Nutrients

Editorial

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4 pages, 213 KiB

Open AccessEditorial

Ultra-Processed Foods, Diet Quality and Human Health

by Monica Dinu and Daniela Martini

Nutrients 2023, 15(13), 2890; https://doi.org/10.3390/nu15132890 - 26 Jun 2023

Cited by 2 | Viewed by 2805

Abstract

The increase in the volume of industrially processed products in the global food supply has coincided with an increasing prevalence of obesity and non-communicable diseases in many countries, suggesting that ultra-processed foods (UPF) consumption may be detrimental to human health [...] Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

Research

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10 pages, 630 KiB

Open AccessArticle

Ultra-Processed Food Intakes Are Associated with Depression in the General Population: The Korea National Health and Nutrition Examination Survey

by Sunghee Lee and Myungjin Choi

Nutrients 2023, 15(9), 2169; https://doi.org/10.3390/nu15092169 - 1 May 2023

Cited by 12 | Viewed by 3922

Abstract

Depression is the most common mental illnesses worldwide. The consumption of ultra-processed food (UPF) has increased globally due to its affordability and convenience; however, only a few studies have investigated the link between UPF intake and depression in the general population. We investigated [...] Read more.

Depression is the most common mental illnesses worldwide. The consumption of ultra-processed food (UPF) has increased globally due to its affordability and convenience; however, only a few studies have investigated the link between UPF intake and depression in the general population. We investigated the associations between UPF and depression using the Korea National Health and Nutrition Examination Survey. A total of 9463 individuals (4200 males and 5263 females) aged above 19 years old participated in this study. The prevalence of depression was identified using the Patient Health Questionnaire-9. Dietary intake was assessed through a 24-h recall interview. The percentage of energy from UPFs was ascertained based on the NOVA classification. The associations between the quartile ranges of UPF intake and depression were estimated using logistic regression models. Individuals in the highest quartile had a 1.40 times higher likelihood of having depression, with marginal significance (95% confidence intervals (CIs) = 1.00–1.96). In a sex-specific stratification, only females demonstrated a significant association (odds ratio (OR) = 1.51, 95% CI 1.04–2.21), even after adjusting for confounders (p-value for trend = 0.023). Our findings revealed a significant association between higher UPF intake and depression among females but not among males in the Korean general population. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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14 pages, 24225 KiB

Open AccessArticle

Processing and Nutritional Quality of Breakfast Cereals Sold in Italy: Results from the Food Labelling of Italian Products (FLIP) Study

by Donato Angelino, Monica Dinu, Barbara Gandossi, Nicoletta Pellegrini and Daniela Martini

Nutrients 2023, 15(8), 2013; https://doi.org/10.3390/nu15082013 - 21 Apr 2023

Cited by 6 | Viewed by 2323

Abstract

This study aimed to compare the level of processing (as assessed by the NOVA classification) and the nutritional quality (as assessed by nutrition values, Nutri-Score and NutrInform battery) of breakfast cereals currently on the Italian market. A total of 349 items were found, [...] Read more.

This study aimed to compare the level of processing (as assessed by the NOVA classification) and the nutritional quality (as assessed by nutrition values, Nutri-Score and NutrInform battery) of breakfast cereals currently on the Italian market. A total of 349 items were found, mostly belonging to the NOVA 4 group (66.5%) and to Nutri-Score C and A (40% and 30%, respectively). The NOVA 4 products showed the highest energy, total fat, saturates, and sugar content per 100 g and had the highest number of items with Nutri-Score C (49%) and D (22%). Conversely, NOVA 1 products had the highest content of fibre and protein, the lowest amounts of sugars and salt, and 82% of them were Nutri-Score A, while few Nutri-Score B and C were found. Differences were attenuated when products were compared for their NutrInform battery, with NOVA 4 items showing only slightly fuller batteries for saturated fats, sugar, and salt than NOVA 1 and NOVA 3 products. Overall, these results suggest that the NOVA classification partially overlaps with systems based on the nutritional quality of foods. The lower nutritional quality of NOVA 4 foods may at least partially explain the association found between the consumption of ultra-processed foods and the risk of chronic diseases. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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14 pages, 532 KiB

Open AccessArticle

Association between Late-Eating Pattern and Higher Consumption of Ultra-Processed Food among Italian Adults: Findings from the INHES Study

by Marialaura Bonaccio, Emilia Ruggiero, Augusto Di Castelnuovo, Claudia Francisca Martínez, Simona Esposito, Simona Costanzo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano and Licia Iacoviello

Nutrients 2023, 15(6), 1497; https://doi.org/10.3390/nu15061497 - 20 Mar 2023

Cited by 3 | Viewed by 3176

Abstract

Late eating is reportedly associated with adverse metabolic health, possibly through poor diet quality. We tested the hypothesis that meal timing could also be linked to food processing, an independent predictor of health outcomes. We analysed data on 8688 Italians (aged > 19years) [...] Read more.

Late eating is reportedly associated with adverse metabolic health, possibly through poor diet quality. We tested the hypothesis that meal timing could also be linked to food processing, an independent predictor of health outcomes. We analysed data on 8688 Italians (aged > 19years) from the Italian Nutrition & HEalth Survey (INHES) established in 2010–2013 throughout Italy. Dietary data were collected through a single 24 h dietary recall, and the NOVA classification was used to categorize foods according to increasing levels of processing: (1) minimally processed foods (e.g., fruits); (2) culinary ingredients (e.g., butter); (3) processed foods (e.g., canned fish); (4) ultra-processed foods (UPFs; e.g., carbonated drinks, processed meat). We then calculated the proportion (%) of each NOVA group on the total weight of food eaten (g/d) by creating a weight ratio. Subjects were classified as early or late eaters based on the population’s median timing for breakfast, lunch and dinner. In multivariable-adjusted regression models, late eaters reported a lower intake of minimally processed food (β = −1.23; 95% CI −1.75 to −0.71), a higher intake of UPF (β = 0.93; 0.60 to 1.25) and reduced adherence to a Mediterranean Diet (β = −0.07; −0.12 to −0.03) as compared to early eaters. Future studies are warranted to examine whether increased UPF consumption may underpin the associations of late eating with adverse metabolic health reported in prior cohorts. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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10 pages, 1026 KiB

Open AccessArticle

Adherence to the Mediterranean Diet and Ultra-Processed Foods Consumption in a Group of Italian Patients with Celiac Disease

by Marta Tristan Asensi, Giuditta Pagliai, Sofia Lotti, Abigail Corrao, Barbara Colombini, Ilaria Giangrandi, Francesco Sofi and Monica Dinu

Nutrients 2023, 15(4), 938; https://doi.org/10.3390/nu15040938 - 13 Feb 2023

Cited by 8 | Viewed by 2532

Abstract

Evidence on the consumption of ultra-processed foods (UPF) in adults with celiac disease (CD) and its impact on Mediterranean Diet (MD) adherence is still limited. Our aim was to determine UPF consumption and its relationship with MD adherence in a group of adults, [...] Read more.

Evidence on the consumption of ultra-processed foods (UPF) in adults with celiac disease (CD) and its impact on Mediterranean Diet (MD) adherence is still limited. Our aim was to determine UPF consumption and its relationship with MD adherence in a group of adults, according to the presence of CD. This case-control study included 103 adults with CD and 312 without CD. UPF intake was assessed using the NOVA Food Frequency Questionnaire (NFFQ), while MD adherence was assessed using the Medi-Lite score. UPF represented 14.5% of the diet of participants with CD (246 g/day) and came mainly from cereals-based products (29%) and sweets (24.2%). UPF consumption did not differ with the presence of CD, but participants with CD had significantly (p < 0.05) higher consumption of precooked pasta and pre-packaged breads. Participants with CD also reported a significantly lower MD adherence than participants without CD (9.4 vs. 10.4), with higher intake of meat and dairy products, and lower consumption of vegetables and fish. An inverse trend was found between UPF consumption and MD adherence in adults with CD, although not statistically significant. These findings highlight the importance of improving nutrition education for subjects with CD, which should not only focus on gluten exclusion. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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12 pages, 654 KiB

Open AccessArticle

Adherence to the Mediterranean Diet and Health-Related Quality of Life during the COVID-19 Lockdown: A Cross-Sectional Study including Preschoolers, Children, and Adolescents from Brazil and Spain

by Desirée Victoria-Montesinos, Almudena Tárraga-Marcos, Javier Brazo-Sayavera, Estela Jiménez-López, Héctor Gutiérrez-Espinoza, Josefa María Panisello Royo, Pedro J. Tárraga-López and José Francisco López-Gil

Nutrients 2023, 15(3), 677; https://doi.org/10.3390/nu15030677 - 29 Jan 2023

Cited by 9 | Viewed by 3477

Abstract

Scientific literature has suggested positive associations between the Mediterranean diet (MD) and the health-related quality of life (HRQoL) in young populations. However, to our knowledge, this relationship is unexplored during a situation of social isolation (i.e., lockdown). The objective of the current study [...] Read more.

Scientific literature has suggested positive associations between the Mediterranean diet (MD) and the health-related quality of life (HRQoL) in young populations. However, to our knowledge, this relationship is unexplored during a situation of social isolation (i.e., lockdown). The objective of the current study is to examine the relationship between the MD and HRQoL during the COVID-19 lockdown among preschoolers, children, and adolescents from Brazil and Spain. This cross-sectional study includes a sample of 1099 three- to seventeen-year-old participants (47.6% girls) who were recruited via social networks. The HRQoL was assessed with the EQ-5D-Y. The Quality Index for Children and Teenagers (KIDMED) questionnaire was applied to evaluate the relationship between the MD and HRQoL. The highest prevalence of reported problems was found for worried, sad, or unhappy participants (39.8%). Furthermore, the lowest proportion of HRQoL problems was observed for “mobility” (2.5%). The proportion of high adherence to the MD was 44.3%. Participants with greater MD adherence reported higher HRQoL mean scores when compared with those who did not adhere to the MD (83.7 ± 0.6 vs. 85.6 ± 0.7, respectively; p < 0.05). Adherence to the MD and especially daily fruit intake were related to higher HRQoL during the COVID-19 lockdown among Brazilian and Spanish young people aged three to seventeen years. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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11 pages, 287 KiB

Open AccessArticle

Ultra-Processed Food Consumption and Depressive Symptoms in a Mediterranean Cohort

by Justyna Godos, Marialaura Bonaccio, Wahidah H. Al-Qahtani, Wolfgang Marx, Melissa M. Lane, Gian Marco Leggio and Giuseppe Grosso

Nutrients 2023, 15(3), 504; https://doi.org/10.3390/nu15030504 - 18 Jan 2023

Cited by 13 | Viewed by 8751

Abstract

Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of [...] Read more.

Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of this study was to investigate the relationship between the consumption of UPFs and depressive symptoms in a sample of younger Italian adults. A cross-sectional study was conducted on 596 individuals (age 18–35 y) recruited in southern Italy. Food frequency questionnaires and the NOVA classification were used to assess dietary factors; the Center for the Epidemiological Studies of Depression Short Form (CES-D-10) was used to assess presence of depressive symptoms. Individuals in the highest quartile of UPF consumption had higher odds of having depressive symptoms in the energy-adjusted model (odds ratio (OR) = 1.89, 95% confidence interval (CI): 1.06, 3.28); the association remained significant after adjusting for potential confounding factors (OR = 2.04, 95% CI: 1.04, 4.01) and became even stronger after further adjustment for adherence to the Mediterranean diet as a proxy of diet quality (OR = 2.70, 95% CI: 1.32, 5.51). In conclusion, a positive association between UPF consumption and likelihood of having depressive symptoms was found in younger Italian individuals. Given the consistency of the findings after adjustment for diet quality, further studies are needed to understand whether non-nutritional factors may play a role in human neurobiology. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

11 pages, 545 KiB

Open AccessArticle

Ultra-Processed Food Consumption Associated with Incident Hypertension among Chinese Adults—Results from China Health and Nutrition Survey 1997–2015

by Ming Li and Zumin Shi

Nutrients 2022, 14(22), 4783; https://doi.org/10.3390/nu14224783 - 11 Nov 2022

Cited by 11 | Viewed by 2574

Abstract

Objective: Ultra-processed food (UPF) has been shown to increase the cardiometabolic health risks. We aimed to determine the association between UPF intake based on the NOVA classification and the risk of hypertension incidence during 1997–2015. Methods: Data from 15,054 adults aged ≥ 20 [...] Read more.

Objective: Ultra-processed food (UPF) has been shown to increase the cardiometabolic health risks. We aimed to determine the association between UPF intake based on the NOVA classification and the risk of hypertension incidence during 1997–2015. Methods: Data from 15,054 adults aged ≥ 20 years (47.4% males) attending the China Nutrition and Health Survey (CNHS) were used. Food intake at each survey was assessed by a 3-day 24 h dietary recall and weighed food record method between 1997–2011. Cox regression was used to assess the association between UPF intake and incident hypertension. Results: During a mean average of 9.5 years (SD 5.5) of follow up, 4329 hypertension incident cases were identified. The incident rates (per 1000) for non-consumers and 1–49, 50–99, and ≥100 g/day of UPF intake were 29.5 and 29.5, 33.4, and 36.3, respectively. Compared with non-consumers, the hazard ratios (95% CI) for UPF intake of 1–49, 50–99, and >100 g/day were 1.00 (0.90–1.12), 1.17 (1.04–1.33), and 1.20 (1.06–1.35), respectively, (p = 0.001) after adjusting for potential confounding factors. There was a significant interaction between UPF intake and age with a higher risk in the younger group (<40 years) than in the older one. Conclusion: UPF consumption was dose-responsively associated with increased risk of hypertension among Chinese adults, especially in younger groups. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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14 pages, 819 KiB

Open AccessArticle

Description of Ultra-Processed Food Intake in a Swiss Population-Based Sample of Adults Aged 18 to 75 Years

by Valeria A. Bertoni Maluf, Sophie Bucher Della Torre, Corinne Jotterand Chaparro, Fabiën N. Belle, Saman Khalatbari-Soltani, Maaike Kruseman, Pedro Marques-Vidal and Angeline Chatelan

Nutrients 2022, 14(21), 4486; https://doi.org/10.3390/nu14214486 - 25 Oct 2022

Cited by 8 | Viewed by 3602

Abstract

Ultra-processed foods (UPFs) are associated with lower diet quality and several non-communicable diseases. Their consumption varies between countries/regions of the world. We aimed to describe the consumption of UPFs in adults aged 18–75 years living in Switzerland. We analysed data from the national [...] Read more.

Ultra-processed foods (UPFs) are associated with lower diet quality and several non-communicable diseases. Their consumption varies between countries/regions of the world. We aimed to describe the consumption of UPFs in adults aged 18–75 years living in Switzerland. We analysed data from the national food consumption survey conducted among 2085 participants aged 18 to 75 years. Foods and beverages resulting from two 24-h recalls were classified as UPFs or non-UPFs according to the NOVA classification, categorized into 18 food groups, and linked to the Swiss Food Composition Database. Overall, the median energy intake [P25–P75] from UPFs was 587 kcal/day [364–885] or 28.7% [19.9–38.9] of the total energy intake (TEI). The median intake of UPFs relative to TEI was higher among young participants (<30 years, p = 0.001) and those living in the German-speaking part of Switzerland (p = 0.002). The food groups providing the most ultra-processed calories were confectionary, cakes & biscuits (39.5% of total UPF kcal); meat, fish & eggs (14.9%); cereal products, legumes & potatoes (12.5%), and juices & soft drinks (8.0%). UPFs provided a large proportion of sugars (39.3% of total sugar intake), saturated fatty acids (32.8%), and total fats (31.8%) while providing less than 20% of dietary fibre. Consumption of UPFs accounted for nearly a third of the total calories consumed in Switzerland. Public health strategies to reduce UPF consumption should target sugary foods/beverages and processed meat. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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11 pages, 492 KiB

Open AccessArticle

Association between Ultra-Processed Food Consumption and Diabetes in Chinese Adults—Results from the China Health and Nutrition Survey

by Ming Li and Zumin Shi

Nutrients 2022, 14(20), 4241; https://doi.org/10.3390/nu14204241 - 12 Oct 2022

Cited by 14 | Viewed by 3547

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. [...] Read more.

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. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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21 pages, 1118 KiB

Open AccessFeature PaperArticle

Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome

by Jadwiga Konieczna, Miguel Fiol, Antoni Colom, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Dolores Corella, María Trinidad Soria-Florido, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, José López-Miranda, Ramon Estruch, M. Rosa Bernal-López, José Lapetra, Lluís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, José J. Gaforio, Pilar Matía-Martín, Josep Vidal, Clotilde Vázquez, Lidia Daimiel, Emilio Ros, Maira Bes-Rastrollo, María Pascual, Jose V. Sorlí, Albert Goday, María Ángeles Zulet, Anai Moreno-Rodriguez, Francisco Jesús Carmona González, Rafael Valls-Enguix, Juana M. Janer, Antonio Garcia-Rios, Rosa Casas, Ana M. Gomez-Perez, José Manuel Santos-Lozano, F. Javier Basterra-Gortari, María Ángeles Martínez, Carolina Ortega-Azorin, Joan Bayó, Itziar Abete, Itziar Salaverria-Lete, Miguel Ruiz-Canela, Nancy Babio, Lourdes Carres and Dora Romaguera Show full author list Hide full author list

Nutrients 2022, 14(19), 4142; https://doi.org/10.3390/nu14194142 - 5 Oct 2022

Cited by 15 | Viewed by 5448

Abstract

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been [...] Read more.

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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15 pages, 631 KiB

Open AccessArticle

A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index

by Amanda Grech, Anna Rangan, Margaret Allman-Farinelli, Stephen J. Simpson, Tim Gill and David Raubenheimer

Nutrients 2022, 14(19), 3942; https://doi.org/10.3390/nu14193942 - 23 Sep 2022

Cited by 4 | Viewed by 2275

Abstract

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. [...] Read more.

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p < 0.001) between lowest and highest tertiles of DF intake, which was significantly higher than UPF (0.6 MJ, p < 0.001). This demonstrates that, for Australia, the DF classification better distinguishes foods associated with high energy intakes than does the NOVA system. BMI was positively associated with both DFs (−1. 0, p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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11 pages, 280 KiB

Open AccessArticle

Greater Ultra-Processed Food Intake during Pregnancy and Postpartum Is Associated with Multiple Aspects of Lower Diet Quality

by Tonja R. Nansel, Jenna R. Cummings, Kyle Burger, Anna Maria Siega-Riz and Leah M. Lipsky

Nutrients 2022, 14(19), 3933; https://doi.org/10.3390/nu14193933 - 22 Sep 2022

Cited by 13 | Viewed by 3046

Abstract

Low diet quality during pregnancy and postpartum is associated with numerous adverse maternal and infant health outcomes. This study examined relations of ultra-processed food intake with diet quality during pregnancy and postpartum. Using data from 24-h recalls, ultra-processed food intake was operationalized as [...] Read more.

Low diet quality during pregnancy and postpartum is associated with numerous adverse maternal and infant health outcomes. This study examined relations of ultra-processed food intake with diet quality during pregnancy and postpartum. Using data from 24-h recalls, ultra-processed food intake was operationalized as percent energy intake from NOVA-classified ultra-processed foods; diet quality was measured using Healthy Eating Index 2015 (HEI) total and component scores. Pearson correlations examined associations of ultra-processed food intake with HEI total and component scores, and food group intake was compared across four levels of ultra-processed food intake. On average, ultra-processed food comprised 52.6 ± 15.1% (mean ± SD) of energy intake in pregnancy and 50.6 ± 16.6% in postpartum. Ultra-processed food intake was inversely correlated with HEI total and 8 of 13 component scores. Compared to participants with the highest ultra-processed food intake (≥60% energy), those with the lowest ultra-processed food intake (<40% energy) had a 17.6-point higher HEI total score and consumed 2–3 times more fruit, vegetables, and seafood and plant proteins, and 1½ times more total protein. Additionally, they consumed 2/3 as much refined grains and 1/2 as much added sugar. Greater ultra-processed food intake was associated with lower diet quality across most HEI components. Reducing ultra-processed food intake may broadly improve adherence to dietary guidelines in pregnant and postpartum populations. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

21 pages, 4113 KiB

Open AccessArticle

Zinc Supplementation Partially Decreases the Harmful Effects of a Cafeteria Diet in Rats but Does Not Prevent Intestinal Dysbiosis

by Samia Squizani, Jeferson Jantsch, Fernanda da Silva Rodrigues, Matheus Filipe Braga, Sarah Eller, Tiago Franco de Oliveira, Alexandre Kleber Silveira, José Cláudio Fonseca Moreira, Marcia Giovenardi, Marilene Porawski and Renata Padilha Guedes

Nutrients 2022, 14(19), 3921; https://doi.org/10.3390/nu14193921 - 22 Sep 2022

Cited by 9 | Viewed by 3280

Abstract

Zinc (Zn) plays an important role in metabolic homeostasis and may modulate neurological impairment related to obesity. The present study aimed to evaluate the effect of Zn supplementation on the intestinal microbiota, fatty acid profile, and neurofunctional parameters in obese male Wistar rats. [...] Read more.

Zinc (Zn) plays an important role in metabolic homeostasis and may modulate neurological impairment related to obesity. The present study aimed to evaluate the effect of Zn supplementation on the intestinal microbiota, fatty acid profile, and neurofunctional parameters in obese male Wistar rats. Rats were fed a cafeteria diet (CAF), composed of ultra-processed and highly caloric and palatable foods, for 20 weeks to induce obesity. From week 16, Zn supplementation was started (10 mg/kg/day). At the end of the experiment, we evaluated the colon morphology, composition of gut microbiota, intestinal fatty acids, integrity of the intestinal barrier and blood–brain barrier (BBB), and neuroplasticity markers in the cerebral cortex and hippocampus. Obese rats showed dysbiosis, morphological changes, short-chain fatty acid (SCFA) reduction, and increased saturated fatty acids in the colon. BBB may also be compromised in CAF-fed animals, as claudin-5 expression is reduced in the cerebral cortex. In addition, synaptophysin was decreased in the hippocampus, which may affect synaptic function. Our findings showed that Zn could not protect obese animals from intestinal dysbiosis. However, an increase in acetate levels was observed, which suggests a partial beneficial effect of Zn. Thus, Zn supplementation may not be sufficient to protect from obesity-related dysfunctions. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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15 pages, 529 KiB

Open AccessArticle

Ultra-Processed Foods as Ingredients of Culinary Recipes Shared on Popular Brazilian YouTube Cooking Channels

by Anice Milbratz de Camargo, Alyne Michelle Botelho, Állan Milbratz de Camargo, Moira Dean and Giovanna Medeiros Rataichesck Fiates

Nutrients 2022, 14(18), 3689; https://doi.org/10.3390/nu14183689 - 7 Sep 2022

Cited by 3 | Viewed by 2381

Abstract

Social media platforms are readily accessible sources of information about cooking, an activity deemed crucial for the improvement of a population’s diet. Previous research focused on the healthiness of the content shared on websites and blogs, but not on social media such as [...] Read more.

Social media platforms are readily accessible sources of information about cooking, an activity deemed crucial for the improvement of a population’s diet. Previous research focused on the healthiness of the content shared on websites and blogs, but not on social media such as YouTube^®. This paper analysed the healthiness of 823 culinary recipes retrieved from 755 videos shared during a six-month period on ten popular Brazilian YouTube^® cooking channels. Recipes were categorized by type of preparation. To assess recipes’ healthiness, ingredients were classified according to the extension and purpose of industrial processing, in order to identify the use of ultra-processed foods. Additionally, a validated framework developed from criteria established in both editions of the Dietary Guidelines for the Brazilian Population was employed. Recipes for cakes and baked goods, puddings, snacks and homemade fast foods, which were among the most frequently posted, contained the lowest proportion of unprocessed/minimally processed ingredients and the highest proportion of ultra-processed ingredients. Recipes containing whole cereals, fruits, legumes, nuts, and seeds were scarce. Results indicate that users should be critical about the quality of recipes shared on YouTube^® videos, also indicating a need for strategies aimed at informing individuals on how to choose healthier recipes or adapt them to become healthier. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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15 pages, 473 KiB

Open AccessArticle

Higher Ultra-Processed Food Consumption Is Associated with Greater High-Sensitivity C-Reactive Protein Concentration in Adults: Cross-Sectional Results from the Melbourne Collaborative Cohort Study

by Melissa M. Lane, Mojtaba Lotfaliany, Malcolm Forbes, Amy Loughman, Tetyana Rocks, Adrienne O’Neil, Priscila Machado, Felice N. Jacka, Allison Hodge and Wolfgang Marx

Nutrients 2022, 14(16), 3309; https://doi.org/10.3390/nu14163309 - 12 Aug 2022

Cited by 25 | Viewed by 7814

Abstract

Background: Few studies have examined associations between ultra-processed food intake and biomarkers of inflammation, and inconsistent results have been reported in the small number of studies that do exist. As such, further investigation is required. Methods: Cross-sectional baseline data from the Melbourne Collaborative [...] Read more.

Background: Few studies have examined associations between ultra-processed food intake and biomarkers of inflammation, and inconsistent results have been reported in the small number of studies that do exist. As such, further investigation is required. Methods: Cross-sectional baseline data from the Melbourne Collaborative Cohort Study (MCCS) were analysed (n = 2018). We applied the NOVA food classification system to data from a food frequency questionnaire (FFQ) to determine ultra-processed food intake (g/day). The outcome was high-sensitivity C-reactive protein concentration (hsCRP; mg/L). We fitted unadjusted and adjusted linear regression analyses, with sociodemographic characteristics and lifestyle- and health-related behaviours as covariates. Supplementary analyses further adjusted for body mass index (kg/m²). Sex was assessed as a possible effect modifier. Ultra-processed food intake was modelled as 100 g increments and the magnitude of associations expressed as estimated relative change in hsCRP concentration with accompanying 95% confidence intervals (95%CIs). Results: After adjustment, every 100 g increase in ultra-processed food intake was associated with a 4.0% increase in hsCRP concentration (95%CIs: 2.1–5.9%, p < 0.001). Supplementary analyses showed that part of this association was independent of body mass index (estimated relative change in hsCRP: 2.5%; 95%CIs: 0.8–4.3%, p = 0.004). No interaction was observed between sex and ultra-processed food intake. Conclusion: Higher ultra-processed food intake was cross-sectionally associated with elevated hsCRP, which appeared to occur independent of body mass index. Future prospective and intervention studies are necessary to confirm directionality and whether the observed association is causal. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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16 pages, 1659 KiB

Open AccessArticle

Geographical and Temporal Variability of Ultra-Processed Food Consumption in the Spanish Population: Findings from the DRECE Study

by Carmen Romero Ferreiro, Pilar Cancelas Navia, David Lora Pablos and Agustín Gómez de la Cámara

Nutrients 2022, 14(15), 3223; https://doi.org/10.3390/nu14153223 - 6 Aug 2022

Cited by 8 | Viewed by 3758

Abstract

The consumption of ultra-processed foods (UPFs) has increased in recent decades, worldwide. Evidence on the negative impacts of food processing on health outcomes has also been steadily increasing. The aim of this study is to describe changes in consumption patterns of ultra-processed foods [...] Read more.

The consumption of ultra-processed foods (UPFs) has increased in recent decades, worldwide. Evidence on the negative impacts of food processing on health outcomes has also been steadily increasing. The aim of this study is to describe changes in consumption patterns of ultra-processed foods in the Spanish population over time and their geographical variability. Data from four representative cohorts of the Spanish population were used (1991–1996–2004–2008). Dietary information was collected using a validated frequency questionnaire and categorized using the NOVA classification. A total increase of 10.8% in UPF consumption between 1991 and 2008 was found in Spain (p-value < 0.001). The products contributing most to UPF consumption were sugar-sweetened beverages, processed meats, dairy products, and sweets. Those who consumed more ultra-processed foods were younger (p-value < 0.001) and female (p-value = 0.01). Significant differences between the different geographical areas of Spain were found. The eastern part of Spain was the area with the lowest UPF consumption, whereas the north-western part was the area with the highest increase in UPF consumption. Given the negative effect that the consumption of ultra-processed foods has on health, it is necessary to implement public health policies to curb this increase in UPF consumption. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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15 pages, 1605 KiB

Open AccessArticle

Dietitians’ Attitudes and Understanding of the Promotion of Grains, Whole Grains, and Ultra-Processed Foods

by Natasha Krois, Jaimee Hughes and Sara Grafenauer

Nutrients 2022, 14(15), 3026; https://doi.org/10.3390/nu14153026 - 23 Jul 2022

Cited by 6 | Viewed by 2834

Abstract

NOVA is a food-classification system based on four levels of processing, from minimally processed to ultra-processed foods (UPFs). Whole-grain-containing commercial breads and ready-to-eat breakfast cereals are considered ultra-processed within NOVA, despite being considered core foods in the Australian Dietary Guidelines. These food categories [...] Read more.

NOVA is a food-classification system based on four levels of processing, from minimally processed to ultra-processed foods (UPFs). Whole-grain-containing commercial breads and ready-to-eat breakfast cereals are considered ultra-processed within NOVA, despite being considered core foods in the Australian Dietary Guidelines. These food categories contribute the greatest quantities of whole grain in the Australian diet, although consumption is less than half of the 48 g/day daily target intake. Dietitians are key to disseminating messages about nutrition and health; therefore, an accurate understanding of whole grains and the effects of processing is critical to avoid the unnecessary exclusion of nutritionally beneficial foods. The aim was to utilise an online structured questionnaire to investigate dietitians’ attitudes to the promotion of grains and whole grains and understand their level of knowledge about and attitudes towards NOVA and the classification of specific whole-grain foods. Whole-grain foods were perceived positively and are regularly promoted in dietetic practice (n = 150). The dietitians tended not to consider whole-grain breads and ready-to-eat breakfast cereals as excessively processed, although most generally agreed with the classification system based on the extent of processing. If dietitians intend to incorporate NOVA and concepts of UPFs in their counselling advice, the anomalies regarding the categorisation of whole-grain choices and optimum intakes should be addressed. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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11 pages, 726 KiB

Open AccessEditor’s ChoiceArticle

Consumption of Ultra-Processed Foods Is Inversely Associated with Adherence to the Mediterranean Diet: A Cross-Sectional Study

by Monica Dinu, Marta Tristan Asensi, Giuditta Pagliai, Sofia Lotti, Daniela Martini, Barbara Colombini and Francesco Sofi

Nutrients 2022, 14(10), 2073; https://doi.org/10.3390/nu14102073 - 15 May 2022

Cited by 38 | Viewed by 3890

Abstract

Information on the consumption of ultra-processed foods (UPF) in relation to an adherence to the Mediterranean diet (MD) is limited. Our aim was to assess UPF consumption in a group of Italian adults and to evaluate the relationship with the MD adherence. A [...] Read more.

Information on the consumption of ultra-processed foods (UPF) in relation to an adherence to the Mediterranean diet (MD) is limited. Our aim was to assess UPF consumption in a group of Italian adults and to evaluate the relationship with the MD adherence. A total of 670 participants (median age: 30 years) were included in the analysis. The consumption of UPF was assessed through the NOVA Food Frequency Questionnaire (NFFQ). Adherence to the MD was assessed through the Medi-Lite score. The percentage of UPF in the diet was 16.4% corresponding to 299 g of UPF per day. These amounts were significantly (p < 0.05) higher in men than in women and came mainly from ready-to-eat meals or pre-packaged bread, bread alternatives, pizza, frozen potato chips (24.5% of total UPF intake), pre-packaged biscuits and sweets (20.7%), soft drinks (15.8%), and dairy products such as flavored yogurt (12%). As to the MD adherence, a significant inverse association between the Medi-Lite score and the percentage of UPF in the diet (R = −0.35; p < 0.001) was observed. Participants with a low adherence to the MD had a significantly higher contribution of UPF in the diet (22.2%) compared to those with a moderate (16.2%) and high (12.6%) adherence. In terms of individual UPF, the largest difference between low and high MD adherents was observed for pre-packaged biscuits and sweets, soft and energy drinks, sausages and other reconstituted meat products, and pre-packaged bread and bread alternatives. These results suggest that public health strategies are needed to implement more effective actions to promote healthy eating habits in the population. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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Review

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14 pages, 1081 KiB

Open AccessEditor’s ChoiceReview

Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review

by Marta Tristan Asensi, Antonia Napoletano, Francesco Sofi and Monica Dinu

Nutrients 2023, 15(6), 1546; https://doi.org/10.3390/nu15061546 - 22 Mar 2023

Cited by 52 | Viewed by 23879

Abstract

Low-grade inflammation alters the homeostasis of the organism and favors the onset of many chronic diseases. The global growth in the prevalence of noncommunicable diseases in recent years has been accompanied by an increase in the consumption of ultra-processed foods (UPF). Known to [...] Read more.

Low-grade inflammation alters the homeostasis of the organism and favors the onset of many chronic diseases. The global growth in the prevalence of noncommunicable diseases in recent years has been accompanied by an increase in the consumption of ultra-processed foods (UPF). Known to be hyperpalatable, economic and ready-to-eat, increased consumption of UPF has already been recognized as a risk factor for several chronic diseases. Different research groups have tried to investigate whether UPF consumption could promote low-grade inflammation and thus favor the development of noncommunicable diseases. Current evidence highlights the adverse health effects of UPF characteristics, not only due to the nutrients provided by a diet rich in UPF, but also due to the non-nutritive components present in UPF and the effect they may have on gut health. This review aims to summarize the available evidence on the possible relationship between excessive UPF consumption and modulation of low-grade inflammation, as potential promoters of chronic disease. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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Other

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18 pages, 1985 KiB

Open AccessEditor’s ChoiceSystematic Review

Ultra-Processed Food Consumption and Incidence of Obesity and Cardiometabolic Risk Factors in Adults: A Systematic Review of Prospective Studies

by Sara Paola Mambrini, Francesca Menichetti, Simone Ravella, Marta Pellizzari, Ramona De Amicis, Andrea Foppiani, Alberto Battezzati, Simona Bertoli and Alessandro Leone

Nutrients 2023, 15(11), 2583; https://doi.org/10.3390/nu15112583 - 31 May 2023

Cited by 26 | Viewed by 8056

Abstract

Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has increased likewise the incidence of obesity and cardiometabolic diseases. To highlight a possible relationship, we conducted a systematic review of [...] Read more.

Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has increased likewise the incidence of obesity and cardiometabolic diseases. To highlight a possible relationship, we conducted a systematic review of prospective studies from PubMed and Web of Science investigating the association between UPF consumption and the incidence of obesity and cardiometabolic risk factors. Seventeen studies were selected. Eight evaluated the incidence of general and abdominal obesity, one the incidence of impaired fasting blood glucose, four the incidence of diabetes, two the incidence of dyslipidemia, and only one the incidence of metabolic syndrome. Studies’ quality was assessed according to the Critical Appraisal Checklist for cohort studies proposed by the Joanna Briggs Institute. Substantial agreement emerged among the studies in defining UPF consumption as being associated with the incident risk of general and abdominal obesity. More limited was the evidence on cardiometabolic risk. Nevertheless, most studies reported that UPF consumption as being associated with an increased risk of hypertension, diabetes, and dyslipidemia. In conclusion, evidence supports the existence of a relationship between UPF consumption and the incidence of obesity and cardiometabolic risk. However, further longitudinal studies considering diet quality and changes over time are needed. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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24 pages, 1673 KiB

Open AccessSystematic Review

Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis

by Walkyria O. Paula, Erika S. O. Patriota, Vivian S. S. Gonçalves and Nathalia Pizato

Nutrients 2022, 14(15), 3242; https://doi.org/10.3390/nu14153242 - 8 Aug 2022

Cited by 29 | Viewed by 6707

Abstract

The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption [...] Read more.

The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes. Full article

(This article belongs to the Special Issue Ultra-Processed Foods, Diet Quality and Human Health)

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