Ultra-processed Food and Obesity: What Is the Evidence?

Chitosan-Based Nanoparticles Targeted Delivery System: In Treatment Approach for Dyslipidemia

Hyperlipidemia, characterized by abnormally high lipid levels in the bloodstream, is a significant risk factor for cardiovascular diseases. Conventional treatments have limitations in efficacy and may lead to side effects. Nanotechnology offers unique advantages in drug delivery, including improved drug stability, prolonged circulation time, and enhanced tissue targeting. Using nanoparticles as carriers, therapeutic agents can be precisely delivered to the target site, such as the liver or arterial walls, where lipid metabolism occurs. Chitosan nanoparticles represent an advanced approach engineered with precision to target atherosclerotic plaques. They have dual functionalities, serving therapeutic and diagnostic purposes in managing atherosclerosis. Targeting strategies involve coating nanoparticles with ligands or antibodies that recognize specific receptors overexpressed in hyperlipidemic conditions. This selective uptake maximizes the therapeutic effect while minimizing off-target effects, making it a promising alternative to traditional treatments. The review provides an overview of recent research developments for managing dyslipidemia based on the molecular target pathway of dyslipidemia, focusing on Chitosan-based delivery systems that allow controlled drug release, targeting, and enhancing patient compliance.

Behavioral and neural alterations of the ventral tegmental area by exposure to junk food in rats

The brain reward system is essential for regulating appetitive and consummatory behaviors in response to various incentive stimuli. Junk food, characterized by its high palatability, is particularly associated with the potential for excessive consumption. While prior studies indicate that excessive junk food intake can impact reward circuitry, the precise mechanisms underlying these effects remain elusive. Furthermore, it is unclear whether the functionality of this neural system is similarly altered in response to other natural rewards. In this study, we used fiber photometry combined with a behavioral reward test to investigate the effects of six weeks of excessive cafeteria (CAF) diet consumption on ventral tegmental area (VTA) neural activity and behavioral responses to food and sexual rewards in female rats. Our findings demonstrate that prolonged exposure to a CAF diet reduced the exploration and consumption of food rewards. These behavioral changes were accompanied by attenuated neural activity in the VTA. Similarly, reductions in VTA activity were observed in response to a sexual partner, although no significant behavioral differences were detected during sexual interactions. Moreover, a two-week reversal diet of standard chow proved insufficient to restore VTA neural activity in CAF-exposed animals, which continued to exhibit decreased VTA responses to both food rewards and sexual partners. Our results suggest that prolonged junk food exposure induces desensitization of the VTA, resulting in reduced responsiveness to natural rewards.

Exploring the effect of the triglyceride-glucose index on bone metabolism in prepubertal children, a retrospective study: insights from traditional methods and machine-learning-based bone remodeling prediction

Background

Childhood obesity poses a significant risk to bone health, but the impact of insulin resistance (IR) on bone metabolism in prepubertal children, as assessed by the triglyceride-glucose (TyG) index, remains underexplored. Bone turnover markers (BTMs) provide a non-invasive method for evaluating bone remodeling, but their relationship to obesity-related metabolic changes requires further study.

Methods

In this retrospective study of 332 prepubertal children (163 boys and 169 girls), we used multivariate linear regression and five machine learning (ML) algorithms to explore the association between the TyG index and BTMs, including β-C-terminal telopeptide of type 1 collagen (β-CTx), total procollagen type 1 N-terminal propeptide (T-P1NP), and N-terminal mid-fragment of osteocalcin (N-MID). The categorical boosting (CatBoost) models selected based on optimal performance metrics were interpreted using SHapley Additive exPlanation (SHAP) analysis to identify key features affecting prediction.

Results

The TyG index was negatively correlated with β-CTx, T-P1NP, and N-MID levels (P < 0.05), with a dose-response effect. The CatBoost model showed higher predictive accuracy and robustness, with the area under the receiver operating characteristic curve (AUROC) values of 0.782 (95% CI [0.68-0.885]), 0.789 (95% CI [0.691-0.874]), and 0.727 (95% CI [0.619-0.827]) for β-CTx, T-P1NP, and N-MID predictions, respectively. The SHAP analysis highlighted body mass index (BMI) and HbA1c as the key predictors.

Conclusions

The TyG index is a reliable predictor of bone metabolic disorders in prepubertal obese children, and the interpretable CatBoost model provides a cost-effective tool for early intervention. This study has important implications for prevention strategies for disorders of bone metabolism in prepubertal obese children to reduce the risk of skeletal fragility in adulthood or old age.

Advanced glycation end-product intake predicts insulin resistance in a sex-dependent fashion

PURPOSE

Dietary advanced glycation end products (AGEs) have been implicated in promoting insulin resistance. However, their impact on insulin resistance in a mixed population made up of males and females remains controversial. The aim of this study was to evaluate whether the relationship between dietary AGEs and insulin resistance may be sex-dependent.

METHODS

195 males and 239 females were included in this cross-sectional study. Study participants underwent anthropometric and metabolic assessments. AGE intake was estimated using food frequency questionnaires and databases reporting AGE content in individual food items. The relationship between AGE intake and insulin resistance, estimated using HOMA-IR, was assessed using Pearson correlation test. The predictive power of dietary AGEs towards HOMA-IR was investigated using stepwise linear regression.

RESULTS

AGE intake correlated positively with HOMA-IR in females (p < 0.01) but not in male study participants (p > 0.05). Moreover, AGE intake was able to increase the predictive power of BMI towards insulin resistance in females but not males. Instead, anthropometric variables were the only discriminants able to predict insulin resistance in males.

CONCLUSION

Dietary AGEs exert a sex-dependent effect on insulin resistance as their intake is associated with and able to predict HOMA-IR in females but not males. This suggests that females may be more susceptible to the deleterious impact of these glycotoxins on insulin sensitivity. Nevertheless, considering this study not involving a nutritional intervention to directly elucidate whether the effect of AGEs on insulin resistance is sex-dependent, further studies are warranted to confirm the present findings.

The link between ultra-processed food consumption, fecal microbiota, and metabolomic profiles in older mediterranean adults at high cardiovascular risk

BACKGROUND

Ultra-processed food (UPF) consumption has been linked to adverse metabolic outcomes, potentially mediated by alterations in gut microbiota and metabolite production.

OBJECTIVE

This study aims to explore the cross-sectional and longitudinal associations between NOVA-classified UPF consumption, fecal microbiota, and fecal metabolome in a population of Mediterranean older adults at high cardiovascular risk.

METHODS

A total of 385 individuals, aged between 55 and 75 years, were included in the study. Dietary and lifestyle information, anthropometric measurements, and stool samples were collected at baseline and after 1-year follow-up. Fecal microbiota and metabolome were assessed using 16 S rRNA sequencing and liquid chromatography-tandem mass spectrometry, respectively.

RESULTS

At baseline, higher UPF consumption was associated with lower abundance of Ruminococcaceae incertae sedis (β = - 0.275, P = 0.047) and lower concentrations of the metabolites propionylcarnitine (β = - 0.0003, P = 0.013) and pipecolic acid (β = - 0.0003, P = 0.040) in feces. Longitudinally, increased UPF consumption was linked to reduced abundance of Parabacteroides spp. after a 1-year follow-up (β = - 0.278, P = 0.002).

CONCLUSIONS

High UPF consumption was associated with less favorable gut microbiota and metabolite profiles, suggesting a possible link to reduced short-chain fatty acid (SCFA) production, altered mitochondrial energy metabolism, and impaired amino acid metabolism. These findings support the reduction of UPF consumption and the promotion of dietary patterns rich in fiber for better gut health. Further research is needed to confirm these associations and clarify the underlying mechanisms.

TRIAL REGISTRATION

ISRCTN89898870 ( https://doi.org/10.1186/ISRCTN89898870 ).

Beneath the Surface: The Emerging Role of Ultra-Processed Foods in Obesity-Related Cancer

PURPOSEOF REVIEW

Ultra-processed foods (UPFs) are becoming more and more important in daily diets around the world; in some cases, they can account for as much as 60% of daily energy intake. Epidemiological evidence suggests that this shift toward high levels of food processing may be partially responsible for the global obesity epidemic and the rise in the prevalence of chronic diseases.

RECENT FINDINGS

Few prospective studies have examined the relationship between UPF consumption and cancer outcomes. According to currently available information, UPFs may increase the risk of cancer due to their obesogenic properties and exposure to substances that can cause cancer, such as certain food additives and pollution from product processing. The complex relationship between obesity and cancer involves factors such as immune dysregulation, altered adipokine and sex hormone levels, abnormal fatty acid metabolism, extracellular matrix remodeling, and chronic inflammation. Addressing cancer risk associated with UPF consumption could involve a multifaceted approach, including consumer behavior modification programs and robust public health regulations aimed at enhancing food environments. Improved knowledge of the potential dual negative impacts of UPFs on the environment and cancer risk is one of the priority areas we identify for future research and policy implications. Various approaches could be used to prevent cancers associated with UPF consumption, such as consumer behavior change programs and stricter public health regulations needed to improve the food environment. This review examines for the first time the potential role of UPFs in cancer risk associated with obesity, exploring underlying biological mechanisms and identifying key areas for future research and policy action, including the dual environmental and health impact of UPFs.

Association between consumption of ultra processed foods and obesity among Jordanian children and adolescents

The consumption of ultra-processed food (UPF) is associated with obesity. This study aims to evaluate the contribution of UPF to total calorie intake and investigate the correlation between UPF consumption and obesity. The NOVA categorization was used to identify UPF in a single 24-hour dietary recall for participants. UPF consumption has been quantified as a percentage of total energy intake. Weight, height, and waist circumference were measured, and the Body Mass Index-for-Age Z-Score (BAZ) and waist-to-height ratio (WHtR) were computed. The prevalence of overweight and obesity was 23.9% and 13.3%, respectively. Approximately 25.5% of the participants had abnormal WHtR. The average energy intake was 1925 kcal/day, of which 40% was derived from UPF. The subgroups with the highest caloric contributions among UPF were savory snacks and sweets (13.5%), industrial grain products (8.4%), fast foods (7.8%), and sweetened beverages (4.2%). UPF consumption showed a weak but significant correlation with waist circumference (r = 0.119, P = 0.005). The remarkable finding is that 47 (7.6%) of the participants did not have any UPF. UPF's substantial contribution to daily caloric intake reflects an inadequate diet in children and adolescents. Public policies that discourage UPF use and encourage a nutritious diet are desperately needed.

Ultra-Processed Foods Marketed in Türkiye: An Analysis of Nutritional Quality and Packaging Sustainability

This study aimed to evaluate the nutritional profile and packaging recycling status of ultra-processed foods (UPFs) sold in chain markets across Türkiye. In this regard, the nutritional quality and recyclability status of the packages of UPFs, as defined by NOVA, sold in five major supermarket chains across Türkiye were examined. The energy and nutrient content displayed on UPF labels were analysed, and their nutritional profiles considered using the Nutri-Score algorithm. The study also documented the frequency of recycling symbols on the packaging. Of the 1365 UPFs examined across 13 categories, 61.6% were identified as having an unhealthy nutritional profile (Nutri-Score Grades D and E), whereas only 16% were classified as healthy (Grades A and B). Categories predominantly containing unhealthy products included milk and dairy, sauces and dressings, frozen and dehydrated meals, processed meats, along with various snacks and desserts like salty and sweet snacks, candies, chocolates and ice cream. Notably, candies, chocolates, and salty and sweet snacks were identified as the most energy-dense UPF categories. In terms of packaging, 84.4% of UPFs used at least one recycling symbol, 55.3% of these used plastic material and 38.2% used the Green Dot symbol. The results of the study may guide UPF nutrient profile reformulations and contribute to epidemiological studies analysing the relationship between UPF consumption and public health. Furthermore, these results highlight the necessity for more defined national regulations on the recycling of food packaging within the context of food system sustainability.

Thermogenic adipose tissues: Promising therapeutic targets for metabolic diseases

The ongoing increase in the prevalence of obesity and its comorbidities such as cardiovascular disease, type 2 diabetes (T2D) and dyslipidemia warrants discovery of novel therapeutic options for these metabolic diseases. Obesity is characterized by white adipose tissue expansion due to chronic positive energy balance as a result of excessive energy intake and/or reduced energy expenditure. Despite various efforts to prevent or reduce obesity including lifestyle and behavioral interventions, surgical weight reduction approaches and pharmacological methods, there has been limited success in significantly reducing obesity prevalence. Recent research has shown that thermogenic adipocyte (brown and beige) activation or formation, respectively, could potentially act as a therapeutic strategy to ameliorate obesity and its related disorders. This can be achieved through the ability of these thermogenic cells to enhance energy expenditure and regulate circulating levels of glucose and lipids. Thus, unraveling the molecular mechanisms behind the formation and activation of brown and beige adipocytes holds the potential for probable therapeutic paths to combat obesity. In this review, we provide a comprehensive update on the development and regulation of different adipose tissue types. We also emphasize recent interventions in harnessing therapeutic potential of thermogenic adipocytes by bioactive compounds and new pharmacological anti-obesity agents.

Umbrella Review of Systematic Reviews and Meta-Analyses on the Consumption of Different Food Groups and the Risk of Overweight and Obesity

BACKGROUND/OBJECTIVES

Dietary choices play an essential role in energy balance and weight gain. This systematic umbrella review investigates the association between the intake of various food groups (whole grains, refined grains, fruits, vegetables, nuts, legumes, fish, eggs, total dairy, red meat, white meat, processed meat, added sugar, and sugar-sweetened beverages) and their associations to the risk of obesity and being overweight.

METHODS

We systematically searched Medline, Embase, Web of Science, and Epistemonikos for systematic reviews and meta-analyses. A total of 2925 articles were screened, and 13 articles were included in our analysis.

RESULTS

For each food group, data included a mean of 166,100 participants and 36,760 cases, ranging from 19,885 participants and 7183 cases for red meat to 520,331 participants and 91,256 cases for nuts. Heterogeneity was high for most of the food groups except for whole grains and sugar-sweetened beverages. The quality of the most comprehensive meta-analyses was high for all food groups, except for processed meats, which was of low quality. High intakes of whole grains, legumes, nuts, and fruits are associated with a reduced risk of overweight and obesity. In contrast, high intakes of red meat and sugar-sweetened beverages are associated with increased risk of overweight and obesity. No significant results were found for the remaining food groups, and no meta-analysis was found for fish, eggs, white meat, and added sugars.

CONCLUSIONS

Diets rich in whole grains, legumes, nuts, and fruits are associated with a lower risk of developing obesity and being overweight. In contrast, diets high in red meat and sugar-sweetened beverages are associated with an increased risk of overweight and obesity.

Changes in the nutrient composition of top-selling packaged foods and beverages in Colombia between 2016 to 2021

Introduction

In 2022, the Colombian government approved a law requiring by 2024 the use of Front of Package octagonal warning labels in food products with an excess of nutrients of concern for chronic disease, including sodium, sugar, saturated fat, and trans-fat, as well as non-nutritive sweeteners (NNS). In addition, the government began 2023 by applying a 10% tax on sugar-sweetened beverages and foods that also had warning labels for sodium, sugar and saturated fat. This tax increased to 15% in 2024 and to $20% in 2025. While a previous study examined the changes in the nutritional composition of beverage and food products offered in Colombia between 2016 and 2018, it is necessary to update this information to understand whether the industry anticipated labeling and tax regulations by reformulating products.

Methods

This study carried out a comparison of the content of selected nutrients of concern and non-nutritive sweeteners (NNS) from the nutritional panels of 164 matched pairs of packaged foods and beverages from the top selling brands in Colombia in 2021 compared to 2016. McNemar's test for paired data was used to evaluate changes in the proportion of each of the critical nutrients and NNS to be regulated.

Results

There were no significant changes in sodium, saturated fat, trans fat, or free sugar in foods or beverages prior to policy implementation. However, there was a significant increase in the presence of NNS in beverages, during this pre-policy period from 32 to 59%.

Conclusion

These findings suggest that changes in nutrient composition of packaged foods and beverages had been marginal before the implementation of the tax and warning labeling laws.

Ultra-Processed Food Intakes and Health Outcomes in Adults Older Than 60 Years: A Systematic Review

CONTEXT

Relationships between ultraprocessed food (UPF) intakes and health have been well described in adults, but evidence of these relationships in older adults is rather limited. Demographic shifts in aging emphasize the importance of understanding the role of diet in maintaining health during later life.

OBJECTIVE

The aim of this systematic review was to identify health outcomes associated with UPF consumption in those aged ≥60 years.

DATA SOURCES

The Medline, Web of Science, Scopus, and Embase databases were searched from inception until June 2023, using search terms representing UPF and any health outcome. Observational studies restricted to individuals aged ≥60 years using the Nova food classification were included. Articles were screened independently by 2 researchers using PECOS inclusion criteria.

DATA EXTRACTION

Two-thirds of the studies in the present review were prospective cohort studies (n = 4) and the rest were cross-sectional (n = 2). The number of participants ranged from 652 to 2713 across the 6 studies. The mean age of participants ranged between 67 and 73 years.

DATA ANALYSIS

In the prospective cohort studies, the highest consumption of UPF was associated with incident frailty, incident dyslipidemia, renal function decline, and abdominal obesity. For cross-sectional studies, the highest intake of UPF was associated with negative outcomes similar to young and middle-aged cohorts, with the addition of nutritional frailty and worse cognitive performance.

CONCLUSIONS

Currently, the limited understanding of how high UPF intakes could be associated with negative health outcomes for older adults influences the ability to inform policy and practice recommendations. More research is required owing to the very limited number of studies, specifically in older adults.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023442783.

Ultra-Processed Food Consumption and Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): A Longitudinal and Sustainable Analysis

BACKGROUND

The rising prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is a significant health challenge, and the consumption of ultra-processed foods (UPFs) could play a key role.

AIM

The aim is assess the impact of UPF consumption changes on the development and progression of MASLD in adults.

DESIGN

This is a longitudinal study to assess how changes in UPF consumption affect liver fat and MASLD parameters over 6 months in 70 participants.

METHODS

Dietary intake was assessed using a validated food frequency questionnaire, and foods were classified according to the NOVA system. Participants were divided into three groups based on UPF consumption changes: maximum (T1), medium (T2), and minimum reduction (T3). Fatty liver parameters were assessed with magnetic resonance imaging and ultrasonography. Mediterranean diet (Med-diet) adherence and sociodemographic parameters were also recorded. The General Linear Model was used to determine relationships between UPF consumption, fatty liver disease parameters, and diet.

RESULTS

Participants in T1 experienced a 7.7% reduction in intrahepatic fat content (IFC) compared to 2.6% in T3. T1 showed increased Med-diet adherence and decreased meat and sweets consumption. The energy intake decreased by 605.3 kcal/day in T1, while T3 showed an increase of 209.5 kcal/day.

CONCLUSIONS

Reducing UPF consumption leads to a decrease in IFC, associated with high Med-diet adherence and low calorie intake. Adopting these dietary patterns aligns with global sustainability goals and could further benefit MASLD patients by addressing environmental challenges alongside improving liver health.

Experiencing Food Restrictions for Health and Weight Control in Childhood and Their Links to Restrained Eating and Excessive Body Weight in Polish Young Adults-A Cross-Sectional Study

OBJECTIVES

A better understanding of the conditions leading to overweight and obesity is fundamental due to the ever-increasing phenomenon of excess body weight. This study aimed to determine how the occurrence of restrained eating in young adulthood, food-restricted types, and food experiences related to food restrictions originating in childhood correlate with excessive body weight among young adults.

METHODS

The data were collected in Poland in 2020-2021 using a Computer-Assisted Web Interview technique as a cross-sectional study among 358 young adults. Descriptive statistics, frequency analysis, cross-tabulations, and logistic regression analysis were performed.

RESULTS

Restrictions associated with limiting intake of sugar-rich foods were more characteristic of those with normal body weight (52.7%) than those with excessive body weight (39.2%). Weak positive correlations were found between childhood experiences of weight control restrictions and restrained eating (0.222), using food restrictions (0.143), the number of restrictions (0.152), using restrictions on sugar (0.149), and food rich in fat (0.105) in early adulthood. Childhood food experiences related to weight control restrictions favored having excessive body weight in young adults by 53% after adjusting for sex and age.

CONCLUSIONS

The results showed that it is advisable to develop interventions to increase parents' awareness of the possible long-term consequences of practices related to controlling children's eating behavior.

A Meal with Ultra-Processed Foods Leads to a Faster Rate of Intake and to a Lesser Decrease in the Capacity to Eat When Compared to a Similar, Matched Meal Without Ultra-Processed Foods

Background/Objectives: It is unknown whether the negative health effects associated with ultra-processed foods (UPFs) are due to their nutritional composition or to the extent of food processing itself. We evaluated the impact of a test meal composed only of UPF, according to the NOVA classification, compared to a similar meal without UPF in adults with obesity. Methods: This is a parallel, randomized trial. Adult individuals with obesity, according to BMI, % body fat, and/or waist circumference were included. Individuals ate one out of two test meals, matched for energy density, macronutrients, sodium, and fiber, differing in NOVA classification, as a breakfast after a 12-h fast. The rate of intake, appetite, satiety hormones, energy expenditure, and autonomic function were measured. Data were analyzed using mixed analysis of variance. Results: Forty-two individuals were included. We found a significantly faster intake rate (07:52 ± 3:00 vs. 11:07 ± 03:16 min), with less chewing and bites, and greater capacity to eat (39.68 ± 22.69 vs. 23.95 ± 18.92 mm) after the UPF meal, without observed differences in the metabolic outcomes. In an exploratory analysis, after adjusting by sex, leptin levels showed a greater decrease after the test meal in the control group. Conclusions: Although we found a faster intake rate in the UPF meal, only marginal effects were found on the participants' capacity to eat after the UPF meal. The high similarity between meals, despite differences according to the NOVA classification, may explain these results. As our study was small, these findings require further investigation.

Availability, price and nutritional assessment of plant-based meat alternatives in hypermarkets and supermarkets in Petaling, the most populated district in Malaysia

This study investigated the availability, price, nutritional composition, and quality of plant-based meat alternatives (PBMAs) in supermarkets and hypermarkets in Petaling, the most populated district in Malaysia. The survey covered 85 stores through on-site visits, identifying 251 unique PBMA products from 42 brands. The PBMAs were categorized into nine groups: Burgers/Patties, Coated Meat, Luncheon Meat, Minced Meat, Pastries, Pieces/Chunks/Fillets/Strips, Prepacked Cooked Meals, Sausages, and Seafood Balls/Cakes/Meatballs. The survey indicated widespread availability of PBMAs in Petaling, with premium supermarkets offering the most extensive selection. The median prices of PBMAs across categories were below MYR 7 (~USD 1.6) per 100 grams, with Pieces/Chunks/Fillets/Strips being the most affordable. Nutritionally, PBMAs exhibited lower energy, total fat, saturated fat, sodium, and protein levels than meat equivalents, while showing higher carbohydrate content. Nutri-Score profiling revealed generally favourable scores (Grade A to C), indicating moderate to good nutritional quality. These findings suggest that PBMAs offer a viable alternative for consumers in Malaysia seeking healthier and more sustainable food options, particularly for those aiming to reduce their intake of fat and sodium. However, PBMAs may not be recommended for individuals seeking a higher protein and lower carbohydrate diet. Further research is recommended to explore micronutrient profiles to enhance dietary decision-making.

Neural and metabolic factors in carbohydrate reward: Rationale, design, and methods for a flavor-nutrient learning paradigm in humans

Overconsumption of ultra-processed foods (UPFs), which are linked with adverse health outcomes, is a growing public health concern. UPFs deliver highly bioavailable calories rapidly, which may contribute to their reinforcing potential and drive overconsumption. Our primary aim is to test the role of speed of nutrient availability on reward learning. We hypothesize that brain activity in reward related areas and behavioral preferences will be greater to a flavored drink predicting rapidly available calories (CS + Fast) compared with a flavored drink predicting more slowly available (CS + Slow) or no (CS-) calories. Participants (n = 64, aged 18-45 years, will consume 3 novel flavored, isosweet beverages containing 110 kcal of sucrose (CS + Fast), 110 kcal of maltodextrin (CS + Slow), or 0-kcal sucralose (CS-) 6 times in randomized, crossover order. Blood metabolites and indirect calorimetry measures, including metabolic rate and carbohydrate oxidation, will be assessed before and for 1 h after beverage consumption. Behavioral preference for beverages will be assessed in a pre- and post-test. Brain response to each flavor without calories will be assessed via functional magnetic resonance imaging in a post-test. Findings from this study will contribute to the understanding of basic mechanisms that may drive overconsumption of UPFs. Trial registration:clinicaltrials.gov registration #NCT06053294.

Ultra-processed Food Intake During Pregnancy and its Impact on Maternal Diet Quality and Weight Change: A Systematic Review of Observational Studies

PURPOSE OF REVIEW

Adequate and balanced nutrition during pregnancy is essential for both the mother's and fetus's health. The increased dietary intake of ultra-processed foods (UPFs) and their significant share in the diet negatively affects diet quality and gestational weight gain during pregnancy. The aim of this systematic review was to examine the association of UPFs consumption with diet quality and gestational weight change among healthy pregnant women, using data from observational studies (PROSPERO Identifier: CRD42023468269) from the last 10 years.

RECENT FINDINGS

A search was performed in Pubmed, Wiley, Scopus, and Web of Science, and studies published in english language were selected. Study selection and data extraction were made by determining the exclusion and eligible inclusion criterias according to the PECOS framework. Of the 12 studies included, 5 were longitudinal cohort studies and 7 were cross-sectional studies. On average, half of the energy in the participants' daily diets came from UPFs in 3 studies, but the energy share of UPFs was about 20-30% in the remainder studies. UPFs-enriched maternal diet was associated with less dietary intake of legumes, vegetables, fruits and protein sources (seafood and plant protein, total protein) and greater consumption of refined grains compared to those who consume less UPFs. In parallel, UPFs consumption was negatively associated with Healthy Eating Index. UPF intake during pregnancy has a negative impact on diet quality and gestational weight gain. Increasing awareness of UPFs during this period may reduce potential complications during pregnancy and fetal growth.

Current Insights into Industrial Trans Fatty Acids Legal Frameworks and Health Challenges in the European Union and Spain

The presence of industrial trans-fatty acids (iTFAs) in processed foods poses significant public health concerns, necessitating comprehensive regulatory frameworks. In this study, the current legal landscape governing iTFA in the European Union and Spain is analyzed, with a particular focus on regulatory effectiveness and implementation challenges. The research methodology combines a systematic review of existing regulations, including EU Regulation No. 1169/2011 and Spanish Law 17/2011, with the analysis of the scientific literature on iTFA health impacts. The results reveal significant regulatory gaps, particularly in enforcement mechanisms and iTFA detection methods. Key challenges are also identified in the present study, including inconsistent compliance monitoring, varying analytical methods for iTFA detection, and contradictions between EU and Spanish regulatory frameworks. Additionally, in this work, the need for harmonized approaches to ultra-processed food regulation is emphasized. Further, the conclusion is that despite the current regulations providing a foundation for iTFA control, it is compulsory to enhance the monitoring systems, and clearer regulatory guidelines are necessary. These would contribute valuable insights for policymakers, food industry stakeholders, and public health professionals working towards effective iTFA regulation.

Review of the Relationships Between Human Gut Microbiome, Diet, and Obesity

Obesity is a complex disease that increases the risk of other pathologies. Its prevention and long-term weight loss maintenance are problematic. Gut microbiome is considered a potential obesity modulator. The objective of the present study was to summarize recent findings regarding the relationships between obesity, gut microbiota, and diet (vegetable/animal proteins, high-fat diets, restriction of carbohydrates), with an emphasis on dietary fiber and resistant starch. The composition of the human gut microbiome and the methods of its quantification are described. Products of the gut microbiome metabolism, such as short-chain fatty acids and secondary bile acids, and their effects on the gut microbiota, intestinal barrier function and immune homeostasis are discussed in the context of obesity. The importance of dietary fiber and resistant starch is emphasized as far as effects of the host diet on the composition and function of the gut microbiome are concerned. The complex relationships between human gut microbiome and obesity are finally summarized.

Ultra-Processed Food Consumption and Its Association with Risk of Obesity, Sedentary Behaviors, and Well-Being in Adolescents

BACKGROUND/OBJECTIVES

The literature on consumption of ultra-processed food (UPF) using the NOVA classification is still limited. Therefore, the aim of the present study was twofold: (i) to compare the UPF consumption, sedentary behaviors, and well-being perception between boys and girls; and (ii) to investigate the association between the UPF consumption and risk of overweight, sedentary behaviors, and well-being in adolescents.

METHODS

The present cross-sectional study comprised a sample of 245 adolescents (131 boys) aged 12-17 years-old (M = 14.20; SD = 1.09). Height and weight were assessed, and subsequently, the BMI was computed; furthermore, total body fat percentage was measured with bioelectrical impedance. Daily consumption of UPF was assessed by the NOVA screener and time spent sedentary was assessed by the Midlands Behavior Health 2024 questionnaire. The Mental Health Continuum-Short Form (MHC-SF) was used to measure adolescents' psychosocial well-being. Pearson's correlations and logistic regression analysis were used, controlling for biological, behavioral, and socio-economic confounders.

RESULTS

No sex differences were observed for the different UPF NOVA subscales. Boys reported higher computer use levels than girls on the weekend (p = 0.025), and they spent more time playing electronic games during the week (p = 0.005) and on the weekend than their female counterparts (p < 0.001). Moreover, boys reported higher scores in all well-being dimensions (p < 0.001) than girls.

CONCLUSIONS

The findings revealed, after controlling for sex, sedentary time, and active behaviors, adolescents who consumed UPF on the previous day tended to be associated with a higher risk of being overweight, but also marginally without statistical significance (OR = 0.91, 95% CI: 0.83-1.01, p = 0.06). Of relevance, the present study revealed that both boys and girls of mothers with high educational levels were less likely to be classified as overweight or obese youth.

Obesity in the US: Exploring the paradox of increasing obesity rates alongside growing physical activity

The study analyzes a CDC dataset on US adult obesity and physical activity from 2011 to 2022. Despite rising obesity rates and insufficient fruit consumption, physical activity levels are increasing and overweight rates are slightly declining. The role of ultra-processed food intake, price sensitivity, early eating habits, and stress in obesity is highlighted. The findings suggest a complex obesity epidemic, indicating the need for multifaceted solutions such as regulating ultra-processed foods, improving access to healthy foods, and promoting healthy eating habits from childhood.

Food consumption by degree of food processing and risk of type 2 diabetes mellitus: a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC)

Background

It is unknown whether the association between ultra-processed food (UPF) intake and type 2 diabetes mellitus differs from other degrees of food processing. We examined the association between degree of food processing and incident type 2 diabetes mellitus.

Methods

This was a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline using dietary questionnaires and classified according to the Nova classification into unprocessed/minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF. Type 2 diabetes mellitus cases were verified through multiple methods. Cox regression and statistical substitution analysis was used to estimate associations between MPF + PCI, PF and UPF intake and incident type 2 diabetes mellitus. To investigate heterogeneity in the association between UPF and incident type 2 diabetes mellitus, UPF sub-group analysis was conducted. Different reference groups were used in each analysis.

Findings

Over an average 10.9 years follow-up of 311,892 individuals, 14,236 type 2 diabetes mellitus cases were identified. Each 10% increment of total daily food intake from UPF (%g/day) was associated with 17% (95% confidence interval (95%CI): 1.14-1.19) higher incident type 2 diabetes mellitus. Each 10% increment in MPF + PCI or PF intake was associated with lower incident type 2 diabetes mellitus (MPF + PCI hazard ratio: 0.94 (95%CI: 0.92-0.96); PF hazard ratio: 0.92 (95%CI: 0.89-0.95)). Replacing UPF with MPF + PCI or PF was associated with lower incident type 2 diabetes mellitus. However, heterogeneity was observed across UPF sub-groups, with breads, biscuits and breakfast cereals, sweets and desserts, and plant-based alternatives associated with lower incident type 2 diabetes mellitus.

Interpretation

These findings support recommendations to focus on reducing intake of specific UPF for lowering type 2 diabetes mellitus risk.

Funding

International Agency for Research on Cancer.

Association of Ultraprocessed Foods Intake with Untargeted Metabolomics Profiles in Adolescents and Young Adults in the DONALD Cohort Study

BACKGROUND

High consumption of ultraprocessed foods (UPFs) continues to draw significant public health interest because of the associated negative health outcomes. Metabolomics can contribute to the understanding of the biological mechanisms through which UPFs may influence health.

OBJECTIVES

To investigate urine and plasma metabolomic biomarkers of UPF intake in adolescents and young adults.

METHODS

We used data from the Dortmund Nutritional and Anthropometric Longitudinally Designed study to investigate cross-sectional associations of UPF intake with concentrations of urine metabolites in adolescents using 3d weighed dietary records (3d-WDR) and 24-h urine samples (n = 339), and associations of repeatedly assessed UPF intake with concentrations of circulating plasma metabolites in young adults with 3-6 3d-WDRs within 5 y preceding blood measurement (n = 195). Urine and plasma samples were analyzed using mass spectrometry-based metabolomics. Biosample-specific metabolite patterns (MPs) were determined using robust sparse principal components analysis. Multivariable linear regression models were applied to assess the associations of UPF consumption (as a percentage of total food intake in g/d) with concentrations of individual metabolites and MP scores.

RESULTS

The median proportion of UPF intake was 22.0% [interquartile range (IQR): 12.3, 32.9] in adolescents and 23.2% (IQR: 16.0, 31.6) in young adults. We identified 42 and 6 UPF intake-associated metabolites in urine and plasma samples, respectively. One urinary MP, "xenobiotics and amino acids" [β = 0.042, 95% confidence interval (CI): 0.014, 0.070] and 1 plasma MP, "lipids, xenobiotics, and amino acids" (β = 0.074, 95% CI: 0.031, 0.117) showed positive association with UPF intake. Both patterns shared 29 metabolites, mostly of xenobiotic metabolism.

CONCLUSIONS

We identified urine and plasma metabolites associated with UPF intake in adolescents and young adults, which may represent some of the biological mechanisms through which UPFs may influence metabolism and health.

Mediterranean Diet and Ultra-Processed Food Intake in Older Australian Adults-Associations with Frailty and Cardiometabolic Conditions

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors.

Association between consumption of nonessential energy-dense food and body mass index among Mexican school-aged children: a prospective cohort study

BACKGROUND/OBJECTIVES

Obesity prevalence in Mexican children has increased rapidly and is among the highest in the world. We aimed to estimate the longitudinal association between nonessential energy-dense food (NEDF) consumption and body mass index (BMI) in school-aged children 5 to 11 years, using a cohort study with 6 years of follow-up.

SUBJECTS/METHODS

We studied the offspring of women in the Prenatal omega-3 fatty acid supplementation, child growth, and development (POSGRAD) cohort study. NEDF was classified into four main groups: chips and popcorn, sweet bakery products, non-cereal based sweets, and ready-to-eat cereals. We fitted fixed effects models to assess the association between change in NEDF consumption and changes in BMI.

RESULTS

Between 5 and 11 years, children increased their consumption of NEDF by 225 kJ/day (53.9 kcal/day). In fully adjusted models, we found that change in total NEDF was not associated with change in children's BMI (0.033 kg/m2, [p = 0.246]). However, BMI increased 0.078 kg/m2 for every 418.6 kJ/day (100 kcal/day) of sweet bakery products (p = 0.035) in fully adjusted models. For chips and popcorn, BMI increased 0.208 kg/m2 (p = 0.035), yet, the association was attenuated after adjustment (p = 0.303).

CONCLUSIONS

Changes in total NEDF consumption were not associated with changes in BMI in children. However, increases in the consumption of sweet bakery products were associated with BMI gain. NEDF are widely recognized as providing poor nutrition yet, their impact in Mexican children BMI seems to be heterogeneous.

Quantitative Assessment of the Inadequate Intake of Macronutrients, Minerals, and Vitamins Associated with Ultra-Processed Food Consumption

Studies indicate that ultra-processed food (UP) consumption correlates negatively with essential vitamin and mineral intake and positively with sodium and lipid intake. The objective of this study was to explore the relationship between UP consumption and deviations from nutritional guidelines. An observational, cross-sectional analytical study was conducted on a probability sample of manufacturing workers in the state of Rio Grande do Norte, Brazil. Food consumption was assessed with a 24 h recall survey, and nutrient intake inadequacies were calculated as the difference between individuals' intake of energy, macronutrients, minerals and vitamins, and the dietary reference intakes for individuals of the same sex and age group, and then analyzed for trends across the percentage contribution of UP to total energy intake with nonparametric multiple regression adjusted for covariates. The study included 921 workers from 33 industries, 55.9% male, with a mean age of 32 years. Overall, the study population exhibited deficits in energy, all macronutrients, and in some micronutrients. With increasing UP contribution to total energy intake, there is a trend towards a greater intake of energy (p < 0.001), total, saturated, monounsaturated, and trans fats (p < 0.001), n6-polyunsaturated fatty acids (p = 0.03), carbohydrates (p < 0.001), calcium (p = 0.008), and manganese (p < 0.001), thiamin (p < 0.001), and vitamin B6 (p = 0.01); however, this comes with a negative consequence in terms of reducing the protein consumption (p = 0.037), fiber (p = 0.035), copper (p = 0.033), and vitamin E (p = 0.002) intake. The results show that correcting energy and micronutrient deficiencies by increasing UP consumption can also lead to a decrease in diet quality.

Unraveling the Evolutionary Diet Mismatch and Its Contribution to the Deterioration of Body Composition

Over the millennia, patterns of food consumption have changed; however, foods were always whole foods. Ultra-processed foods (UPFs) have been a very recent development and have become the primary food source for many people. The purpose of this review is to propose the hypothesis that, forsaking the evolutionary dietary environment, and its complex milieu of compounds resulting in an extensive metabolome, contributes to chronic disease in modern humans. This evolutionary metabolome may have contributed to the success of early hominins. This hypothesis is based on the following assumptions: (1) whole foods promote health, (2) essential nutrients cannot explain all the benefits of whole foods, (3) UPFs are much lower in phytonutrients and other compounds compared to whole foods, and (4) evolutionary diets contributed to a more diverse metabolome. Evidence will be presented to support this hypothesis. Nutrition is a matter of systems biology, and investigating the evolutionary metabolome, as compared to the metabolome of modern humans, will help elucidate the hidden connections between diet and health. The effect of the diet on the metabolome may also help shape future dietary guidelines, and help define healthy foods.

Ultra-processed foods consumption and health-related outcomes: a systematic review of randomized controlled trials

Introduction

The increase in ultra-processed foods (UPFs) intake has raised concerns about its impact on public health. Prospective observational studies have reported significant associations between higher intake of UPFs and adverse health outcomes. The aim of this study is to determine whether these associations could be confirmed in randomized controlled trials (RCTs).

Methods

We conducted a systematic review to analyze the evidence on the effects of UPFs intake on health. A systematic search was conducted in Medline, Embase, Web of Science, Scopus, LILACS, and CENTRAL up to April 22, 2024. RCTs in English, Spanish, and Portuguese evaluating the health effects of interventions to modify UPFs intake were included. The certainty of evidence was determined using the GRADE methodology.

Results

Three educational intervention studies and one controlled feeding trial were included, evaluating the effect of reducing the consumption of UPFs (455 participants, median follow-up, 12 weeks). No significant effects were observed in 30 out of the 42 outcomes evaluated. The controlled feeding trial in adults with stable weight showed a reduction in energy intake, carbohydrates, and fat (low certainty of evidence), as well as in body weight, total cholesterol, and HDL cholesterol (moderate certainty of evidence). In the educational intervention studies, a reduction in body weight and waist circumference was observed (low certainty of evidence) in women with obesity, as well as improvement in some dimensions of quality of life (very low certainty of evidence). No significant changes were observed in children and adolescents with obesity, while in overweight pregnant women, the consumption of UPFs was not reduced, so the observed benefits could be attributed to other components of the intervention.

Conclusion

Interventions aimed at reducing the consumption of UPFs showed benefits on some anthropometric and dietary intake outcomes, although significant effects were not observed for most of the evaluated outcomes. The limited number and significant methodological limitations of the studies prevent definitive conclusions. Further well-designed and conducted RCTs are needed to understand the effects of UPF consumption on health.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023469984.