Remco C Havermans
- Laboratory of Behavioural Gastronomy, Centre for Healthy Eating and Food Innovation, Maastricht University Campus Venlo, the Netherlands
| | - Stef P J Kremers
- NUTRIM, Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Alie de Boer
- Food Claims Centre Venlo, Campus Venlo, Maastricht University, Venlo, the Netherlands
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28
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Calcaterra V, Cena H, Rossi V, Santero S, Bianchi A, Zuccotti G. Ultra-Processed Food, Reward System and Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050804. [PMID: 37238352 DOI: 10.3390/children10050804] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in childhood may increase the BMI/BMI z-score, body fat percentage, or likelihood of overweight. A strict feeding regulation system allows for sufficient food to be consumed to meet ongoing metabolic demands while avoiding overconsumption. This narrative review explores the issues of obesity and the regulation of food intake related to reward systems and UPF consumption. Nutrient composition alone cannot explain the influence of UPFs on the risk of obesity. Furthermore, the non-nutritional properties of UPFs may explain the mechanisms underlying the relationship with obesity and NCDs. UPFs are designed to be highly palatable, appealing, and energy dense with a unique combination of the main taste enhancer ingredients to generate a strong rewarding stimulus and influence the circuits related to feeding facilitation. How individual UPF ingredients influence eating behavior and reward processes remains not fully elucidated. To increase the knowledge on the relationship between UPFs and pediatric obesity, it may be useful to limit the rapid growth in the prevalence of obesity and subsequent related complications, and to develop new strategies for appropriate food and nutrition policies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition Unit, General Medicine, Istituti Clinici Salvatore Maugeri Istituto di Ricovero e Cura a Carattere Sscientifico, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Alice Bianchi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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29
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Hinnouho G, Ferguson EL, MacDougall A, Kroeun H, Sophonneary P, Chea M, Pries AM. High consumption of unhealthy commercial foods and beverages tracks across the complementary feeding period in rural/peri-urban Cambodia. MATERNAL & CHILD NUTRITION 2023; 19:e13485. [PMID: 36751966 PMCID: PMC10019055 DOI: 10.1111/mcn.13485] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/02/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
Consumption of unhealthy commercial foods and beverages (UCFB) is common among infants and young children living in low- and middle-income countries. Such foods can displace other nutritious foods, however, there is limited evidence on how this consumption tracks across time. This study assessed and tracked UCFB consumption of children living in rural/peri-urban Cambodia during the complementary feeding period, identified UCFB consumption patterns of these children, and explored the association between UCFB consumption and growth. A 6-month longitudinal cohort study was implemented among 567 caregivers of children aged 10-14 months at recruitment. UCFB consumption was estimated each month via a telephone-administered 7-day food frequency questionnaire, and UCFB consumption patterns were identified based on changes in this frequency of consumption over time. The majority of children either maintained (45.7%, n = 246) or developed (43.5%, n = 234) an unhealthy consumption pattern and only 10.8% (n = 58) of children maintained/transitioned into a healthy consumption pattern. High consumers of UCFB at 10-14 months had a 4.7 (CI: 4.7 [3.1-7.2]) times odds of being high consumers of UCFB at 15-19 months (p < 0.001). There was a trend of lower length-for-age z-scores (LAZ) among children maintaining or developing an unhealthy consumption pattern (~-0. SD LAZ) compared to children maintaining/transitioning into a healthy consumption pattern, however, this association was not statistically significant. Findings indicate that high UCFB consumption begins during infancy and tracks into early childhood. National policies and programmes centred on early interventions addressing the use of UCFB for infant and young child feeding are needed.
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Affiliation(s)
| | | | | | - Hou Kroeun
- Helen Keller InternationalNew York CityNew YorkUSA
| | | | - Mary Chea
- Ministry of HealthPhnom PenhCambodia
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30
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Detopoulou P, Dedes V, Syka D, Tzirogiannis K, Panoutsopoulos GI. Relation of Minimally Processed Foods and Ultra-Processed Foods with the Mediterranean Diet Score, Time-Related Meal Patterns and Waist Circumference: Results from a Cross-Sectional Study in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2806. [PMID: 36833504 PMCID: PMC9957033 DOI: 10.3390/ijerph20042806] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Ultra-processed foods are associated with chronic diseases, cardiometabolic factors and obesity. According to the NOVA system, foods are classified into four categories (from 1 = unprocessed to 4 = ultra-processed foods). The purpose of the present study was to assess the consumption of minimally processed foods (MPF) and ultra-processed foods (UPF) in university students and their relationship with obesity, Mediterranean diet adherence and meal patterns. In total, 346 students (269 women) of the University of Peloponnese participated. A food frequency questionnaire was used, and the MedDietScore was calculated. The % energy contribution of MPF and UPF was calculated. The identification of meal patterns was performed via principal component analysis. Both multivariate regression and Spearman's correlations were used to measure the association of UPF/MPF consumption with anthropometric indices (body mass index, BMI and waist circumference, WC), Mediterranean diet adherence and early/late meal patterns. UPF and MPF provided 40.7 ± 13.6% and 44.3 ± 11.9% (mean ± standard deviation) of energy intake, respectively. In multi-adjusted linear regression models UPF consumption (% energy) was positively associated with WC in men but it was not related to BMI (total sample, men, women). UPF consumption was negatively related to the MedDietScore (Spearman rho = -0.214, p < 0.001) and an "early eating" pattern (Spearman rho = -0.120, p = 0.029) and positively associated with a "late eating" meal pattern (Spearman rho = 0.190, p = 0.001). MPF consumption was positively associated with the MedDietScore (Spearman rho = 0.309, p < 0.001) and an "early eating" pattern (Spearman rho = 0.240, p < 0.001). In conclusion, UPF consumption was positively related to WC in male university students. Nutritional and sociodemographic correlates of UPF consumption, such as low Mediterranean diet adherence and having a "late eating" pattern serve as a basis to better understand the UPF consumption-central obesity relation in young adults and should be considered in nutrition education programs for young adults.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece
| | - Vassilios Dedes
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
| | - Dimitra Syka
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
| | | | - Georgios I. Panoutsopoulos
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
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31
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Zhou L, Li H, Zhang S, Yang H, Ma Y, Wang Y. Impact of ultra-processed food intake on the risk of COVID-19: a prospective cohort study. Eur J Nutr 2023; 62:275-287. [PMID: 35972529 PMCID: PMC9379888 DOI: 10.1007/s00394-022-02982-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Nutrition plays a key role in supporting the human immune system and reducing the risk of infections. However, there is limited evidence exploring the relationship between diet and the risk of COVID-19. This study aimed to assess the associations between consumption of ultra-processed foods (UPF) and COVID-19 risk. METHODS In total, 41,012 participants from the UK Biobank study with at least 2 of up to 5 times 24-h dietary assessments were included in this study. Dietary intakes were collected using an online 24-h dietary recall questionnaire and food items were categorized according to their degree of processing by the NOVA classification. COVID-19 infection was defined as individuals tested COVID-19 positive or dead of COVID-19. Association between average UPF consumption (% daily gram intake) and COVID-19 infection was assessed by multivariable logistic regression adjusted for potential confounders. RESULTS Compared to participants in the lowest quartile of UPF proportion (% daily gram intake) in the diet, participants in the 2nd, 3rd, and highest quartiles were associated with a higher risk of COVID-19 with the odds ratio (OR) value of 1.03 (95% CI: 0.94-1.13), 1.24 (95% CI: 1.13-1.36), and 1.22 (95% CI: 1.12-1.34), respectively (P for trend < 0.001), after adjusting for potential confounders. The results were robust in a series of sensitivity analyses. No interaction effect was identified between the UPF proportions and age groups, education level, body mass index, and comorbidity status. BMI mediated 13.2% of this association. CONCLUSION Higher consumption of UPF was associated with an increased risk of COVID-19 infection. Further studies are needed to better understand the underlying mechanisms in such association.
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Affiliation(s)
- Lihui Zhou
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Huiping Li
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.,Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Shunming Zhang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.,Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yue Ma
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
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32
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Calvo MS, Uribarri J. Food Additive Use in Ultraprocessed Foods: Can Processing Use of Industrial Additives Contribute to Adverse Health Outcomes in Children? J Acad Nutr Diet 2023; 123:861-864. [PMID: 36682684 DOI: 10.1016/j.jand.2023.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Affiliation(s)
- Mona S Calvo
- The Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Jaime Uribarri
- The Icahn School of Medicine at Mount Sinai, New York, New York.
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Haghighatdoost F, Hajihashemi P, Mohammadifard N, Najafi F, Farshidi H, Lotfizadeh M, Kazemi T, Karimi S, Shirani S, Solati K, Sarrafzadegan N. Association between ultra-processed foods consumption and micronutrient intake and diet quality in Iranian adults: a multicentric study. Public Health Nutr 2022; 26:1-9. [PMID: 36274641 DOI: 10.1017/s1368980022002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality. DESIGN In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density. SETTING The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord). PARTICIPANTS A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method. RESULTS UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased. CONCLUSION The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box 81745-15, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Simin Karimi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahin Shirani
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamal Solati
- Department of Psychiatry, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box 81745-15, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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34
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Association between Ultra-Processed Food Consumption and Diabetes in Chinese Adults-Results from the China Health and Nutrition Survey. Nutrients 2022; 14:nu14204241. [PMID: 36296925 PMCID: PMC9609918 DOI: 10.3390/nu14204241] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Aims: We aimed to assess the association between ultra-processed food (UPF) consumption with diabetes in Chinese adults. Methods: This study included 12,849 eligible adults aged 20 years and over attending at least two surveys in the China Nutrition and Health Survey during 1997−2011. Food intake at each survey was assessed by a 3-day 24-h dietary recall method. UPF was defined based on the NOVA classification. Diabetes was obtained from questionnaires and/or ascertained by fasting blood tests. The association of diabetes with UPF was examined using mix effect logistic regression adjusting for potential confounding factors. Results: The mean age of the participants was 43.3 (SD 14.8) years. The age and gender adjusted mean UPF intake increased four times and the prevalence of diabetes increased eight times in 1997−2011. Compared with non-consumers, the odds ratios (95% CI) of diabetes for those with mean UPF consumption of 1−19 g/day, 20−49 g/day, and ≥50 g/day were 1.21 (0.98, 1.48), 1.49 (1.19, 1.86), and 1.40 (1.08, 1.80), respectively (p trend < 0.001) after adjusted for the measured covariates including lifestyle factors (smoking, alcohol drinking, and physical activity), BMI and hypertension. Conclusions: both UPF consumption and prevalence of diabetes increased among adults in China during 1997−2011. Higher UPF consumption was positively associated with diabetes.
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Gustafson DI, Decker EA, Drewnowski A, Hamm MW, Hwang J, Merrigan KA. Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods. Curr Dev Nutr 2022; 6:nzac136. [PMID: 36204327 PMCID: PMC9529222 DOI: 10.1093/cdn/nzac136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.
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Affiliation(s)
- David I Gustafson
- Adjunct Research Faculty, Biological Systems Engineering, Washington State University, Pullman, WA, USA
| | - Eric A Decker
- Department of Food Science, University of Massachusetts, Amherst, MA, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA; USA
| | - Michael W Hamm
- Department of Community Sustainability, Michigan State University, Lansing, MI, USA
| | - Jane Hwang
- Social Accountability International, New York, NY, USA
| | - Kathleen A Merrigan
- Swette Center for Sustainable Food Systems, Arizona State University, Tempe, AZ, USA
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Godos J, Giampieri F, Al-Qahtani WH, Scazzina F, Bonaccio M, Grosso G. Ultra-Processed Food Consumption and Relation with Diet Quality and Mediterranean Diet in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11360. [PMID: 36141629 PMCID: PMC9517140 DOI: 10.3390/ijerph191811360] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Ultra-processed food (UPF) consumption has been the focus of major attention due to their potential effects on human health. The aim of this study was to investigate the intake of UPFs in a sample of southern Italian individuals and assess its relationship with nutrient profile and dietary quality parameters. A cross-sectional study was conducted on 1936 individuals older than 18 years randomly selected from the general population. A total of 110 food times have been categorized based on the level of processing using the NOVA classification. The average daily energy intake of the sample was 2091.1 kcal, 38.7% of which were from the NOVA group of unprocessed/minimally processed foods, 5.7% from processed culinary ingredients, 38.3% from processed foods, and 17.9% from the UPFs group. UPFs were more consumed among young, unmarried individuals, with high cultural level, smokers, and often eating out of home. The mean energy share of UPFs varied from 6.3% of total daily energy intake for individuals in the lowest quintile of UPF consumption to 34.2% for those in the upper quintile. Within the UPF group, the highest energy contribution was provided by fast foods and sweets. Compared to the lowest quintile of UPF consumption, individuals in the highest quintile consumed, on average, additional 300 kcals per day and less fiber. Some plant-derived vitamins, such as vitamin A and vitamin C showed an inverse trend toward increasing shares of UPF consumption, while sodium intake increased. A significant higher intake of UPFs in individuals meeting the European and Italian dietary recommendations for carbohydrates, vitamin B12, vitamin D, and vitamin E was found, while UPFs were less consumed among those meeting the recommendations for total fats, fiber, sodium, potassium, and vitamin C. Finally, individuals displaying a "healthier" dietary profile, such as higher adherence to either the Mediterranean diet, the Dietary Approaches to Stop Hypertension, the Alternate Diet Quality Index, and the Diet Quality Index-International, consumed less UPFs and more unprocessed/minimally processed foods, with minor variation in the other NOVA food categories. In conclusion, consumption of UPF in southern Italy is in line with those reported in some other Mediterranean countries, although it negatively impacted the nutrient profile. It is important to monitor the consumption of UPFs before their availability and popularity put the grounds on younger generations' dietary habits.
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Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, European University of the Atlantic, 39011 Santander, Spain
| | - Wahidah H. Al-Qahtani
- Department of Food Sciences & Nutrition, College of Food & Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Francesca Scazzina
- Department of Food and Drug, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
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Senior AM, Raubenheimer D, Simpson SJ. Testing the protein-leverage hypothesis using population surveillance data. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220756. [PMID: 36177194 PMCID: PMC9515627 DOI: 10.1098/rsos.220756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
It is hypothesized that humans exhibit 'protein leverage' (PL), whereby regulation of absolute protein intake results in the over-consumption of non-protein food on low percentage protein diets. Testing for PL using dietary surveillance data involves seeking evidence for a negative association between total energy intake and percentage energy from protein. However, it is unclear whether such an association might emerge without PL due to the structure of intake data (protein and non-protein intakes have different means and variances and covary). We derive a set of models that describe the association between the expected estimate of PL and the distributions of protein and non-protein intake. Models were validated via simulation. Patterns consistent with PL will not emerge simply because protein intake has a lower mean and/or variance than non-protein. Rather, evidence of PL is observed where protein has a lower index of dispersion (variance/mean) than non-protein intake. Reciprocally, the stronger PL is the lower the index of dispersion for protein intake becomes. Disentangling causality is ultimately beyond the power of observational data alone. However, we show that one can correct for confounders (e.g. age) in generating signals of PL, and describe independent measures that can anchor inferences around the role of PL.
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Affiliation(s)
- Alistair M. Senior
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
- School of Mathematics and Statistics, The University of Sydney, Camperdown, NSW 2006, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
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Bays HE, Golden A, Tondt J. Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 3:100034. [PMID: 37990730 PMCID: PMC10661978 DOI: 10.1016/j.obpill.2022.100034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of 30 common obesity myths, misunderstandings, and/or oversimplifications. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS discusses 30 common obesity myths, misunderstandings, and/or oversimplifications, utilizing referenced scientific publications such as the integrative use of other published OMA CPSs to help explain the applicable physiology/pathophysiology. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on 30 common obesity myths, misunderstandings, and/or oversimplifications is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of the underlying science may assist the obesity medicine clinician improve the care of patients with obesity.
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Affiliation(s)
- Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288, Illinois Avenue, Louisville, KY, 40213, USA
| | - Angela Golden
- NP Obesity Treatment Clinic, Flagstaff, AZ, 86001, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Penn State Health, Penn State College of Medicine, 700 HMC Crescent Rd Hershey, PA, 17033, USA
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Cummings JR, Lipsky LM, Schwedhelm C, Liu A, Nansel TR. Associations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth. Int J Behav Nutr Phys Act 2022; 19:61. [PMID: 35619114 PMCID: PMC9137185 DOI: 10.1186/s12966-022-01298-w] [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: 01/18/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive intake of ultra-processed foods, formulated from substances extracted from foods or derived from food constituents, may be a modifiable behavioral risk factor for adverse maternal and infant health outcomes. Prior work has predominately examined health correlates of maternal ultra-processed food intake in populations with substantially lower ultra-processed food intake compared to the US population. This longitudinal study investigated relations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth in a US cohort. METHODS Mothers in the Pregnancy Eating Attributes Study were enrolled at ≤12 weeks gestation and completed multiple 24-Hour Dietary Recalls within six visit windows through one-year postpartum (458 mothers enrolled, 321 retained at one-year postpartum). The NOVA (not an acronym) system categorized food and underlying ingredient codes based on processing level. Maternal anthropometrics were measured throughout pregnancy and postpartum, and infant anthropometrics were measured at birth and ages 2 months, 6 months, and 1 year. Maternal cardiometabolic markers were analyzed from blood samples obtained during the second and third trimesters. RESULTS Holding covariates and total energy intake constant, a 1-SD greater percent energy intake from ultra-processed foods during pregnancy was associated with 31% higher odds of excessive gestational weight gain (p = .045, 95% CI [1.01, 1.70]), 0.68±0.29 mg/L higher c-reactive protein during pregnancy (p = .021, 95% CI [0.10, 1.26]), 6.7±3.4% greater gestational weight gain retained (p = .049, 95% CI [0.03, 13.30]), and 1.09±0.36 kg greater postpartum weight retention (p = .003, 95% CI [0.38, 1.80]). No other significant associations emerged. CONCLUSIONS Ultra-processed food intake during pregnancy may be a modifiable behavioral risk factor for adverse maternal weight outcomes and inflammation. Randomized controlled trials are needed to test whether targeting ultra-processed food intake during pregnancy may support optimal maternal health. TRIAL REGISTRATION Clinicaltrials.gov. Registration ID - NCT02217462 . Date of registration - August 13, 2014.
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Affiliation(s)
- Jenna R Cummings
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Carolina Schwedhelm
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.
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The Association between Ultra-Processed Foods, Quality of Life and Insomnia among Adolescent Girls in Northeastern Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106338. [PMID: 35627875 PMCID: PMC9141842 DOI: 10.3390/ijerph19106338] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023]
Abstract
Ultra-processed foods have been associated with increased risk of chronic disease, poor overall health and psychological outcomes. This study explored the association of ultra-processed foods with quality of life in adolescent girls from northeastern Iran. In an interdisciplinary cross-sectional study, n = 733 adolescent girls were recruited by random cluster sampling. Assessments were completed for demographics, physical activity, anthropometric and biochemical parameters, psychological health and dietary intake. The participants were categorized into quartiles of ultra-processed food intake, and multivariable logistic regression was used in several models to investigate the association between ultra-processed food intake and psychological health. The mean age of the participants was 14 years. There were no significant differences in participant demographics for the quartiles of ultra-processed food intake including weight, waist-hip ratio, waist circumference, depression, insomnia and cardiometabolic markers related to cardiovascular disease risk. Adjusted logistic regression showed participants in the highest category of ultra-processed food consumption had an increased likelihood of reduced quality of life (OR: 1.87, 95% CI: 1.13-3.11), with a greater chance for insomnia (OR: 4.04, 95% CI: 1.83-8.94) across all models. However, no significant associations were observed between consumption of ultra-processed foods and daytime sleepiness. We highlight the association between ultra-processed food consumption and poor quality of life and insomnia amongst adolescent girls. Large longitudinal integrated public health studies in different ethnicities are needed to confirm these associations and evaluate their possible impact for optimizing health promotion programs.
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Sarmiento-Santos J, Souza MBN, Araujo LS, Pion JMV, Carvalho RA, Vanin FM. Consumers’ Understanding of Ultra-Processed Foods. Foods 2022; 11:foods11091359. [PMID: 35564081 PMCID: PMC9099562 DOI: 10.3390/foods11091359] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Food classification systems have been proposed to improve food quality criteria. Among these systems, “processing level” has been used as a criterion. NOVA classification, as the denotation “ultra-processed” food (UPF), has been widely used in different countries. However, even though some studies have pointed out some controversial aspects, no study has evaluated its comprehension by the population where it is used as reference. Therefore, this study explored the understanding of the term UPF for Brazilian consumers, where this denotation has been used in the last 8 years. A questionnaire was used, with questions referring to different aspects of self-assessment of knowledge about UPF. Altogether, 939 valid participants completed the questionnaire, and 81.9% of them declared to know the term UPF. For 78.2%, a better definition for UPF should be “foods that have gone through many processes in industry”. Finally, it was concluded that the term UPF is still confusing for most Brazilians, indicating the risk of use and the urgent necessity to improve the classifications systems and consequently consumer understanding. Only when all parties interested in healthy food work together could this problem be solved.
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Affiliation(s)
- Juliana Sarmiento-Santos
- Laboratory of Bread and Dough Process (LAPROPAMA), Food Engineering Department, Faculty of Animal Science and Food Engineering (USP/FZEA), University of São Paulo, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil; (J.S.-S.); (M.B.N.S.); (L.S.A.)
| | - Melissa B. N. Souza
- Laboratory of Bread and Dough Process (LAPROPAMA), Food Engineering Department, Faculty of Animal Science and Food Engineering (USP/FZEA), University of São Paulo, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil; (J.S.-S.); (M.B.N.S.); (L.S.A.)
| | - Lydia S. Araujo
- Laboratory of Bread and Dough Process (LAPROPAMA), Food Engineering Department, Faculty of Animal Science and Food Engineering (USP/FZEA), University of São Paulo, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil; (J.S.-S.); (M.B.N.S.); (L.S.A.)
| | - Juliana M. V. Pion
- NOZ Pesquisa e Inteligência, Rua Cauowaá, 1575-92, São Paulo 01258-011, SP, Brazil;
| | - Rosemary A. Carvalho
- Food Engineering Department, Macromolecules Functionality Multi-User Center (CEMFUM), Faculty of Animal Science and Food Engineering (USP/FZEA), University of São Paulo, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil;
| | - Fernanda M. Vanin
- Laboratory of Bread and Dough Process (LAPROPAMA), Food Engineering Department, Faculty of Animal Science and Food Engineering (USP/FZEA), University of São Paulo, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil; (J.S.-S.); (M.B.N.S.); (L.S.A.)
- Correspondence: ; Tel.: +55-19-3565-6866
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Cutroneo S, Angelino D, Tedeschi T, Pellegrini N, Martini D. Nutritional Quality of Meat Analogues: Results From the Food Labelling of Italian Products (FLIP) Project. Front Nutr 2022; 9:852831. [PMID: 35558740 PMCID: PMC9090485 DOI: 10.3389/fnut.2022.852831] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/17/2022] [Indexed: 01/13/2023] Open
Abstract
Nowadays, the interest in meat substitutes is increasing, and consumers perceive their nutritional quality better than that of the animal products they intend to resemble. Therefore, this work aimed to investigate the overall nutritional quality of these new products. Regulated information [Regulation (EU) 1169/2011], the presence/absence of nutrition or health claim and organic declarations, the gluten-free indication, and the number of ingredients were collected from the food labels of 269 commercial meat analogues currently sold on the Italian market. Nutritional information of reference animal meat products was used to compare the nutrition profile. As an indicator of the nutritional quality, the Nutri-Score of meat analogues and counterparts was also determined. Plant-based steaks showed significantly higher protein, lower energy, fats and salt contents, and better Nutri-Scores than the other analogues. All the meat analogues showed a higher fibre content than meat products, while plant-based burgers and meatballs had lower protein contents than meat counterparts. Ready-sliced meat analogues showed a lower salt content than cured meats. Overall, all these plant-based products showed a longer list of ingredients than animal meat products. Results from this survey highlighted that plant-based steaks, cutlets, and cured meats have some favourable nutritional aspects compared to animal-based products. However, they cannot be considered a "tout-court" alternative to meat products from a nutritional point of view.
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Affiliation(s)
- Sara Cutroneo
- Food and Drug Department, University of Parma, Parma, Italy
| | - Donato Angelino
- Faculty of Bioscience and Agro-Food and Environmental Technology, University of Teramo, Teramo, Italy
| | | | - Nicoletta Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Udine, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
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Aceves-Martins M, Bates RL, Craig LCA, Chalmers N, Horgan G, Boskamp B, de Roos B. Nutritional Quality, Environmental Impact and Cost of Ultra-Processed Foods: A UK Food-Based Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063191. [PMID: 35328877 PMCID: PMC8948822 DOI: 10.3390/ijerph19063191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Food-based analyses of the healthiness, environmental sustainability and affordability of processed and ultra-processed foods are lacking. This paper aimed to determine how ultra-processed and processed foods compare to fresh and minimally processed foods in relation to nutritional quality, greenhouse gas emissions and cost on the food and food group level. Data from the National Diet and Nutrition Survey nutrient databank year 11 (2018/2019) were used for this analysis. Median and bootstrapped medians of nutritional quality (NRF8.3 index), greenhouse gas emissions (gCO2-equivalents) and cost (in GBP) were compared across processing categories. An optimal score based on the medians was created to identify the most nutritional, sustainable, and affordable options across processing categories. On a per 100 kcal basis, ultra-processed and processed foods had a lower nutritional quality, lower greenhouse gas emissions, and were cheaper than minimally processed foods, regardless of their total fat, salt and/or sugar content. The most nutritious, environmentally friendly, and affordable foods were generally lower in total fat, salt, and sugar, irrespective of processing level. The high variability in greenhouse gas emissions and cost across food groups and processing levels offer opportunities for food swaps representing the healthiest, greenest, and most affordable options.
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Affiliation(s)
- Magaly Aceves-Martins
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
- Correspondence:
| | - Ruth L. Bates
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
| | - Leone C. A. Craig
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK;
| | - Neil Chalmers
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
| | - Graham Horgan
- Biomathematics & Statistics Scotland, Aberdeen AB25 2ZD, UK;
| | - Bram Boskamp
- Biomathematics & Statistics Scotland, The King’s Buildings, Edinburgh EH9 3FD, UK;
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
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Sadler CR, Grassby T, Hart K, Raats MM, Sokolović M, Timotijevic L. “Even We Are Confused”: A Thematic Analysis of Professionals' Perceptions of Processed Foods and Challenges for Communication. Front Nutr 2022; 9:826162. [PMID: 35284464 PMCID: PMC8904920 DOI: 10.3389/fnut.2022.826162] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
Processed foods are increasingly under the spotlight since the development of classification systems based on proxies for food processing. Published critical reviews and commentaries suggest different views among professional disciplines about the definition and classification of processed food. There is a need to further understand perspectives of professionals on the conceptualisation of processed food and the agreements and disagreements among experts, to encourage interdisciplinary dialogue and aid communication to the public. The aim of this research was to elicit views and understandings of professionals on processed food, their perceptions of lay people's perceptions of the same, and their perspectives on the challenges of communicating about processed foods to the public. The online discussion groups brought together a range of professionals (n = 27), covering the fields of nutrition, food technology, policy making, industry, and civil society, mixed in 5 heterogenous groups. Through thematic analysis the following themes relating to the conceptualisation of processed food and challenges for communication were identified: (1) Broad concepts that need differentiation; (2) Disagreements on scope and degree of processing; (3) The role of food processing within the food system: the challenges in framing risks and benefits; and (4) The challenge of different perspectives and interests for risk communication. Throughout the discussions blurred lines in the characterisation of processing, processed foods, and unhealthy foods were observed. Participants agreed that consensus is important, but difficult. Participants identified a need for further interdisciplinary dialogue, including public engagement, to break down the observed issues, and work towards a mutual understanding and develop clear communication messages.
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Affiliation(s)
- Christina R. Sadler
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- European Food Information Council, Brussels, Belgium
- *Correspondence: Christina R. Sadler
| | - Terri Grassby
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kathryn Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Monique M. Raats
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | | | - Lada Timotijevic
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Visioli F, Sofi F. Editorial: Analyzing the Relationship Between Dietary Patterns, Health Outcomes, and Individual Food Choices. Front Nutr 2022; 9:840554. [PMID: 35178423 PMCID: PMC8843831 DOI: 10.3389/fnut.2022.840554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/07/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Francesco Visioli
- Department of Molecular Medicine, University of Padova, Padua, Italy
- IMDEA-Food, Madrid, Spain
- *Correspondence: Francesco Visioli
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Tseng M, Grigsby CJ, Austin A, Amin S, Nazmi A. Sensory-Related Industrial Additives in the US Packaged Food Supply. Front Nutr 2022; 8:762814. [PMID: 35096926 PMCID: PMC8792784 DOI: 10.3389/fnut.2021.762814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Increasing evidence suggests that ultra-processed foods (UPFs) lead to elevated risk of obesity-related conditions, but UPF measurement has been criticized for its subjectivity and lack of clarity on biological mechanism. Sensory-related industrial additives (SRIAs) are a defining feature of UPFs and may encourage overconsumption by enhancing the sensory quality of foods. However, practical challenges have prevented systematic incorporation of SRIAs into UPF measurement. Objective: The objectives of this work were to describe a new, open-source ingredient list search method and to apply this method to describe the presence of SRIAs in US packaged foods. Methods: We developed computer coding to search for 64 common SRIAs related to sweetness, flavor, appearance, and texture in 241,688 foods in the US Branded Food Products Database (BFPD). The BFPD includes manufacturer-provided ingredient lists for ~300,000 branded and private label food items. We determined the total number of SRIAs (0–64) and the number of different types of SRIAs (sweetness, flavor, appearance, texture, 0–4) in each food, then calculated the percent of all foods with SRIAs. This was done for all foods, and by food group for 224,098 items with food group data. Results: Most (64.9%) foods in the BFPD contained at least one SRIA, and more than a third had at least three. Sweets (89.5%), beverages (84.9%), and ready-to-eat (RTE) foods (82.0%) were the most likely to contain SRIAs. With respect to SRIA types, 25.7% of all food items had at least three of the four types of SRIAs examined, with texture-related additives being the most common. Among sweets, 20% had all four types of SRIAs. Discussion: This work confirms the high prevalence of SRIAs in US packaged foods. They are ubiquitous in sweets, beverages, and RTE foods, but also present in substantial proportions of other food groups. Quantifying the presence of SRIAs in ingredient lists offers a novel way to identify UPFs for research; to distinguish more vs. less ultra-processed foods; and to test whether UPFs increase risk for obesity-related conditions through additives that enhance the product's sensory qualities.
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Affiliation(s)
- Marilyn Tseng
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States
- *Correspondence: Marilyn Tseng
| | - Camille J. Grigsby
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States
| | - Abigail Austin
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States
| | - Samir Amin
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, United States
| | - Aydin Nazmi
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, United States
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The Relationship between Addictive Eating and Dietary Intake: A Systematic Review. Nutrients 2021; 14:nu14010164. [PMID: 35011039 PMCID: PMC8747081 DOI: 10.3390/nu14010164] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Research suggests that certain foods may have addictive effects; however, no reviews have systematically appraised studies in this area. The aims of this review were to determine the nutrients, foods and dietary patterns associated with addictive eating. (2) Methods: Published studies up to November 2020 were identified through searches of 6 electronic databases. Eligible studies included those in in children and adults that reported dietary intakes of individuals with 'food addiction'. (3) Results: Fifteen studies (n = 12 in adults and n = 3 in children/adolescents with Yale Food Addiction Scale defined 'food addiction') were included. Foods commonly associated with addictive eating were those high in a combination of fat and refined carbohydrates. Generally, intakes of energy, carbohydrates and fats were significantly higher in individuals with addictive eating compared to those without. (4) Conclusions: Due to the heterogeneity in study methodologies and outcomes across included studies, it is difficult to conclude if any specific foods, nutrients or dietary patterns facilitate an addictive process. Further research is needed to elucidate potential associations. However, present addictive eating treatment approaches could incorporate individualised dietary advice targeting foods high in fat and refined carbohydrates.
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Fedde S, Rimbach G, Schwarz K, Bosy-Westphal A. [What is ultra-processed food and how is it related to diet-related diseases?]. Dtsch Med Wochenschr 2021; 147:46-52. [PMID: 34963174 DOI: 10.1055/a-1683-3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ultra-processed food is part of a modern lifestyle and accounts for about 46 % of daily energy intake in Germany. Cross-sectional and cohort studies indicate associations between consumption of ultra-processed food and a range of non-communicable diseases (obesity, diabetes, cancer, cardiovascular disease, and depression). As underlying mechanisms, a high energy density, altered food matrix, an unbalanced nutritional composition, high glycemic index, adverse additives, processing- and packaging contaminants are discussed. In order to understand the role of these potential mechanisms and to provide a scientifically based and risk-associated definition of ultra-processed food it is important to conduct appropriate intervention studies and to improve dietary assessment of processed food in prospective cohort studies.
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Affiliation(s)
- Svenja Fedde
- Institut für Humanernährung und Lebensmittelkunde, Abteilung Humanernährung, Christian-Albrechts-Universität zu Kiel
| | - Gerald Rimbach
- Institut für Humanernährung und Lebensmittelkunde, Abteilung Lebensmittelwissenschaften, Christian-Albrechts-Universität zu Kiel
| | - Karin Schwarz
- Institut für Humanernährung und Lebensmittelkunde, Abteilung Lebensmitteltechnologie, Christian-Albrechts-Universität zu Kiel
| | - Anja Bosy-Westphal
- Institut für Humanernährung und Lebensmittelkunde, Abteilung Humanernährung, Christian-Albrechts-Universität zu Kiel
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Li Y, Su J, Luo D, Duan Y, Huang Z, He M, Tao J, Xiao S, Xiao Y, Chen X, Shen M. Processed Food and Atopic Dermatitis: A Pooled Analysis of Three Cross-Sectional Studies in Chinese Adults. Front Nutr 2021; 8:754663. [PMID: 34938758 PMCID: PMC8685501 DOI: 10.3389/fnut.2021.754663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: The effect of processed foods on atopic dermatitis (AD) in adults is unclear. This study was to evaluate the association between processed foods and AD in the Chinese adult population. Design: This study included three population-based cross-sectional studies using cluster sampling by villages, institutions, or factories. Participants underwent dermatological examinations by certificated dermatologists and a food frequency questionnaire survey. A spot urine sample was collected to estimate the daily sodium intake. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were presented as the effect size. Setting: Shiyan city of Hubei province, and Huayuan, Shimen, Hengyang, Zhuzhou, and Changsha of Hunan province. Participants: Automobile manufacture workers from Shiyan of Hubei province, and rural residents and civil servants from Hunan. Results: A total of 15,062 participants, including 3,781 rural residents, 5,111 civil servants, and 6,170 workers, completed all evaluations. Compared to those hardly consumed pickles, consumption of pickles 1–3 times per week was significantly associated with AD (aOR: 1.35; 95% CI: 1.06–1.70). The intake of processed meats 1–3 times per month (aOR: 1.29; 95% CI: 1.05–1.58) and 1–3 times per week (aOR: 1.44; 95% CI: 1.11–1.87) were associated with AD dose-dependently when compared with those who rarely ate processed meats. Compared with non-consumers, the consumption of any processed foods 1–3 times per week (aOR: 1.39; 95% CI: 1.08–1.80) and ≥4 times per week (aOR: 1.41; 95% CI: 1.05–1.89) showed increased risks of AD. A positive association of estimated sodium intake with AD was also observed. Conclusion: Intake of processed foods is associated with AD in Chinese adults.
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Affiliation(s)
- Yajia Li
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Su
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yanying Duan
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhijun Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Meian He
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Tao
- Department of Dermatology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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50
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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: 80] [Impact Index Per Article: 26.7] [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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