[Consumption of ultra-processed products and wheezing respiratory diseases in children: The SENDO project]

Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

BACKGROUND

Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated.

METHODS

We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines.

RESULTS

Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies.

CONCLUSION

More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.

Trend of Ultraprocessed Product Intake Is Associated with the Double Burden of Malnutrition in Mexican Children and Adolescents

BACKGROUND

Ultraprocessed products (UPPs) have been associated with unfavorable health outcomes; however, until now, they have not been associated with the coexistence of undernutrition and overnutrition, known as the double burden of malnutrition (DBM) at the individual level.

METHODS

Cross-sectional analyses were performed on data collected from children and adolescents participating in the 2006 and 2016 Mexican National Health and Nutrition Surveys. The food and beverages reported in the food frequency questionnaire (SFFQ) were classified as UPPs as defined by the NOVA classification system. Associations of UPPs with anemia, excess weight, and the DBM were estimated with logistic regression models. A pseudo-panel was generated using the cohorts of children born from 1997 to 2001 to estimate the effect of the UPPs on anemia, excess weight, and the DBM.

RESULTS

The consumption of UPPs (% energy) was higher in 2016 (children 30.1% and adolescents 28.3%) than in 2006 (children 27.3% and adolescents 23.0%) in both age-groups. The higher contribution of UPPs was positively associated with excess weight and the DBM in children's lower tertile of socioeconomic status (SES) and the DBM in higher tertile of SES in adolescents. The pseudo-panel analysis shows the positive association between UPPs and DBM in lower SES.

CONCLUSIONS

These results provide evidence of the association between the consumption of UPPs and the DBM and excess weight in children and adolescents.

Relative Validity of a Semi-Quantitative Food Frequency Questionnaire to Estimate Dietary Intake According to the NOVA Classification in Mexican Children and Adolescents

BACKGROUND

Ultra-processed foods (UPFs) are associated with poor diet quality and chronic diseases. UPFs fall into 1 of the following 4 groups classified according to the extent and purpose of processing: group 1 is unprocessed or minimally processed foods (MPFs); group 2 is processed culinary ingredients; group 3 is processed foods; and group 4 is UPFs.

OBJECTIVE

The aim of this study was to evaluate the relative validity of a semi-quantitative food frequency questionnaire (SFFQ) compared with two 24-hour dietary recalls (24DRs) to estimate dietary intake per NOVA food group in Mexican children and adolescents.

DESIGN

This study is a secondary analysis of dietary data from a subsample of children and adolescents who participated in the 2012 Mexican National Health and Nutrition Survey.

PARTICIPANTS/SETTING

The study participants were 217 children (aged 5 through 11 years) and 165 adolescents (aged 12 through 19 years) with complete information for the SFFQ and two 24DRs.

MAIN OUTCOME MEASURES

Daily averages of energy intake and percent of energy intake for each NOVA category were calculated using the SFFQ and two 24DRs.

STATISTICAL ANALYSIS

To assess relative validity, the SFFQ was compared with two 24DRs to estimate dietary intake per NOVA food group. Mean differences, Spearman correlations, intraclass correlations coefficients (ICCs), and Bland-Altman plots for continuous variables and weighted κ for ordinal variables were calculated.

RESULTS

For percentage of energy intake, ICCs in children and adolescents were moderate for MPFs (ICC = 0.47 and ICC = 0.56, respectively) and UPFs (ICC = 0.53 and ICC = 0.57, respectively). Bland-Altman plots indicated reasonably consistent agreement for UPFs and MPFs groups in children and adolescents. Classification by quintiles was acceptable in all groups.

CONCLUSIONS

Data from this study indicated reasonable relative validity of the SFFQ to rank the percentage of energy intake from MPFs and UPFs in Mexican children and adolescents.

Influence of Ultra-Processed Foods Consumption on Redox Status and Inflammatory Signaling in Young Celiac Patients

The current study was designed to assess the influence of consumption of ultra-processed (UPF) on oxidative/antioxidant balance and evoked inflammatory signaling in young patients with celiac disease (CD). The study included 85 children. The celiac group (n = 53) included children with CD with a long (>18 months, n = 17) or recent (<18 months, n = 36) adherence to a gluten-free diet (GFD). The control group (n = 32) included healthy children with a significantly lower consumption of UPF compared to the CD group, both expressed as kcal/day (p = 0.043) and as percentage of daily energy intake (p = 0.023). Among children with CD, the group with the lowest consumption of UPF (below the 50% of daily energy intake) had a greater Mediterranean diet (MD) adherence and higher moderate physical activity levels. In addition, CD children with the lowest consumption of UPF had healthier redox (lower soluble superoxide dismutase-1 and 15-F2t-isoprostanes) and inflammatory profiles (lower macrophage inflammatory protein-1α) compared to the group with the highest consumption of UPF (all, p < 0.05) regardless of the time on a GFD. These findings highlight the importance of a correct monitoring of the GFD. An unbalanced GFD with high consumption of UPF and an unhealthy pattern with less physical activity and worse adherence to MD results in a worse inflammatory profile, which could act as a parallel pathway that could have important consequences on the pathophysiology of the disease.