In This Issue: Ultra-processed food and health.
01 Aug 2021-Public Health Nutrition (Cambridge University Press (CUP))-Vol. 24, Iss: 11, pp 3177-3178
About: This article is published in Public Health Nutrition.The article was published on 2021-08-01 and is currently open access. It has received 1 citations till now. The article focuses on the topics: Food processing.
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TL;DR: Different approaches to the compilation of branded foods datasets are presented, the history and progress of building and updating such datasets in Slovenia are described, and data to support nutrition research and monitoring of the food supply is presented.
Abstract: Branded foods databases are becoming very valuable not only in nutrition research but also for clinical practice, policymakers, businesses, and general population. In contrast to generic foods, branded foods are marked by rapid changes in the food supply because of reformulations, the introduction of new foods, and the removal of existing ones from the market. Also, different branded foods are available in different countries. This not only complicates the compilation of branded foods datasets but also causes such datasets to become out of date quickly. In this review, we present different approaches to the compilation of branded foods datasets, describe the history and progress of building and updating such datasets in Slovenia, and present data to support nutrition research and monitoring of the food supply. Manufacturers are key sources of information for the compilation of branded foods databases, most commonly through food labels. In Slovenia, the branded food dataset is compiled using standard food monitoring studies conducted at all major retailers. Cross-sectional studies are conducted every few years, in which the food labels of all available branded foods are photographed. Studies are conducted using the Composition and Labeling Information System (CLAS) infrastructure, composed of a smartphone application for data collection and online data extraction and management tool. We reviewed various uses of branded foods datasets. Datasets can be used to assess the nutritional composition of food in the food supply (i.e., salt, sugar content), the use of specific ingredients, for example, food additives, for nutrient profiling, and assessment of marketing techniques on food labels. Such datasets are also valuable for other studies, for example, assessing nutrient intakes in dietary surveys. Additional approaches are also being tested to keep datasets updated between food monitoring studies. A promising approach is the exploitation of crowdsourcing through the mobile application VešKajJeš, which was launched in Slovenia to support consumers in making healthier dietary choices.
9 citations
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TL;DR: It is concluded that the ever-increasing production and consumption of ultra-processed products is a world crisis, to be confronted, checked and reversed as part of the work of the UN Sustainable Development Goals and its Decade of Nutrition.
Abstract: Given evident multiple threats to food systems and supplies, food security, human health and welfare, the living and physical world and the biosphere, the years 2016-2025 are now designated by the UN as the Decade of Nutrition, in support of the UN Sustainable Development Goals. For these initiatives to succeed, it is necessary to know which foods contribute to health and well-being, and which are unhealthy. The present commentary outlines the NOVA system of food classification based on the nature, extent and purpose of food processing. Evidence that NOVA effectively addresses the quality of diets and their impact on all forms of malnutrition, and also the sustainability of food systems, has now accumulated in a number of countries, as shown here. A singular feature of NOVA is its identification of ultra-processed food and drink products. These are not modified foods, but formulations mostly of cheap industrial sources of dietary energy and nutrients plus additives, using a series of processes (hence 'ultra-processed'). All together, they are energy-dense, high in unhealthy types of fat, refined starches, free sugars and salt, and poor sources of protein, dietary fibre and micronutrients. Ultra-processed products are made to be hyper-palatable and attractive, with long shelf-life, and able to be consumed anywhere, any time. Their formulation, presentation and marketing often promote overconsumption. Studies based on NOVA show that ultra-processed products now dominate the food supplies of various high-income countries and are increasingly pervasive in lower-middle- and upper-middle-income countries. The evidence so far shows that displacement of minimally processed foods and freshly prepared dishes and meals by ultra-processed products is associated with unhealthy dietary nutrient profiles and several diet-related non-communicable diseases. Ultra-processed products are also troublesome from social, cultural, economic, political and environmental points of view. We conclude that the ever-increasing production and consumption of these products is a world crisis, to be confronted, checked and reversed as part of the work of the UN Sustainable Development Goals and its Decade of Nutrition.
1,063 citations
TL;DR: The issue of food processing is largely ignored or minimised in education and information about food, nutrition and health, and also in public health policies.
Abstract: Orthodox teaching and practice on nutrition and health almost always focuses on nutrients, or else on foods and drinks. Thus, diets that are high in folate and in green leafy vegetables are recommended, whereas diets high in saturated fat and in full-fat milk and other dairy products are not recommended. Food guides such as the US Food Guide Pyramid are designed to encourage consumption of healthier foods, by which is usually meant those higher in vitamins, minerals and other nutrients seen as desirable. What is generally overlooked in such approaches, which currently dominate official and other authoritative information and education programmes, and also food and nutrition public health policies, is food processing. It is now generally acknowledged that the current pandemic of obesity and related chronic diseases has as one of its important causes increased consumption of convenience including pre-prepared foods. However, the issue of food processing is largely ignored or minimised in education and information about food, nutrition and health, and also in public health policies. A short commentary cannot be comprehensive, and a general proposal such as that made here is bound to have some problems and exceptions. Also, the social, cultural, economic and environmental consequences of food processing are not discussed here. Readers’ comments and queries are invited.
428 citations
TL;DR: In this paper, a 4-year follow-up study was conducted to estimate changes in blood pressure and the incidence of hypertension associated with consumption of ultraprocessed foods (UPF) by Brazilian civil servants.
Abstract: Objective: To estimate changes in blood pressure and the incidence of hypertension associated with consumption of ultra-processed foods (UPF) by Brazilian civil servants at a 4-year follow-up. Design:
Longitudinal analysis of the ELSA-Brasil with non-hypertensive individuals at baseline. We applied the FFQ at the baseline and categorised energy intake by degree of processing, using the NOVA classification. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at baseline (2008–2010) and again at first follow-up (2012–2014). Incidence of arterial hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or antihypertensive medication during the previous 2 weeks. A mixed-effect linear regression model and mixed-effect logistic regression model were used to estimate associations between UPF consumption and, respectively, changes in blood pressure and incidence of hypertension. Setting:
Brazil. Participants:
Civil servants of Brazilian public academic institutions in six cities (n 8754), aged 35–74 years at baseline (2008–2010). Results:
UPF consumption contributed 25·2 % (sd = 9·6) of total energies consumed. After adjustment, participants with high UPF consumption presented a 23 % greater risk of developing hypertension (OR = 1·23, 95 % CI 1·06, 1·44) than those with low UPF consumption. We did not find association between UPF consumption and changes in blood pressure over time. Conclusions:
The higher the UPF consumption, the higher the risk of hypertension in adults. Reducing UPF consumption is thus important to promote health and prevent hypertension.
36 citations
TL;DR: Adherence to the traditional Mediterranean diet was inversely associated with energy intake from UPF, and public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.
Abstract: Objective: To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake. Design:
Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index. Setting:
Spain. Participants:
Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis. Results:
74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption. Conclusions:
Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.
22 citations
TL;DR: It was found that an increase of 1 percentage point in energy consumption from UPF in the third gestational trimester led to an average increase of 4·17 (95 % CI 0·55; 7·79) g in weekly GWG in this period.
Abstract: Objective: To investigate whether the consumption of ultra-processed foods (UPF) during pregnancy is associated with gestational weight gain (GWG). Design:
Cohort study with collection of two 24-h dietary recalls during each gestational trimester obtained on non-consecutive days and differentiating weekday v. weekend/holiday. The foods were classified according to the NOVA system into fresh or minimally processed foods and their culinary preparations, processed and UPF and subsequently analysed as a percentage contribution to dietary energy. The outcome was average GWG in the second and in the third trimesters, expressed in g/week. Setting:
Botucatu, a medium-sized Brazilian city. Participants:
Pregnant women with regular obstetric risk (n 259) undergoing prenatal care in primary healthcare. Results:
In a multiple linear regression model, it was found that an increase of 1 percentage point in energy consumption from UPF in the third gestational trimester led to an average increase of 4·17 (95 % CI 0·55; 7·79) g in weekly GWG in this period. There was no association between second-trimester UPF consumption and GWG. Conclusions:
Consumption of UPF in the third gestational trimester is positively associated with average weekly GWG in this period.
19 citations