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Martín-Calvo N, Usechi A, Fabios E, Gómez SF, López-Gil JF. Television watching during meals is associated with higher ultra-processed food consumption and higher free sugar intake in childhood. Pediatr Obes 2024:e13130. [PMID: 38785294 DOI: 10.1111/ijpo.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/22/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The consumption of ultra-processed foods (UPFs) is associated with an increased risk of noncommunicable diseases and mortality in adults. The aim of this study was to analyse the association between mealtime television (TV) watching and UPF consumption in childhood. MATERIALS AND METHODS Participants in the SENDO project recruited in 2015-2023 were classified into three categories based on the frequency at which they watched TV during meals. Dietary information was collected with a validated 147-item semi-quantitative food frequency questionnaire. Generalized mixed models were used to compare mean UPF consumption between groups after accounting for the main confounders. The predictive margins of participants who had a free sugar intake >10% of their energy intake in each category were also calculated. RESULTS Totally 970 subjects (482 girls) with a mean age of 5.00 years (SD = 0.85) were studied. Children who watched TV during meals ≥4 times/week consumed a mean of 4.67% more energy from UPF than those who watch TV <3 times/month. The adjusted proportions of children who had a free sugar intake >10% of their energy intake in the categories of <3 times/month, 1-3 times/week and ≥4 times/week exposure to TV during meals were 44.9%, 45.9% and 58.7%, respectively. CONCLUSION TV watching during meals is associated with higher consumption of UPFs and a higher risk of exceeding 10% of TEI in free sugar intake in childhood.
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Affiliation(s)
- Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Medical Research Institute of Navarra (IdiSNA), Pamplona, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
| | - Ane Usechi
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Medical Research Institute of Navarra (IdiSNA), Pamplona, Spain
| | - Elise Fabios
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Medical Research Institute of Navarra (IdiSNA), Pamplona, Spain
| | - Santiago Felipe Gómez
- Gasol Foundation Europe, Sant Boi de Llobregat, Barcelona, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute, Barcelona, Spain
- Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain
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Canella DS, Louzada MLDC, Oliveira N, Azevedo ABCD, Levy RB. Evolution of household availability of added sugars and their sources in Brazil: analysis of Household Budget Surveys from 2002 to 2017. Br J Nutr 2024:1-8. [PMID: 38634261 DOI: 10.1017/s0007114524000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002-2003, 2008-2009 and 2017-2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians' total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.
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Affiliation(s)
- Daniela Silva Canella
- Department of Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Natália Oliveira
- Postgraduate Program in Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Renata Bertazzi Levy
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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López-Gil JF, Fernandez-Montero A, Bes-Rastrollo M, Moreno-Galarraga L, Kales SN, Martínez-González MÁ, Moreno-Montañés J. Is Ultra-Processed Food Intake Associated with a Higher Risk of Glaucoma? A Prospective Cohort Study including 19,255 Participants from the SUN Project. Nutrients 2024; 16:1053. [PMID: 38613086 PMCID: PMC11013077 DOI: 10.3390/nu16071053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/16/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively. METHODS Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated. RESULTS After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12). CONCLUSIONS This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.
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Grants
- (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, PI17/01795, and G03/140) Instituto de Salud Carlos III
- (27/2011, 45/2011, 122/2014) Gobierno de Navarra
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Affiliation(s)
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA;
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Laura Moreno-Galarraga
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Stefanos N. Kales
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA;
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Javier Moreno-Montañés
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
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Royo-Bordonada MÁ, Cavero-Esponera C, Romero-Fernández MM, González-Díaz C, Ordaz Castillo E. Differences in children's exposure to television advertising of unhealthy foods and beverages in Spain by socio-economic level. BMC Public Health 2024; 24:739. [PMID: 38454414 PMCID: PMC10921598 DOI: 10.1186/s12889-023-17410-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/05/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. METHODS Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. RESULTS The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). CONCLUSION Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television.
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Affiliation(s)
- Miguel Ángel Royo-Bordonada
- National School of Public Health, Institute of Health Carlos III, Ministry of Science and Innovation, Madrid, 28029, Spain
| | - Cristina Cavero-Esponera
- Department of Preventive Medicine and Public Health, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, 28003, Spain.
- Doctoral Program in Biomedical Sciences and Public Health, International Doctorate Program, National University of Distance Education (UNED), Madrid, 28015, Spain.
| | - María Mar Romero-Fernández
- Puertollano Integrated Care Management. Health Service of Castilla-La Mancha, Unit of Teaching and Research, Santa Bárbara Hospital, Castilla-La Mancha, Spain
| | | | - Elena Ordaz Castillo
- National School of Public Health, Institute of Health Carlos III, Ministry of Science and Innovation, Madrid, 28029, Spain
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Vale C, Almeida C, Azevedo J, Padrão P. Nutrient profile of packaged foods according to the degree of processing. Int J Food Sci Nutr 2024; 75:148-158. [PMID: 38186325 DOI: 10.1080/09637486.2023.2299771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
An increased consumption of ultra-processed foods (UPF) leads to a rising prevalence of chronic noncommunicable diseases. This study aims to characterise the nutrient profile of white-label pre-packaged foods and bakery products available in a market leader Portuguese food retail chain, according to the extent of processing proposed by NOVA classification system. The nutrient profile (energy, sugar, total fat, saturated fat and sodium) according to processing degree was analysed using non-parametric tests. UPF were the most energy dense (278 kcal/100 g, p < .001) and the highest in sugar (15.9 g/100 g, p < .001). Processed foods were the highest in sodium (538 mg/100 g, p < .001). Processed and UPF showed significantly higher total (12.4 and 10.8 g/100 g, respectively) and saturated fat content (6.10 and 4.61 g/100 g, respectively) than unprocessed/minimally processed foods (p < .001). Regarding the variation of the nutritional value across the extent of processing, different results were observed for some categories suggesting the importance of a stratified analysis. The consumption of less processed foods and the manufacture of processed/UPF with better nutrient profile should be promoted.
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Affiliation(s)
- Catarina Vale
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Carla Almeida
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - José Azevedo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Faculdade de Letras de Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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Ashraf R, Duncan AM, Darlington G, Buchholz AC, Haines J, Ma DWL. The degree of food processing contributes to sugar intakes in families with preschool-aged children. Clin Nutr ESPEN 2024; 59:37-47. [PMID: 38220399 DOI: 10.1016/j.clnesp.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 11/08/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIMS Evidence implicates ultra-processed food intake as a major contributor of excess dietary sugars. However, little research exists on the relationship between the degree of food processing and sugar intake in families with young children. We investigated associations between the degree of food processing and sugar intake (total and free sugars) in Canadian preschool-aged children and parents. METHODS This cross-sectional study of 242 families included preschool-aged children (n = 267) and parents (n = 365) participating in the Guelph Family Health Study. Dietary intake was assessed via the web-based Automated Self-Administered 24-h Dietary Assessment Tool (ASA24-Canada-2016) and classified according to the NOVA Food Classification System including, unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods. Linear regression models with generalized estimating equations were used to examine associations between the energy contribution of each NOVA classification category and sugar intake (% kcal of total and free sugars). Pearson correlation coefficient estimates were used to assess dietary relationships between parents and children. RESULTS Ultra-processed foods were the greatest source of energy (44.3%) and energy from total (8.7%) and free sugars (7.3%) in the parents' diets, and the greatest source of energy (41.3%) and energy from free sugars (7.6%) in the children's diet. Ultra-processed food intake was positively associated with sugar intake in parents (total sugars: B = 0.05, 95% CI: 0.02-0.09, p = 0.01; free sugars: B = 0.11, 95% CI: 0.08-0.15, p < 0.001) and children (total sugars: B = 0.10, 95% CI: 0.04-0.16, p = 0.001; free sugars: B = 0.16, 95% CI: 0.12-0.21, p < 0.001). Unprocessed or minimally processed food intake was negatively associated with free sugar intake in parents (B = -0.08, 95% CI: -0.12 to -0.05, p < 0.001) and children (B = -0.15, 95% CI: -0.19 to -0.10, p < 0.001). Weak correlations were found between parents and children for processed culinary ingredients and ultra-processed processed food intake (p < 0.001). CONCLUSIONS This study highlights the associations between degree of food processing and sugar intake in parents and children, whereby ultra-processed foods were positively, and unprocessed or minimally processed foods were negatively, associated with sugar intake. These are important considerations in the development of policy and recommendations for foods to potentially promote or limit.
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Affiliation(s)
- Rahbika Ashraf
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
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Levy RB, Barata MF, Leite MA, Andrade GC. How and why ultra-processed foods harm human health. Proc Nutr Soc 2024; 83:1-8. [PMID: 37424296 DOI: 10.1017/s0029665123003567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The analysis of food using a perspective centred on nutrients seems inadequate for understanding the dietary transition and its impact on the growth of obesity and chronic diseases. Industrial food processing is now proposed as the key to explain the relationship between food and health. The NOVA food classification considers the degree and the purpose of food processing, which includes physical, biological and chemical processes used after foods are separated from nature, and before being consumed or prepared as dishes and meals. NOVA has four food groups: (1) unprocessed and minimally processed foods; (2) processed culinary ingredients; (3) processed foods and (4) ultra-processed foods, which are formulations made mostly or entirely from substances derived from group 1 foods and additives, with little if any intact group 1 food. Many investigations linking high ultra-processed food consumption with deterioration of diets and adverse health outcomes are reinforced by prospective studies, systematic reviews and meta-analyses. There are various plausible explanations of why diets high in ultra-processed foods are harmful. Their production and consumption continue to rise worldwide. Efficient and effective public policies and actions that reduce production and consumption of ultra-processed products are needed, to protect human health now and in future.
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Affiliation(s)
- Renata Bertazzi Levy
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Mayra Figueiredo Barata
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Maria Alvim Leite
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
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Oliver Olid A, de la O V, Bueso OE, Moreno-Villares JM, Martínez-González MÁ, Martín-Calvo N. Longer Breastfeeding Duration is Associated With Lower Consumption of Ultraprocessed Foods in a Sample of Spanish Preschoolers: The SENDO Project. J Acad Nutr Diet 2023; 123:1555-1567. [PMID: 37276962 DOI: 10.1016/j.jand.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Breastfeeding has been linked to a higher consumption of fruit and vegetables at ages 4 to 5 years. More recently, it has been suggested that it may also be associated with lower ultraprocessed food (UPF) consumption in childhood. OBJECTIVE The aim of this study was to assess whether breastfeeding duration was associated with consumption of UPF in a sample of Mediterranean preschoolers. DESIGN This study involved a cross-sectional analysis of baseline information of children in the Child Follow-Up for Optimal Development cohort. Children were enrolled at ages 4 to 5 years and information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative food frequency questionnaire and foods were classified based on the degree of processing according to the NOVA classification. PARTICIPANTS/SETTING This study used baseline information for 806 participants enrolled in the Child Follow-Up for Optimal Development cohort between January 2015 and June 2021 in Spain. MAIN OUTCOMES MEASURES Main study outcome measures were difference in grams per day and in the percentage of total energy intake from UPF consumption related to breastfeeding duration, and odds ratio that UPF represents a high percentage of total energy intake. STATISTICAL ANALYSES Crude and multivariable adjusted estimates were calculated with generalized estimating equations to account for intracluster correlation between siblings. RESULTS The prevalence of breastfeeding in the sample was 84%. After adjusting for potential confounders, children who were breastfed for some time reported significantly lower consumption of UPF than children who were not breastfed at all. The mean differences were -19.2 g (95% CI -44.2 to 10.8) for children who were breastfed for <6 months, -42.5 g (95% CI -77.2 to -7.80) for those who were breastfed for 6 to 12 months, and -43.6 g (95% CI -79.8 to -7.48) for those who were breastfed for 12 months or more (P value for trend = 0.01). After adjusting for potential confounders, compared with children who were not breastfed, those who were breastfed for ≥12 months had consistently lower odds of UPF representing more than 25%, 30%, 35%, and 40% of total energy intake. CONCLUSIONS Breastfeeding is associated with lower consumption of UPF in Spanish preschoolers.
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Affiliation(s)
- Asier Oliver Olid
- Department of Pediatrics, Hospital Universitario de Navarra, Pamplona, Spain
| | - Víctor de la O
- IMDEA Research Institute on Food & Health Sciences. Precision Nutrition and Cardiometabolic Health, Madrid, Spain
| | | | | | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.
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Rossato SL, Khandpur N, Lo CH, Jezus Castro SM, Drouin-Chartier JP, Sampson L, Yuan C, Murta-Nascimento C, Carvalhaes MA, Monteiro CA, Sun Q, Fung TT, Willett WC. Intakes of Unprocessed and Minimally Processed and Ultraprocessed Food Are Associated with Diet Quality in Female and Male Health Professionals in the United States: A Prospective Analysis. J Acad Nutr Diet 2023; 123:1140-1151.e2. [PMID: 36965524 DOI: 10.1016/j.jand.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND High unprocessed and minimally processed food (UMP) intake has been associated with high-quality diets, whereas the opposite has been shown for ultraprocessed food (UPF). Nevertheless, the association between UMP and UPF consumption and diet quality over the long-term warrants further examination. OBJECTIVE This study aimed to assess whether UMP and UPF intake are associated with three diet-quality metrics in female and male health professionals from two US cohorts over 3 decades of follow-up. DESIGN This was a cohort study, including data from the Nurses' Health Study (NHS), from 1986 to 2010 (N = 51,956) and the Health Professionals Follow-up Study (HPFS) from 1986 to 2006 (n = 31,307). PARTICIPANTS AND SETTING Participants were invited in 1976 (NHS) and 1986 (HPFS) to respond to mailed questionnaires every 2 to 4 years and diet was assessed with a semi-quantitative food frequency questionnaire every 4 years. MAIN EXPOSURE MEASURES UMP and UPF intake were calculated using the NOVA classification. STATISTICAL ANALYSES Generalized estimating equations for marginal means and repeated cross-sectional associations between diet-quality metrics and quintiles of UMP and UPF. Diets were assessed every 4 years from 1986 to 2010. RESULTS With increasing quintiles of UMP intakes, the Alternate Healthy Eating Index-2010 increased 7.1% (3.80 points, 95% CI 3.66 to 3.93) in the NHS and 10.1% (5.75 points, 95% CI 5.52 to 5.98) in the HPFS; the Mediterranean diet index increased 11.7% (0.50 points, 95% CI 0.47 to 0.52) in the NHS and 14.0% (0.64 points, 95% CI 0.60 to 0.68) in the HPFS; and the Dietary Approaches To Stop Hypertension diet score increased 7.5% (1.81 points, 95% CI 1.76 to 1.87) in the NHS and 10.6% (2.66 points, 95% CI 2.57 to 2.76) in the HPFS. In the fifth quintile of UPF intake compared with the first, the Alternate Healthy Eating Index-2010 was -9.3% (-4.60 points, 95% CI -4.73 to -4.47) lower in the NHS and -13.7% (-6.89 points, 95% CI -7.12 to -6.66) lower in the HPFS; the Mediterranean diet index was -14.7% (-0.55 points, 95% CI -0.57 to -0.53) lower in the NHS, and -19.0% (-0.74 points, 95% CI -0.78 to -0.70) lower in the HPFS; and the Dietary Approaches To Stop Hypertension diet score was -8.1% (-1.81 points, 95% CI -1.86 to -1.76) lower in the NHS and -12.8% (-2.84 points, 95% CI -2.93 to -2.74) lower in the HPFS. CONCLUSIONS Consumption of UMP was associated with better dietary quality, whereas consumption of UPF was associated with poorer dietary quality.
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Affiliation(s)
- Sinara Laurini Rossato
- Institute of Geography, Graduation Course of Collective Health, Universidade Federal de Uberlândia. Uberlândia, Minas Gerais, Brazil; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Chun-Han Lo
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Stela Maris Jezus Castro
- Department of Statistics, Institute of Math and Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jean Philippe Drouin-Chartier
- Centre Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, Québec, Canada; Faculté de Pharmacie, Université Laval, Ferdinand Vandry Pavillon, Québec City, Québec, Canada
| | - Laura Sampson
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Changzheng Yuan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Big Data and Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cristiane Murta-Nascimento
- Department of Public Health, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Maria Antonieta Carvalhaes
- Department of Public Health, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil; Postgraduate Program in Nursing, Master and Doctorate Courses, School of Medicine, São Paulo State University, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Simmons College, Boston, Massachusetts
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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10
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García-Blanco L, de la O V, Santiago S, Pouso A, Martínez-González MÁ, Martín-Calvo N. High consumption of ultra-processed foods is associated with increased risk of micronutrient inadequacy in children: The SENDO project. Eur J Pediatr 2023; 182:3537-3547. [PMID: 37204600 PMCID: PMC10460344 DOI: 10.1007/s00431-023-05026-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/31/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
Due to its rising prevalence, which parallels that of ultraprocessed food (UPF) consumption, inadequate micronutrient intake in childhood is a public health concern. This study aimed to evaluate the association between UPF consumption and inadequate intake of 20 micronutrients in a sample of children from the Mediterranean area. Cross-sectional information from participants in the "Seguimiento del Niño para un Desarrollo Óptimo" (SENDO) project 2015-2021 was used. Dietary information was gathered with a previously validated 147-item semi-quantitative food frequency questionnaire and the NOVA system was used to classify food items. Children were classified by tertiles of energy intake from UPF. Twenty micronutrients were evaluated, and inadequate intake was defined using the estimated average requirement as a cutoff. Crude and multivariable adjusted OR (95% CI) for the inadequacy of ≥ 3 micronutrients associated with UPF consumption were calculated fitting hierarchical models to take into account intra-cluster correlation between siblings. Analyses were adjusted for individual and family confounders. This study included 806 participants (51% boys) with a mean age of 5 years old (SD: 0.90) and an average energy intake from UPF of 37.64% (SD: 9.59). An inverse association between UPF consumption and the intake of 15 out of the 20 micronutrients evaluated was found (p < 0.01). After the adjustment for individual and family confounders, compared with children in the first tertile of UPF consumption, those in the third tertile showed higher odds of inadequate intake of ≥ 3 micronutrients (OR 2.57; 95%CI [1.51-4.40]). Conclusion: High UPF consumption is associated with increased odds of inadequate intake of micronutrients in childhood. What is Known: • Micronutrient deficiency is among the 20 most important risk factors for disease and affect around two billion people worldwide. • UPF are rich in total fat, carbohydrates and added sugar, but poor in vitamins and minerals. What is New: • Compared with children in the 1st tertile of UPF consumption, those in the 3rd tertile had 2.57 times higher odds (95% CI: 1.51-4.40) of inadequate intake of ≥ 3 micronutrients after adjusting for potential confounders. • The adjusted proportions of children with inadequate intake of ≥ 3 micronutrients were 23%, 27% and 35% in the 1st, 2nd, and 3rd tertiles of UPF consumption respectively.
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Affiliation(s)
- Lorena García-Blanco
- Olite Primary Care Health Center, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Víctor de la O
- Precision Nutrition and Cardiometabolic Health. IMDEA Research Institute on Food & Health Sciences, Madrid, Spain
| | - Susana Santiago
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- School of Pharmacy and Nutrition, Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Alba Pouso
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, IDISBA & CIBERobn, 07122, Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, C/ Irunlarrea 1, Pamplona, 31080, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, ISCIII, Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Nerea Martín-Calvo
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
- School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, C/ Irunlarrea 1, Pamplona, 31080, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, ISCIII, Madrid, Spain.
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11
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Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6461. [PMID: 37569002 PMCID: PMC10419141 DOI: 10.3390/ijerph20156461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.
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Affiliation(s)
- Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Selena Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA 16802, USA;
| | - Nina Overby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, 4630 Kristiansand, Norway;
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
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12
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Via E, Contreras-Rodríguez O. Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods. Nutrients 2023; 15:2994. [PMID: 37447320 DOI: 10.3390/nu15132994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
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Affiliation(s)
- Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Spain
| | - Oren Contreras-Rodríguez
- Medical Imaging, Girona Biomedical Research Institute (IdIBGi), Parc Hospitalari Martí i Julià-Edifici M2, Salt, 17190 Girona, Spain
- Health Institute Carlos III (ISCIII) and CIBERSAM, 28029 Madrid, Spain
- Department of Psychiatry and Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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13
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González-Palacios S, Oncina-Cánovas A, García-de-la-Hera M, Martínez-González MÁ, Salas-Salvadó J, Corella D, Schröder H, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem JL, Cano-Ibañez N, Tur JA, Martín-Sánchez V, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Vázquez C, Daimiel L, Ros E, Bes-Rastrollo M, Atzeni A, Sorli JV, Zomeño MD, Peña-Orihuela PJ, Compañ-Gabucio LM, Barón-López FJ, Zulet MÁ, Konieczna J, Casas RM, Garrido-Garrido EM, Tojal-Sierra L, Gomez-Perez AM, Ruiz-Canela M, Palau A, Saiz C, Pérez-Vega KA, Garcia-Rios A, Torres-Collado L, Basterra-Gortari J, Garcidueñas-Fimbres TE, Malcampo M, Vioque J. Increased ultra-processed food consumption is associated with worsening of cardiometabolic risk factors in adults with metabolic syndrome: Longitudinal analysis from a randomized trial. Atherosclerosis 2023; 377:12-23. [PMID: 37343432 DOI: 10.1016/j.atherosclerosis.2023.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND AIMS The association between changes in ultra-processed food (UPF) consumption and cardiometabolic risk (CMR) factors remains understudied. We evaluated the association between changes in UPF consumption over 12 months of follow-up and changes in CMR factors in adults diagnosed with metabolic syndrome. METHODS We analysed data from 5373 adults (aged 55-75 years) participating in the PREDIMED-Plus trial. Diet was evaluated at baseline, 6- and 12-month visits using a validated food frequency questionnaire, and UPF consumption (in grams/day and percentage of total daily dietary intake in grams) was categorized based on NOVA classification. We used mixed-effects linear models with repeated measurements at baseline, 6 and 12 months of follow-up to assess the associations between changes in UPF consumption and changes in CMR factors adjusting for sociodemographic and lifestyles variables. RESULTS In multivariable-adjusted models, when comparing the highest versus the lowest quartile of UPF consumption, positive associations were found for several CMR factors: weight (kg, β = 1.09; 95% confidence interval 0.91 to 1.26); BMI (kg/m2, β = 0.39; 0.33 to 0.46); waist circumference (cm, β = 1.03; 0.81 to 1.26); diastolic blood pressure (mm Hg, β = 0.67; 0.29 to 1.06); fasting blood glucose (mg/dl, β = 1.66; 0.61 to 2.70); HbA1c (%, β = 0.04; 0.01 to 0.07); triglycerides (mg/dl, β = 6.79; 3.66 to 9.91) and triglycerides and glucose index (β = 0.06; 0.04 to 0.08). CONCLUSIONS Higher UPF consumption was associated with adverse evolution in objectively measured CMR factors after 12 months of follow-up in adults with metabolic syndrome. Further research is needed to explore whether these changes persist for longer periods.
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Affiliation(s)
- Sandra González-Palacios
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Alejandro Oncina-Cánovas
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Manuela García-de-la-Hera
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program. IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; EpiPHAAN research Group, School of Health Sciences, University of Málaga-Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Institut de Recerca en Nutrició i Seguretata Alimentaria (INSA-UB). University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - J Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Naomi Cano-Ibañez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Vicente Martín-Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d' Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program. IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660, Boadilla del Monte, Spain
| | - Emili Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Maira Bes-Rastrollo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Alessandro Atzeni
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Jose V Sorli
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - M Dolors Zomeño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain; Blanquerna-Ramon Llull University, Barcelona, Spain
| | - Patricia J Peña-Orihuela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Laura M Compañ-Gabucio
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Francisco J Barón-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; EpiPHAAN research Group, School of Health Sciences, University of Málaga-Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
| | - María Ángeles Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jadwiga Konieczna
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
| | - Rosa M Casas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Institut de Recerca en Nutrició i Seguretata Alimentaria (INSA-UB). University of Barcelona, Barcelona, Spain
| | | | - Lucas Tojal-Sierra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Ana M Gomez-Perez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Antoni Palau
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centre d'Assistència Primària Marià Fortuny, ABS Reus V. Salut Sant Joan de Reus, Reus, Spain
| | - Carmen Saiz
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Karla A Pérez-Vega
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Antonio Garcia-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Laura Torres-Collado
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Javier Basterra-Gortari
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Servicio de Endocrinología, Hospital Universitario de Navarra, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Tany E Garcidueñas-Fimbres
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- Unidad de Epidemiología de la Nutrición, Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández, (ISABIAL-UMH), Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain.
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14
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Andueza N, Martin-Calvo N, Navas-Carretero S, Cuervo M. The ALINFA Intervention Improves Diet Quality and Nutritional Status in Children 6 to 12 Years Old. Nutrients 2023; 15:nu15102375. [PMID: 37242258 DOI: 10.3390/nu15102375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The study aimed to evaluate the efficacy of a new nutritional intervention, focused on improving the quality of the diet in children aged 6 to 12 years. A 2-month parallel, controlled randomized trial was conducted in the Spanish child population. The children were randomized to ALINFA nutritional intervention, which consisted of a normocaloric diet that incorporates products, ready-to-eat meals and healthy recipes specifically designed for the study, or a control group, which received the usual advice on healthy eating. The change in diet quality was assessed through the Kidmed index. The secondary outcomes were anthropometry, glucose and lipid profiles, inflammation markers, dietary intake and lifestyle. The participants in the intervention group showed an increase in the mean score of the Kidmed index (p < 0.001). Alongside that, these children decreased their intake of calories (p = 0.046), and total and saturated fat (p = 0.016//p = 0.011), and increased fiber intake (p < 0.001). Likewise, the children in the ALINFA group increased the intake of white fish (p = 0.001), pulses (p = 0.004), whole grains (p < 0.001) and nuts (p < 0.001), and decreased fatty meat (p = 0.014), refined grain (p = 0.008), pastry (p < 0.001), fast food (p < 0.001) and sugar (p = 0.001) intake. Moreover, these children had a significantly decreased BMI (p < 0.001), BMI z-score (p < 0.001), waist circumference (p = 0.016) and fat mass (p = 0.011), as well as leptin (p = 0.004). Participants in the control group did not report significant changes in diet quality. In conclusion, ALINFA nutritional intervention is possibly a useful strategy to increase the diet quality in children, which is associated to improvements in the nutritional status. These results highlight the importance of developing well-designed nutritional interventions.
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Affiliation(s)
- Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Nerea Martin-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, University Campus, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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15
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Cerrillo I, Saralegui-Díez P, Morilla-Romero-de-la-Osa R, González de Molina M, Guzmán GI. Nutritional Analysis of the Spanish Population: A New Approach Using Public Data on Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1642. [PMID: 36674397 PMCID: PMC9867222 DOI: 10.3390/ijerph20021642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Official population consumption data are frequently used to characterize the diet of countries; however, this information may not always be representative of reality. This study analyses the food consumption of the Spanish population by reconstructing the whole food chain. The results have been compared with the data provided by the National Consumption Panel to which the food losses/waste reported in the literature along the distribution chain have been added. The difference between them allowed a new calculation of the estimated food consumption that was subjected to a dietary-nutritional analysis. Most of the foods were consumed more than those officially reported (range of 5-50%). The unhealthy ratios of consumed foods and recommended servings were: meat products (Rcr = 3.6), fruits and legumes (Rcr = 0.5), and nuts (Rcr = 0.14). Caloric intake surpasses needs. The results were consistent with the data on the prevalence of overweight and obesity in Spain, as well as with the prevalence of associated diseases. To make a judgment about the quality of a country's diet, it is necessary to have reliable data on food consumption, as well as energy and nutrient intake. This study encourages other authors to implement this method to verify and quantify the possible difference between official and real consumption data.
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Affiliation(s)
- Isabel Cerrillo
- Department of Molecular Biology and Biochemistry Engineering, Area of Nutrition and Food Sciences, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
| | - Pablo Saralegui-Díez
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Rubén Morilla-Romero-de-la-Osa
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41015 Seville, Spain
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Spanish National Research Council (CSIC), Universidad de Sevilla, 41015 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Virgen del Rocío, 41015 Seville, Spain
| | - Manuel González de Molina
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Gloria I. Guzmán
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
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16
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Miguel-Berges ML, Jimeno-Martínez A, Larruy-García A, Moreno LA, Rodríguez G, Iguacel I. The Effect of Food Vouchers and an Educational Intervention on Promoting Healthy Eating in Vulnerable Families: A Pilot Study. Nutrients 2022; 14:nu14234980. [PMID: 36501009 PMCID: PMC9739317 DOI: 10.3390/nu14234980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Cost has been reported as the main barrier to healthy eating in vulnerable groups. We aimed to evaluate the effect of a nutrition education intervention on adherence to Mediterranean Diet and health when providing food vouchers. This pilot study has a randomized control trial design. We included 66 vulnerable users from the Red Cross of Zaragoza (Spain). Intervention and control group individuals received 120 euros/month of food vouchers over 3 months to be spent in supermarkets (60 euros/month if under 12 y) plus a 10-week nutrition education program for the intervention group. Family food purchases were assessed using electronically recorded supermarket-obtained transactions. During and at the end of the intervention the percentage of healthy food was higher in the intervention than in the control group. Once the nutrition education was over, differences between groups dissipated. In the intervention group, health parameters improved, particularly weight-status, lipids, and liver enzymes. Control participants gained weight, although lipid and liver enzymes improved. Blood pressure and HbA1c did not improve in either the intervention or the control group. In conclusion, providing unrestricted food vouchers to vulnerable groups to increase healthy food consumption appears to be insufficient and should be accompanied by medium-long term nutrition education.
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Affiliation(s)
- María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
| | - Andrea Jimeno-Martínez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
| | - Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Isabel Iguacel
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
- Correspondence: ; Tel.:+34-(97)-6761749
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17
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Ultra-Processed Foods and Drinks Consumption Is Associated with Psychosocial Functioning in Adolescents. Nutrients 2022; 14:nu14224831. [PMID: 36432518 PMCID: PMC9694351 DOI: 10.3390/nu14224831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022] Open
Abstract
Adolescents show one of the highest rates of ultra-processed foods and drinks (UPF) consumption, and studies indicate an association between their consumption and internalizing problems. We aim to investigate whether UPF consumption associates with dysfunctions in other psychosocial domains, as well as sex effects. In 560 Spanish adolescents (14-17 years old), we assessed the UPF products consumed in the previous day, fruits and vegetables consumption (servings/day), and physical activity (days/week). Psychosocial functioning (total and subscales) was assessed through the Pediatric Symptom Checklist-Youth self-report. Associations between UPF and psychosocial functioning were assessed using linear regression models, adjusting for sex, age, fruits and vegetables consumption, and physical activity. Sex-specific associations were also explored. Participants reported a daily consumption of 7.72 UPF servings per day, with male adolescents showing higher consumption than female adolescents. Consumption of fruits and vegetables and physical activity levels were lower than recommended. Psychosocial impairment was present in 26.2% of the participants. Higher UPF consumption was associated with higher presence of depressive symptoms and internalizing and externalizing problems in the whole sample and in male adolescents. The present study supports previous studies suggesting that UPF consumption may interact with mental health problems and indicates that these effects may go beyond internalizing problems.
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Grams L, Nelius AK, Pastor GG, Sillero-Quintana M, Veiga ÓL, Homeyer D, Kück M. Comparison of Adherence to Mediterranean Diet between Spanish and German School-Children and Influence of Gender, Overweight, and Physical Activity. Nutrients 2022; 14:4697. [PMID: 36364959 PMCID: PMC9655044 DOI: 10.3390/nu14214697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Poor dietary habits and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The Mediterranean Diet (MD) is known to be extremely healthy, associated with lower BMI and a lower risk of obesity in children and adolescents. Therefore, adherence to the MD was compared between Spanish (n = 182) and German (n = 152) children aged 10 to 13 years to examine a possible more "westernized" diet in Spain with a non-Mediterranean country, that traditionally prefers a "Western diet" and to determine the association between adherence to the MD and gender, body composition, and PA levels. METHODS In the German observational longitudinal cohort study and the Spanish cohort study, body composition and questionnaires (KIDMED, Diet Quality (IAES)) were obtained, and accelerometers (Actigraph) were applied to detect PA. RESULTS Girls had higher BMI-standard deviation score (SDS) than boys and Spanish girls were less active than boys. Differences were detected in MD habits, such as favorable fruit-, vegetables-, fish-intakes, and dairy products in Spanish children and unfavorable consumptions of fast food, processed bakery goods, candies, and sweet beverages in German children. Independently of country, girls, children with lower BMI-SDS and children with higher PA level were related with better diet quality. CONCLUSION Spanish children showed higher adherence to MD and diet quality (IAES) compared to German children, but there was a trend toward a more "westernized" diet. Gender, body composition, and PA influenced nutrition regardless of country.
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Affiliation(s)
- Lena Grams
- Faculty of Science, Physical Activity and Sports (INEF), Technical University of Madrid (UPM), 28040 Madrid, Spain
| | - Anne-Katrin Nelius
- Institute of Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Guadalupe Garrido Pastor
- Faculty of Science, Physical Activity and Sports (INEF), Technical University of Madrid (UPM), 28040 Madrid, Spain
| | - Manuel Sillero-Quintana
- Faculty of Science, Physical Activity and Sports (INEF), Technical University of Madrid (UPM), 28040 Madrid, Spain
| | - Óscar L. Veiga
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid (UAM), 28049 Madrid, Spain
| | - Denise Homeyer
- Institute of Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Momme Kück
- Institute of Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
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19
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Hartman-Petrycka M, Witkoś J, Lebiedowska A, Błońska-Fajfrowska B. Who Likes Unhealthy Food with a Strong Flavour? Influence of Sex, Age, Body Mass Index, Smoking and Olfactory Efficiency on Junk Food Preferences. Nutrients 2022; 14:nu14194098. [PMID: 36235750 PMCID: PMC9571372 DOI: 10.3390/nu14194098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/09/2022] Open
Abstract
Background. Unhealthy food is an important element in the development of diseases of civilisation. The aim of this study was to determine how sex, age, body mass index, smoking and olfactory efficiency influence the consumption of such foods. Methods. A total of 283 people living in the Silesian Voivodeship in Poland took part in the study. They were aged 18−82. An interview and olfactory tests were conducted together with assessments of food preferences from 25 types of food products. The extent to which sex, age, body mass index, tobacco addiction and sense of smell influence unhealthy food consumption was assessed. Results. Using the VARIMAX factor analysis, a coherent group of ‘unhealthy food with a strong flavour’ products was selected: crisps, salty snacks, fast food, sugary carbonated drinks and sour products. Unhealthy food was liked more by people who were younger (B = −0.04; PU = −0.05, −0.03; t = −7.43, eta2 = 0.17; p < 0.001) and who had a higher BMI (B = 0.03; PU ≤ 0.01, 0.06; t = 1.92, eta2 = 0.01; p = 0.056). The efficiency of the sense of smell does not play a significant role in the preference for the ‘unhealthy food’ group as a whole. The analysis of each type of unhealthy food separately showed that young people liked crisps, salty snacks, fast food and sugary carbonated drinks more, men liked fast food and sugary carbonated drinks more than women, and people with a good sense of smell liked sour products. Conclusion. According to the food preferences stated, dietary education should be targeted at young people, especially young men, to prevent the development of overweight and obesity.
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Affiliation(s)
- Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland
- Correspondence: ; Tel.: +48-32-269-9830
| | - Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland
| | - Agata Lebiedowska
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland
| | - Barbara Błońska-Fajfrowska
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland
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20
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Nutritional Assessment of Hospital Meals by Food-Recording Applications. Nutrients 2022; 14:nu14183754. [PMID: 36145130 PMCID: PMC9505777 DOI: 10.3390/nu14183754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Mobile food records are currently used to determine the nutrition of healthy subjects. To determine the accuracy of such records, we evaluated the nutritional composition of a test meal (noodles and fruit juice) and a hospital meal (Japanese set meal) using two types of mobile food records. Eighteen healthy subjects (2 males and 16 females) were enrolled. Using these diets and validated nutrient-composition information, we evaluated the accuracy of the dietary assessments made by two dietary-record applications, Asken® and Calomeal®, over 5 days. For the test meal, the values provided by the two applications were close to the actual values. In contrast, for the hospital meal, the values provided by the two applications were approximately 1.5 times higher than the actual values. A linear-mixed-model analysis showed that the total energy, carbohydrate, and salt contents were significantly overestimated in the hospital meal. Protein also tended to be overestimated, while the fat content was not significantly overestimated. Furthermore, the total energy and fat contents increased significantly over time. No association with age was observed. A comparison of the coefficients of variation (CVs) for each nutrient in the hospital meal indicated that the fat levels were significantly higher than those in the test meal. In conclusion, the accuracy of mobile food records depends on the type of meal. Our data will provide lessons for the use of meal-recording applications in special cases, such as hospital food.
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21
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Geographical and Temporal Variability of Ultra-Processed Food Consumption in the Spanish Population: Findings from the DRECE Study. Nutrients 2022; 14:nu14153223. [PMID: 35956398 PMCID: PMC9370340 DOI: 10.3390/nu14153223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
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 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.
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Public Opinion on Food Policies to Combat Obesity in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148561. [PMID: 35886411 PMCID: PMC9321178 DOI: 10.3390/ijerph19148561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022]
Abstract
(1) Introduction: Poor diet is the fourth-leading cause of mortality in Spain, where adherence to the Mediterranean diet has declined in recent decades. To remedy this situation, a series of food policies have been proposed that would be easier to implement if they had public support. (2) Material and methods: Cross-sectional study covering a representative sample of the Spanish population (n = 1002), using telephone interviews that addressed nine food policies under four headings, namely, advertising, labeling, composition, and provision and sale. The sociodemographic determinants of support for these policies were analyzed using the chi-squared (χ2) test and Poisson multiple regression models with robust variance. (3) Results: All the proposed measures received more than 60% support. The policies that received greatest support were those targeting labeling at 96.6%, while the policies that received the least support were those directed at banning free refills at restaurants, at 63%. Support for policies was higher among women, older adults, and persons professing left-wing ideological affiliations. Compared with men, women’s support for advertising policies was 21% higher: similarly, compared with the youngest age group (18–29 years), support by the over-65 segment for provision and sale policies was 52% higher. Support for composition policies was 28% lower among persons with right-wing as opposed to left-wing political sympathies. (4) Conclusions: The authorities enjoy the support of the Spanish public as regards implementing food policies proposed by experts and overcoming the resistance of sectors opposed to such measures.
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García-Blanco L, de la O Pascual V, Berasaluce A, Moreno-Galarraga L, Martínez-González MÁ, Martín-Calvo N. Individual and family predictors of ultra-processed food consumption in Spanish children. The SENDO project. Public Health Nutr 2022; 26:1-22. [PMID: 35618704 DOI: 10.1017/s136898002200132x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BRACKGROUND Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects. OBJECTIVE To identify individual and family factors predicting UPF consumption in childhood. DESIGN The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (p< 0.20) in univariate analyses were introduced in a model of generalized estimating equations (GEE) which accounted for intra-cluster correlations between siblings. SETTING The SENDO proyect (Spain), 2015-2021. PARTICIPANTS Spanish children are recruited at the age of 4-5 years and followed yearly through online questionnaires completed by parents. RESULTS In this sample of 806 participants (49% girls; mean age 5 years [SD: 0.90]), the mean UPF consumption was 37.64 % of total energy intake (sd: 9.59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children's dietary recommendations, healthy dietary attitudes towards child's eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16% of the variability on the consumption of UPF in childhood. CONCLUSION Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting heathy dietary habits in early life.
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Affiliation(s)
- Lorena García-Blanco
- San Juan Primary Care Health Center. Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
| | - Víctor de la O Pascual
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
| | - Arantxa Berasaluce
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
| | - Laura Moreno-Galarraga
- Department of Pediatrics. Complejo Hospitalario de Navarra B, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
| | - Miguel Ángel Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III. Av. Monforte de Lemos, 3-5. 28029 Madrid, Spain
| | - Nerea Martín-Calvo
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain. IdiSNA, Instituto de Investigación Sanitaria de Navarra
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III. Av. Monforte de Lemos, 3-5. 28029 Madrid, Spain
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Royo-Bordonada MÁ, Fernández-Escobar C, Gil-Bellosta CJ, Ordaz E. Effect of excise tax on sugar-sweetened beverages in Catalonia, Spain, three and a half years after its introduction. Int J Behav Nutr Phys Act 2022; 19:24. [PMID: 35279194 PMCID: PMC8917362 DOI: 10.1186/s12966-022-01262-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The World Health Organisation urges countries to levy specific excise taxes on SSBs. Currently, more than 50 countries have introduced some type of tax on SSBs. In March 2017, the Autonomous Region of Catalonia approved the introduction of a tiered excise tax on SSBs for public health reasons. To evaluate the effect of the Catalonian excise tax on the price and purchase of sugar-sweetened beverages (SSBs) and their possible substitutes, i.e., non-sugar-sweetened beverages (NSSBs) and bottled water, three and half years after its introduction, and 1 year after the outbreak of the COVID-19 pandemic.
Methods
We analysed purchase data on soft drinks, fruit drinks and water, sourced from the Ministry of Agriculture food-consumption panel, in a random sample of 12,500 households across Spain. We applied the synthetic control method to infer the causal impact of the intervention, based on a Bayesian structural time-series model which predicts the counterfactual response that would have occurred in Catalonia, had no intervention taken place.
Results
As compared to the predicted (counterfactual) response, per capita purchases of SSBs fell by 0.17 l three and a half years after implementing the SSB tax in Catalonia, a 16.7% decline (95% CI: − 23.18, − 8.74). The mean SSB price rose by 0.11 €/L, an 11% increase (95% CI: 9.0, 14.1). Although there were no changes in mean NSSB prices, NSSB consumption rose by 0.19 l per capita, a 21.7% increase (95% CI: 18.25, 25.54). There were no variations in the price or consumption of bottled water. The effects were progressively greater over time, with SSB purchases decreasing by 10.4% at 1 year, 12.3% at 2 years, 15.3% at 3 years, and 16.7% at three and a half years of the tax’s introduction.
Conclusions
The Catalonian SSB excise tax had a sustained and progressive impact over time, with a fall in consumption of as much as 16.7% three and half years after its introduction. The observed NSSB substitution effect should be borne in mind when considering the application of this type of tax to the rest of Spain.
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Martinez-Perez C, Daimiel L, Climent-Mainar C, Martínez-González MÁ, Salas-Salvadó J, Corella D, Schröder H, Martinez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Sánchez VM, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Vázquez C, Ros E, Basterra J, Babio N, Guillem-Saiz P, Zomeño MD, Abete I, Vaquero-Luna J, Barón-López FJ, Gonzalez-Palacios S, Konieczna J, Garcia-Rios A, Bernal-López MR, Santos-Lozano JM, Bes-Rastrollo M, Khoury N, Saiz C, Pérez-Vega KA, Zulet MA, Tojal-Sierra L, Ruiz ZV, Martinez MA, Malcampo M, Ordovás JM, San-Cristobal R. Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF). Int J Behav Nutr Phys Act 2022; 19:6. [PMID: 35073909 PMCID: PMC8785596 DOI: 10.1186/s12966-021-01240-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent lifestyle changes include increased consumption of highly processed foods (HPF), which has been associated with an increased risk of non-communicable diseases (NCDs). However, nutritional information relies on the estimation of HPF consumption from food-frequency questionnaires (FFQ) that are not explicitly developed for this purpose. We aimed to develop a short screening questionnaire of HPF consumption (sQ-HPF) that integrates criteria from the existing food classification systems. METHODS Data from 4400 participants (48.1% female and 51.9% male, 64.9 ± 4.9 years) of the Spanish PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial were used for this analysis. Items from the FFQ were classified according to four main food processing-based classification systems (NOVA, IARC, IFIC and UNC). Participants were classified into tertiles of HPF consumption according to each system. Using binomial logistic regression, food groups associated with agreement in the highest tertile for at least two classification systems were chosen as items for the questionnaire. ROC analysis was used to determine cut-off points for the frequency of consumption of each item, from which a score was calculated. Internal consistency of the questionnaire was assessed through exploratory factor analysis (EFA) and Cronbach's analysis, and agreement with the four classifications was assessed with weighted kappa coefficients. RESULTS Regression analysis identified 14 food groups (items) associated with high HPF consumption for at least two classification systems. EFA showed that items were representative contributors of a single underlying factor, the "HPF dietary pattern" (factor loadings around 0.2). We constructed a questionnaire asking about the frequency of consumption of those items. The threshold frequency of consumption was selected using ROC analysis. Comparison of the four classification systems and the sQ-HPF showed a fair to high agreement. Significant changes in lifestyle characteristics were detected across tertiles of the sQ-HPF score. Longitudinal changes in HPF consumption were also detected by the sQ-HPF, concordantly with existing classification systems. CONCLUSIONS We developed a practical tool to measure HPF consumption, the sQ-HPF. This may be a valuable instrument to study its relationship with NCDs. TRIAL REGISTRATION Retrospectively registered at the International Standard Randomized Controlled Trial Registry ( ISRCTN89898870 ) on July 24, 2014.
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Affiliation(s)
- Celia Martinez-Perez
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Ctra. Cantoblanco, 8, 28049, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Ctra. Cantoblanco, 8, 28049, Madrid, Spain.
| | - Cristina Climent-Mainar
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Ctra. Cantoblanco, 8, 28049, Madrid, Spain
| | - Miguel Ángel Martínez-González
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Jordi Salas-Salvadó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i biotecnologia, Universitat Rovira i Virgili, 43201, Reus, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
| | - Dolores Corella
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
| | - Jose Alfredo Martinez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049, Madrid, Spain
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009, Pamplona, Spain
| | - Ángel M Alonso-Gómez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29016, Málaga, Spain
| | - Jesús Vioque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), 03010, Alicante, Spain
| | - Dora Romaguera
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120, Palma de Mallorca, Spain
| | - José López-Miranda
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14017, Córdoba, Spain
| | - Ramón Estruch
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08007, Barcelona, Spain
| | - Francisco J Tinahones
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016, Málaga, Spain
| | - José Lapetra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Sevilla, Spain
| | - Lluis Serra-Majem
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016, Las Palmas, Spain
| | - Aurora Bueno-Cavanillas
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18011, Granada, Spain
| | - Josep A Tur
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS & IDISBA, 07122, Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, 24071, León, Spain
| | - Xavier Pintó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departamento de Ciencias de la Salud, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, Universidad de Jaén, 23071, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - Josep Vidal
- Biomedical Research Centre for Diabetes and Metabolic Diseases Network (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08007, Barcelona, Spain
| | - Clotilde Vázquez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autónoma, 28015, Madrid, Spain
| | - Emilio Ros
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08007, Barcelona, Spain
| | - Javier Basterra
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009, Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008, Pamplona, Spain
| | - Nancy Babio
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i biotecnologia, Universitat Rovira i Virgili, 43201, Reus, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
| | - Patricia Guillem-Saiz
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - María Dolores Zomeño
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
- School of Health Sciences, Blanquerna-Ramon Llull University, 08001, Barcelona, Spain
| | - Itziar Abete
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009, Pamplona, Spain
| | - Jessica Vaquero-Luna
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Francisco Javier Barón-López
- Department of Public Health, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29016, Málaga, Spain
| | - Sandra Gonzalez-Palacios
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), 03010, Alicante, Spain
| | - Jadwiga Konieczna
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120, Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14017, Córdoba, Spain
| | - María Rosa Bernal-López
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010, Málaga, Spain
| | - José Manuel Santos-Lozano
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Sevilla, Spain
| | - Maira Bes-Rastrollo
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009, Pamplona, Spain
| | - Nadine Khoury
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i biotecnologia, Universitat Rovira i Virgili, 43201, Reus, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
| | - Carmen Saiz
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Karla Alejandra Pérez-Vega
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
| | - María Angeles Zulet
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009, Pamplona, Spain
| | - Lucas Tojal-Sierra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Zenaida Vázquez Ruiz
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009, Pamplona, Spain
| | - Maria Angeles Martinez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i biotecnologia, Universitat Rovira i Virgili, 43201, Reus, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
| | - Mireia Malcampo
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
| | - José M Ordovás
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Ctra. Cantoblanco, 8, 28049, Madrid, Spain
- Nutrition and Genomics Laboratory, JM_USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 02155, USA
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Shim JS. Ultra-processed foods and total sugars intake in Korea: evidence from the Korea National Health and Nutrition Examination Survey 2016–2018. Nutr Res Pract 2022; 16:476-488. [PMID: 35919288 PMCID: PMC9314195 DOI: 10.4162/nrp.2022.16.4.476] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dietary sugars intake worldwide is stable or decreasing, but overall sugars intake remains above the recommended level. Some studies suggest that ultra-processed foods (UPFs) drive excessive sugars intake. However, UPF consumption in Korea and its association with sugars intake have not yet been studied. This study aimed to estimate the contribution of UPF consumption to total sugars intake and to investigate the association between UPF consumption and total sugars intake in Koreans. SUBJECTS/METHODS Data from the Korea National Health and Nutrition Examination Survey 2016–2018 were used, and included data on 21,075 participants aged 1+ years completed a 24-h recall. Food items reported in the 24-h recall were classified according to the NOVA system as UPFs, processed foods, processed culinary ingredients, or unprocessed or minimally processed foods. RESULTS The average daily energy intake was 1,996 kcal, and UPFs accounted for 26.2% of the total energy intake (% TE). The average total sugars intake was 63.1 g (13.0% TE), and 44.9% of total sugars intake came from UPFs. Among the entire population, 15.8% exceeded the recommended limit for total sugars within 20% TE, and excessive total sugars intake was more prevalent among females (19.5%) and children (21.1%). The prevalence of excessive total sugars intake showed a significantly increasing tendency across the quartiles of UPF energy contribution, ranging from 11.9% in the lowest quartile to 23.2% in the highest quartile. Even after adjustment for sociodemographic variables, UPF consumption was positively associated with the prevalence of excessive total sugars intake (P for trend < 0.001). This association was similar in subgroup analyses by sex and age. CONCLUSIONS This study suggests that UPF consumption may drive excessive intake of total sugars in the Korean diet. Our findings conclusively establish that restricting UPF consumption may be an efficient way to reduce sugars intake in Korean population.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
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RODRÍGUEZ ALBERTHOMIER, AMARILLA NJDUARTE, RODRÍGUEZ MMTRINIDAD, MARTÍNEZ BENÚÑEZ, MEZA-MIRANDA ER. Processed and ultra-processed foods consumption in adults and its relationship with quality of life and quality of sleep. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e220173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Objective: To evaluate the consumption of processed and ultra-processed foods in Paraguayan adults and its relationship with quality of life and sleep quality. Methods: A cross-sectional descriptive observational study was carried out on Paraguayan adults in May 2022. An online survey was applied in which sociodemographic data, frequency of food consumption using the NOVA classification and Pan American Health Organization criteria, quality of life evaluated by the European Quality of Life-5 Dimensions and report of hours of sleep were collected. Results: A total of 273 Paraguayan adults were included in the study, of which 71.1% were female, 51.6% lived in the capital, 53.1% were single, 66% had a university educational level and the average age was 36.48±13.2. Regarding the consumption of processed and ultra-processed foods, the critical nutrients most consumed daily were free sugars by 34.0%, and fats by 23.4% of the population. The global quality of life index was low (0,58±0,05) and 69.0% reported insufficient hours of sleep. Statistically significant relationships were found between the consumption of processed and ultra-processed foods with quality of life and quality of sleep (p<0.05 for both). Conclusion: The most consumed critical nutrients in the Paraguayan adult population are free sugars and fats, finding a significant relationship between the consumption of processed and ultra-processed foods with quality of life and quality of sleep.
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Garrido-Pastor G, San Cristóbal Díaz FM, Fernández-López N, Ferro-Sánchez A, Sillero-Quintana M. Sustainable Food Support during an Ultra-Endurance and Mindfulness Event: A Case Study in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12991. [PMID: 34948600 PMCID: PMC8701145 DOI: 10.3390/ijerph182412991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/19/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022]
Abstract
The present industrial food-production system is not suitably ecological for the environment. Mindful nutrition in sport is a relevant emergent sub-discipline that could help reduce environmental degradation. This case study describes a sustainable support diet during an ultra-endurance running (UR) event called the "Indoor Everest Challenge". This UR challenge involved attaining the altitude of Mount Everest (8849 m) in a simulated way, in less than 24 h, without using ultra-processed food and without wasting plastics. During this challenge, a male athlete (34 years, weight: 78 kg, and height: 173 cm) wore a SenseWear Armband® (BodyMedia Inc., Pittsburg, PA, USA) accelerometer on his right arm to estimate energy expenditure. To supply his nutritional requirements, the athlete consumed only specially prepared homemade and organic food. All consumption was weighed and recorded in real-time; we determined nutrients using two databases: a food composition software, Dial Alce Ingenieria® (Madrid, Spain), to measure energy and macro- and micro-nutrients, and Phenol Explorer Database® (INRA Institut National de Recherche pour l'Alimentation, Paris, France) precisely to determine polyphenolic content. Most energy intake (up to 96%) came from plant foods. We found that subject consumed 15.8 g/kg-1/d-1 or 1242 g of carbohydrates (CHO), (2.4 g/kg-1/d-1) or 190 g of proteins (P), and 10,692 mL of fluid. The total energy intake (7580 kcal) showed a distribution of 65% CHO, 10% P, and 25% lipids (L). Furthermore, this sustainable diet lead to a high antioxidant intake, specifically vitamin C (1079 mg), vitamin E (57 mg), and total polyphenols (1910 mg). This sustainable approach was suitable for meeting energy, CHO, and P recommendations for UR. Physical and mental training (mindfulness) were integrated from the specific preliminary phase to the day of the challenge. The athlete completed this challenge in 18 h with a low environmental impact. This sports event had an educational component, as it awakened curiosity towards food sustainability.
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Affiliation(s)
- Guadalupe Garrido-Pastor
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Francisco Manuel San Cristóbal Díaz
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Nieves Fernández-López
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (N.F.-L.); (A.F.-S.); (M.S.-Q.)
| | - Amelia Ferro-Sánchez
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (N.F.-L.); (A.F.-S.); (M.S.-Q.)
| | - Manuel Sillero-Quintana
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (N.F.-L.); (A.F.-S.); (M.S.-Q.)
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Lauria F, Dello Russo M, Formisano A, De Henauw S, Hebestreit A, Hunsberger M, Krogh V, Intemann T, Lissner L, Molnar D, Moreno LA, Reisch LA, Tornaritis M, Veidebaum T, Williams G, Siani A, Russo P. Ultra-processed foods consumption and diet quality of European children, adolescents and adults: Results from the I.Family study. Nutr Metab Cardiovasc Dis 2021; 31:3031-3043. [PMID: 34518085 DOI: 10.1016/j.numecd.2021.07.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Food processing has been indicated as a factor capable of negatively affecting the global food system, including the profile of consumers' diets. The objectives of the present study were to provide a description of the consumption of ultra-processed foods (UPFs) in the large population of children, adolescents and adults from eight European countries participating to the I.Family study, and to investigate the association between UPFs intake and nutritional quality of the diet. METHODS AND RESULTS Dietary intake was assessed using a 24-h dietary recall. The quality of the diet was evaluated by the Healthy Dietary Adherence Score (HDAS) using an FFQ. UPFs were classified according to the NOVA classification. Almost half of the daily energy intake of the 7073 participants came from UPFs, and this trend decreased progressively with age. UPFs contributed more than 50 % of the daily intake of total and saturated fat, carbohydrates and about 70 % of sugars intake in children and adolescents. No differences in UPFs consumption were found according to the educational and socio-economic status of the population. Energy intake increased across the quintiles of UPFs intake, while HDAS decreased. The frequency of consumption of fruit and vegetable, fish, and fibre rich foods was low in the fifth quintile of UPFs intake, both in adolescents and in adults. The consumption of foods rich in calories and low in nutritional content, operationally defined as "junk food", was significantly higher in the fifth quintile. CONCLUSIONS In the population of the European I.Family study, UPFs contributed a large proportion of the daily energy intake, especially in children and adolescents. Higher consumption of UPFs was associated with a lower quality of the diet. REGISTRATION NUMBER FOR CLINICAL TRIALS ISRCTN62310987.
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Affiliation(s)
- Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy.
| | | | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Denes Molnar
- Department of Paediatrics, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, Zaragoza, Spain
| | - Lucia A Reisch
- El-Erian Institute for Behavioural Economics and Policy, Cambridge University, UK
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Garrath Williams
- Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
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Béghin L, Huybrechts I, Drumez E, Kersting M, Walker RW, Kafatos A, Molnar D, Manios Y, Moreno LA, De Henauw S, Gottrand F. High Fructose Intake Contributes to Elevated Diastolic Blood Pressure in Adolescent Girls: Results from The HELENA Study. Nutrients 2021; 13:3608. [PMID: 34684609 PMCID: PMC8538236 DOI: 10.3390/nu13103608] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The association between high fructose consumption and elevated blood pressure continues to be controversial, especially in adolescence. The aim of this study was to assess the association between fructose consumption and elevated blood pressure in an European adolescent population. METHODS A total of 1733 adolescents (mean ± SD age: 14.7 ± 1.2; percentage of girls: 52.8%) were analysed from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries. Blood pressure was measured using validated devices and methods for measuring systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary data were recorded via repeated 24 h recalls (using specifically developed HELENA-DIAT software) and converted into pure fructose (monosaccharide form) and total fructose exposure (pure fructose + fructose from sucrose) intake using a specific fructose composition database. Food categories were separated at posteriori in natural vs. were non-natural foods. Elevated BP was defined according to the 90th percentile cut-off values and was compared according to tertiles of fructose intake using univariable and multivariable mixed logistic regression models taking into account confounding factors: centre, sex, age and z-score-BMI, MVPA (Moderate to Vigorous Physical Activity) duration, tobacco consumption, salt intake and energy intake. RESULTS Pure fructose from non-natural foods was only associated with elevated DBP (DBP above the 10th percentile in the highest consuming girls (OR = 2.27 (1.17-4.40); p = 0.015) after adjustment for cofounding factors. CONCLUSIONS Consuming high quantities of non-natural foods was associated with elevated DBP in adolescent girls, which was in part due to high fructose levels in these foods categories. The consumption of natural foods containing fructose, such as whole fruits, does not impact blood pressure and should continue to remain a healthy dietary habit.
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Affiliation(s)
- Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286—INFINITE and CIC-1403, F-59000 Lille, France;
| | - Inge Huybrechts
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Ghent, Belgium; (I.H.); (S.D.H.)
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, F-69000 Lyon, France
| | - Elodie Drumez
- Univ. Lille, CHU Lille, ULR 2694—METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France;
- CHU Lille, Department of Biostatistics, F-59000 Lille, France
| | - Mathilde Kersting
- Research Department of Child Nutrition, Pediatric University Clinic, Ruhr-University Bochum, D-44791 Bochum, Germany;
| | - Ryan W Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Anthony Kafatos
- Preventive Medicine and Nutrition Clinic, University of Crete School of Medicine, G-14122 Crete, Greece;
| | - Denes Molnar
- Department of Pediatrics, University of Pecs, H-7600 Pecs, Hungary;
| | - Yannis Manios
- Department of Nutrition and Dietetics, University of Harakopio, G-10431 Athens, Greece;
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, S-50009 Zaragoza, Spain;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Ghent, Belgium; (I.H.); (S.D.H.)
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286—INFINITE and CIC-1403, F-59000 Lille, France;
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Donat-Vargas C, Sandoval-Insausti H, Rey-García J, Moreno-Franco B, Åkesson A, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. High Consumption of Ultra-Processed Food is Associated with Incident Dyslipidemia: A Prospective Study of Older Adults. J Nutr 2021; 151:2390-2398. [PMID: 34038538 DOI: 10.1093/jn/nxab118] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/18/2020] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption has been associated with higher cardiovascular disease (CVD) and mortality risks. OBJECTIVES The aim of this study was to assess the relationship between UPF consumption and incident dyslipidemia in older adults, where evidence is limited. METHODS We studied a prospective cohort of 1082 community-dwelling adults in Spain, older than 60 (mean age, 68 ± 6 years old). Participants (52% were women) were recruited between 2008-10 and followed up to 2015. At baseline, food intake data were collected using a validated computerized face-to-face dietary history. UPFs were identified according to the nature and extent of their industrial processing (NOVA classification). Triglycerides, HDL cholesterol, and LDL cholesterol were measured in fasting plasma samples collected at baseline and at follow-up. Statistical analyses were performed with logistic regression adjusted for the main potential confounders. RESULTS Among those free of corresponding dyslipidemia at baseline, and after a follow-up of between 5 to 7 years, 60 (out of 895) developed incident hypertriglyceridemia (≥150 mg/dL), 112 (out of 878) had low HDL cholesterol (<40 in men/<50 mg/dL in women), and 54 (out of 472) had high LDL cholesterol (>129 mg/dL). The mean percentage of UPF consumption was 19% ± 11% of total energy intake. Those in the highest versus the lowest tertile of energy intake from UPFs had more than twice the odds of incident hypertriglyceridemia (OR, 2.66; 95% CI: 1.20-5.90; P-trend, 0.011) or low HDL cholesterol (OR, 2.23; 95% CI: 1.22-4.05; P-trend, 0.012). UPF consumption was not associated with high LDL cholesterol plasma concentrations. CONCLUSIONS Although UPF consumption in Spain was low among older adults, high consumption of UPFs was clearly associated with incident dyslipidemia. The increase in CVD risk recently found to be associated with UPF consumption might be mediated by these atherogenic lipid abnormalities.
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Affiliation(s)
- Carolina Donat-Vargas
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jimena Rey-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Belén Moreno-Franco
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,Biomedical Research Center Network for Cardiovascular (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, Preventive Medicine, and Public Health of the University of Zaragoza, Zaragoza, Spain
| | - Agneta Åkesson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jose Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Guallar-Castillón
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Romero Ferreiro C, Martín-Arriscado Arroba C, Cancelas Navia P, Lora Pablos D, Gómez de la Cámara A. Ultra-processed food intake and all-cause mortality: DRECE cohort study. Public Health Nutr 2021; 25:1-10. [PMID: 34348832 PMCID: PMC9991788 DOI: 10.1017/s1368980021003256] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/17/2021] [Accepted: 08/02/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the association between ultra-processed food (UPF) intake and all-cause mortality in a representative sample of Spanish population. DESIGN Prospective cohort design in which follow-up lasted from baseline (1991) to mortality date or 31 December 2017, whichever was first. Dietary information was collected using a validated frequency questionnaire and categorised following the NOVA classification according to the extent of food processing. The association between consumption of UPF and mortality was analysed using Cox models. Isoenergetic substitution models were constructed to compare the health effects of the NOVA groups. SETTING Cohort from the Diet and Risk of Cardiovascular Diseases (CVD) in Spain (DRECE) study, representative of the Spanish population. PARTICIPANTS Totally, 4679 subjects between 5 and 59 years old. RESULTS Average consumption of UPF was 370·8 g/d (24·4 % of energy intake). After a median follow-up of 27 years, 450 deaths occurred. Those who consumed the highest amount of UPF had higher risk of mortality. For every 10 % of the energy intake from UPF consumption, an increase of 15 % in the hazard of all-cause mortality was observed (HR 1·15; (95 % CI 1·03, 1·27); P-value = 0·012). Substitution of UPF with minimally processed foods was significantly associated with a decreased risk of mortality. CONCLUSIONS An increase in UPF consumption was associated with higher risk of all-cause mortality in a representative sample of the Spanish population. Moreover, the theoretical substitution of UPF with unprocessed or minimally processed foods leads to a decrease in mortality. These results support the need to promote diets based on unprocessed or minimally processed foods.
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Affiliation(s)
- Carmen Romero Ferreiro
- Scientific Support Unit (i+12), Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, Madrid28041, Spain
- Spanish Clinical Research Network (SCReN), Madrid, Spain
| | - Cristina Martín-Arriscado Arroba
- Scientific Support Unit (i+12), Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, Madrid28041, Spain
- Spanish Clinical Research Network (SCReN), Madrid, Spain
| | - Pilar Cancelas Navia
- Scientific Support Unit (i+12), Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, Madrid28041, Spain
- Spanish Clinical Research Network (SCReN), Madrid, Spain
| | - David Lora Pablos
- Scientific Support Unit (i+12), Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, Madrid28041, Spain
- Spanish Clinical Research Network (SCReN), Madrid, Spain
- Consorcio de Investigación Biomédica en Red de epidemiología y salud pública (CIBEResp), Madrid, Spain
- Faculty of Statistics, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Agustín Gómez de la Cámara
- Scientific Support Unit (i+12), Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, Madrid28041, Spain
- Spanish Clinical Research Network (SCReN), Madrid, Spain
- Consorcio de Investigación Biomédica en Red de epidemiología y salud pública (CIBEResp), Madrid, Spain
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Low- and No-Calorie Sweetener (LNCS) Consumption Patterns Amongst the Spanish Adult Population. Nutrients 2021; 13:nu13061845. [PMID: 34071307 PMCID: PMC8230335 DOI: 10.3390/nu13061845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/22/2021] [Accepted: 05/26/2021] [Indexed: 12/23/2022] Open
Abstract
Low- and no-calorie sweeteners (LNCS) are a group of food additives characterized by their high sweetness intensity and virtually zero caloric content, attributes that make them potential substitutes for added sugars in processed foods and beverages. However, there is currently scarce information available about both the different LNCS used in food products available in Spain and their consumption patterns. Prompted by these reasons, the aim of this research work was to identify the presence and consumption of LNCS in food and beverages consumed by a representative sample of the Spanish adult population (n = 507). For this purpose, a Food Frequency Questionnaire was carried out. Overall, it was found that 4.5% of the foods and 22.3% of the beverages consumed by the surveyed population contained LNCS. The food groups that presented the highest percentage of daily servings containing LNCS were non-alcoholic beverages such as soft drinks and juices (36.1%); sugars and sweets such as chocolates, candies, or chewing gum (14.2%); milk and dairy products (7.0%); meat and derivative products (5.1%); cereals and derivatives (4.3%); appetizers (1.7%); and, finally, sauces and condiments such as ketchup or mustard (1.0%). The main LNCS consumed were acesulfame-K, sucralose, sorbitol, aspartame, and cyclamate, although their prevalence of use differs greatly among foods, beverages, or tabletop sweeteners. Our results show the great diversity of food groups that are currently including these compounds as ingredients. Consequently, there is a need for these food additives to be included in food composition databases, which should be regularly updated to include LNCS in order to facilitate their assessment and monitoring in dietary nutritional surveys.
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Elías Zambrano R, Jiménez-Marín G, Galiano-Coronil A, Ravina-Ripoll R. Children, Media and Food. A New Paradigm in Food Advertising, Social Marketing and Happiness Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073588. [PMID: 33808388 PMCID: PMC8037704 DOI: 10.3390/ijerph18073588] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 01/21/2023]
Abstract
The growing number of children who are obese or overweight in certain countries or geographical areas is a fact, as evidenced by the continuous studies and reports on the subject, endorsed or carried out by the World Health Organisation and independent research. In this context, food and beverage advertising can contribute to this. The main objective of this research is to evaluate compliance with the Food and Drink Advertising Code for Children (PAOS Code) in Spain and its relationship with nutritional habits on television, specifically on channels aimed at children. The methodology is therefore mixed: on the one hand, a qualitative technique based on discourse analysis and, on the other, a quantitative technique based on the content analysis of the advertising broadcast for seven consecutive days on three specialised channels and two generalist channels on Spanish television. The results reveal a systematic noncompliance with this code, which translates into inadequate eating habits among children. The immediate conclusion is that 9 out of 10 parts of food and drink advertising do not comply with any of the rules of the PAOS Code and that self-regulation by the advertising companies is negligible and insufficient.
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Affiliation(s)
- Rodrigo Elías Zambrano
- Audiovisual and Advertising Department, Faculty of Communication, University of Seville, 41012 Seville, Spain;
| | - Gloria Jiménez-Marín
- Audiovisual and Advertising Department, Faculty of Communication, University of Seville, 41012 Seville, Spain;
- Correspondence:
| | - Araceli Galiano-Coronil
- Marketing and Communication Department, Faculty of Social Sciences and Communication and INDESS, University of Cádiz, 11406 Jerez de la Frontera, Spain;
| | - Rafael Ravina-Ripoll
- Business Organization Department and INDESS, Faculty of Economics and Business, University of Cádiz, 11406 Jerez de la Frontera, Spain;
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Shim JS, Shim SY, Cha HJ, Kim J, Kim HC. Socioeconomic Characteristics and Trends in the Consumption of Ultra-Processed Foods in Korea from 2010 to 2018. Nutrients 2021; 13:1120. [PMID: 33805412 PMCID: PMC8065678 DOI: 10.3390/nu13041120] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
There is growing evidence for a global transition to a more highly processed diet. While the dietary share of ultra-processed foods depends on a country's economic status, food choice and consumption are also influenced by the socioeconomic situation of individuals. This study investigated whether ultra-processed food consumption differed across socioeconomic subgroups and over time (2010-2018) in Korea. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2010-2018 were analyzed. Food and beverages reported in a one-day 24 h recall were classified according to the NOVA food classification criteria. The dietary energy contribution of ultra-processed foods was high among men and urban residents, and increased with education and income level; additionally, it reached its peak in adolescents and thereafter decreased with increasing age. After adjusting the socioeconomic variables, such associations remained significant, except for income level. The overall contribution of ultra-processed foods increased from 23.1% (2010-2012) to 26.1% (2016-2018), and the same trend over time was observed in all age groups and socioeconomic strata. In the Korean population, ultra-processed food consumption differed by individual socioeconomic characteristics, but gradually increased over time, and this trend was consistently found in all socioeconomic subgroups. Future strategies to promote healthy food choices are needed for the Korean population.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Sun-Young Shim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea;
| | - Hee-Jeung Cha
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
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Breakfast Food Advertisements in Mediterranean Countries: Products' Sugar Content in the Adverts from 2015 to 2019. CHILDREN-BASEL 2020; 8:children8010014. [PMID: 33396189 PMCID: PMC7823948 DOI: 10.3390/children8010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/24/2020] [Accepted: 12/27/2020] [Indexed: 11/17/2022]
Abstract
Although Spain was considered to be the healthiest country in the world in 2019, some studies reported that Mediterranean diet (MD) adherence, especially for breakfast, is low among children in Mediterranean countries, where child obesity is increasing alarmingly. This study correlated longitudinally the sugar content of breakfast products with advertising strategies. The research design applied quantitative analysis to compile the advertising data from 2015 to 2019 for all media, qualitative analysis of the content, and the use of popular characters to promote the food purchase. Additionally, a nutritional analysis was used to determine the products’ sugar content. The results were analyzed according to the target they were aimed at (adults or children). Results showed that the Spanish food industry promoted unhealthy products for breakfast, especially those targeted to children, with very high sugar content. To improve the childhood obesity rate in Spain, greater involvement from the food industry is needed. The reformulation of breakfast products must be a priority along with additional sugar reduction strategies so as not to lose adherence to MD in younger generations. More nutrition education is necessary among children, especially on balanced breakfast consumption, a basic meal that helps children to concentrate better in class during the morning.
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A Memetic Decomposition-Based Multi-Objective Evolutionary Algorithm Applied to a Constrained Menu Planning Problem. MATHEMATICS 2020. [DOI: 10.3390/math8111960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Encouraging healthy and balanced diet plans is one of the most important action points for governments around the world. Generating healthy, balanced and inexpensive menu plans that fulfil all the recommendations given by nutritionists is a complex and time-consuming task; because of this, computer science has an important role in this area. This paper deals with a novel constrained multi-objective formulation of the menu planning problem specially designed for school canteens that considers the minimisation of the cost and the minimisation of the level of repetition of the specific courses and food groups contained in the plans. Particularly, this paper proposes a multi-objective memetic approach based on the well-known multi-objective evolutionary algorithm based on decomposition (MOEA/D). A crossover operator specifically designed for this problem is included in the approach. Moreover, an ad-hoc iterated local search (ILS) is considered for the improvement phase. As a result, our proposal is referred to as ILS-MOEA/D. A wide experimental comparison against a recently proposed single-objective memetic scheme, which includes explicit mechanisms to promote diversity in the decision variable space, is provided. The experimental assessment shows that, even though the single-objective approach yields menu plans with lower costs, our multi-objective proposal offers menu plans with a significantly lower level of repetition of courses and food groups, with only a minor increase in cost. Furthermore, our studies demonstrate that the application of multi-objective optimisers can be used to implicitly promote diversity not only in the objective function space, but also in the decision variable space. Consequently, in contrast to the single-objective optimiser, there was no need to include an explicit strategy to manage the diversity in the decision space in the case of the multi-objective approach.
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Llorens-Ivorra C, Pereyra-Zamora P. Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED). Nutrients 2020; 12:nu12113257. [PMID: 33114384 PMCID: PMC7693738 DOI: 10.3390/nu12113257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 12/04/2022] Open
Abstract
Individuals’ perceptions of their food environments are a mediator between exposure to the environment and people’s interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach’s alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population’s perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Correspondence: ; Tel.: +34-96-590-34-00 (ext. 3834)
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Cristóbal Llorens-Ivorra
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Public Health Center of Dénia (Alicante), Valencian Community, 03700 Alicante, Spain
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
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Chen X, Zhang Z, Yang H, Qiu P, Wang H, Wang F, Zhao Q, Fang J, Nie J. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J 2020; 19:86. [PMID: 32819372 PMCID: PMC7441617 DOI: 10.1186/s12937-020-00604-1] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Consumption of ultra-processed foods (UPFs) plays a potential role in the development of obesity and other diet-related noncommunicable diseases (NCDs), but no studies have systematically focused on this. This study aimed to summarize the evidence for the association between UPFs consumption and health outcomes. Methods A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies. Epidemiological studies were included, and identified studies were evaluated for risk of bias.A narrative review of the synthesized findings was provided to assess the association between UPFs consumption and health outcomes. Results 20 studies (12 cohort and 8 cross-sectional studies) were included in the analysis, with a total of 334,114 participants and 10 health outcomes. In a narrative review, high UPFs consumption was obviously associated with an increased risk of all-cause mortality, overall cardiovascular diseases, coronary heart diseases, cerebrovascular diseases, hypertension, metabolic syndrome, overweight and obesity, depression, irritable bowel syndrome, overall cancer, postmenopausal breast cancer, gestational obesity, adolescent asthma and wheezing, and frailty. It showed no significant association with cardiovascular disease mortality, prostate and colorectal cancers, gestational diabetes mellitus and gestational overweight. Conclusions This study indicated a positive association between UPFs consumption and risk of several health outcomes. Large-scale prospective designed studies are needed to confirm our findings.
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Affiliation(s)
- Xiaojia Chen
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Zhang Zhang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Huijie Yang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Peishan Qiu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Haizhou Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Fan Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
| | - Jun Fang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
| | - Jiayan Nie
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
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Montero-Salazar H, Donat-Vargas C, Moreno-Franco B, Sandoval-Insausti H, Civeira F, Laclaustra M, Guallar-Castillón P. High consumption of ultra-processed food may double the risk of subclinical coronary atherosclerosis: the Aragon Workers' Health Study (AWHS). BMC Med 2020; 18:235. [PMID: 32787915 PMCID: PMC7425006 DOI: 10.1186/s12916-020-01678-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease. We aimed to assess whether consumption of UPF is directly associated with subclinical coronary atherosclerosis in middle-aged men. METHODS A computed tomography scan was performed on 1876 men from the Aragon Workers' Health Study, recruited from January 2011 to December 2014, to assess coronary calcium. All participants were free of coronary heart disease. Dietary intake was collected by a validated 136-item semi-quantitative food frequency questionnaire. UPF was defined according to the NOVA classification. Associations between consumption of total energy-adjusted UPF and Coronary Calcium Agatston Score (CACS)-categorized into CACS of 0, > 0 and < 100, and ≥ 100-were cross-sectionally assessed by generalized ordered logistic regression adjusted for main confounders. RESULTS No coronary calcium was detected in 60.2% of the participants, whereas 10.2% had a CACS ≥ 100. A significant dose-response association was observed between energy-adjusted UPF consumption and the risk of having a CACS ≥ 100, when compared with those in the lowest CACS categories (CACS of 0 together with CACS > 0 and < 100). The fully adjusted ORs (95% CI) of having a CACS ≥ 100 across quartiles of energy-adjusted UPF consumption (approximately 100 g/day in the lowest quartile (ref.) and 500 g/day in the highest) were 1.00 (ref.), 1.50 (0.93, 2.42), 1.56 (0.96, 2.52), and 2.00 (1.26, 3.16), p trend .005. CONCLUSION In this middle-aged worker's sample, approximately 500 g/day of UPF consumption was associated with a 2-fold greater prevalence of subclinical coronary atherosclerosis than consuming only 100 g/day, independently of total energy intake and other well-established cardiovascular risk factors.
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Affiliation(s)
- Henry Montero-Salazar
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain. .,Unit of Nutritional and Cardiovascular Epidemiology, Environmental Medicine Institute (IMM), Karolinska Institutet, Stockholm, Sweden. .,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain. .,Instituto de Investigación IdiPaz, Madrid, Spain. .,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain.
| | - Belén Moreno-Franco
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Civeira
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Martín Laclaustra
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación IdiPaz, Madrid, Spain.,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain
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Abstract
Purpose of Review This review will present the latest evidence on the impacts of sugar taxes on obesity with a focus on sugar-sweetened beverages (SSB). Recent Findings Evidence of direct impacts of SSB taxation policies on obesity prevalence continues to be limited. Natural experiments involving SSB taxation policies implemented in Mexico and Berkley, CA, indicate that this type of intervention alters beverage consumption patterns. Naturalistic evidence in combination with modeling studies suggests that SSB taxation is a viable anti-obesity policy. However, researchers and public health practitioners need to be vigilant of industry tactics to curtail SSB lowering efforts. Summary To maximize the impacts of SSB taxation, it should be combined with interventions that increase access to non-sweetened beverages, educate consumers about alternative healthy beverages, and explore taxation of other non-nutritive foods and beverages. Furthermore, both intended and unintended consequences of interventions should be closely monitored.
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Affiliation(s)
- Melissa A. Fernandez
- School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 – 87 Ave., Edmonton, AB T6G 1C9 Canada
| | - Kim D. Raine
- School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 – 87 Ave., Edmonton, AB T6G 1C9 Canada
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Adherence to Mediterranean diet is inversely associated with the consumption of ultra-processed foods among Spanish children: the SENDO project. Public Health Nutr 2020; 24:3294-3303. [DOI: 10.1017/s1368980020001524] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AbstractObjective:To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake.Design:Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index.Setting:Spain.Participants:Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis.Results:74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption.Conclusions:Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.
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Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-Processed Foods and Health Outcomes: A Narrative Review. Nutrients 2020; 12:E1955. [PMID: 32630022 PMCID: PMC7399967 DOI: 10.3390/nu12071955] [Citation(s) in RCA: 298] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/16/2022] Open
Abstract
The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature; integration and interpretation of findings from diverse study types, populations, health outcomes and dietary assessments; and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks; cancer, type-2 diabetes and cardiovascular diseases; irritable bowel syndrome, depression and frailty conditions; and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the 'healthiness' of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.
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Affiliation(s)
- Leonie Elizabeth
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
| | - Priscila Machado
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
| | - Marit Zinöcker
- Department of Nutrition, Bjørknes University College, 0456 Oslo, Norway;
| | - Phillip Baker
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
| | - Mark Lawrence
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
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44
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Association between Heat-Induced Chemical Markers and Ultra-Processed Foods: A Case Study on Breakfast Cereals. Nutrients 2020; 12:nu12051418. [PMID: 32423099 PMCID: PMC7285198 DOI: 10.3390/nu12051418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 02/01/2023] Open
Abstract
Nutritional composition and neo-formed contaminant content in ultra-processed foods, amongst other factors, may contribute to increasing overall risk of non-communicable diseases and cancer. Commercial breakfast cereals (n = 53) were classified according to the NOVA approach as un-/minimally processed (NOVA-1, 11%), processed (NOVA-3, 30%), and ultra-processed (NOVA-4, 59%) foods. Acrylamide and hydroxymethylfurfural (HMF) content as heat-induced chemical markers was taken from our research team database. The NutriScore was used as the nutritional profiling system. Samples were distributed between groups A (19%), B (13%), C (38%), and D (30%). No statistically significant differences in acrylamide and HMF were found across the NutriScore groups. Sugar content was the only nutritional descriptor found to be significantly different between processed (11.6 g/100 g) and ultra-processed (23.1 g/100 g) breakfast cereal groups. Sugar content correlated with acrylamide (p < 0.001) and HMF (p < 0.0001). Acrylamide and HMF contents were not significantly higher in the NOVA-4 group when compared with the NOVA-3 group. However, trends towards higher acrylamide and HMF content are observed, amounting to a change of 75 µg/kg and 13.3 mg/kg in processed breakfast cereals, and 142 µg/kg and 32.1 mg/kg in ultra-processed breakfast cereals, respectively. Thus, the NOVA classification may not reflect the extent of the thermal treatment applied to the breakfast cereal but the type and amount of ingredients incorporated. Ultra-processed breakfast cereal does not predict significantly higher toxicological concern based on acrylamide content than processed breakfast cereals; a clear trend is seen whose contributing factors should be further studied.
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Salamanca-Fernández E, Rodríguez-Barranco M, Arrebola JP, Vela F, Díaz C, Chirlaque MD, Colorado-Yohar S, Jiménez-Zabala A, Irizar A, Guevara M, Ardanaz E, Iribarne-Durán LM, Pérez Del Palacio J, Olea N, Agudo A, Sánchez MJ. Bisphenol-A in the European Prospective Investigation into Cancer and Nutrition cohort in Spain: Levels at recruitment and associated dietary factors. ENVIRONMENTAL RESEARCH 2020; 182:109012. [PMID: 31837551 DOI: 10.1016/j.envres.2019.109012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/26/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Bisphenol A (BPA) is considered an endocrine disruptor and it is present in numerous products of daily use. The aim of this study was to analyze serum BPA concentrations in a subcohort of the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC), as well as to identify potential predictors of the exposure. The population consisted on 3553 subjects from 4 EPIC-Spain centres and BPA levels were measured in serum samples by UHPLC-MS/MS. Almost 70% of the participants showed detectable BPA values (>0.2 ng/ml), with a geometric mean of 1.19 ng/ml (95% CI: 1.12-1.25). By sex, detectable percentages were similar (p = 0.56) but with higher serum levels in men (1.27 vs 1.11 ng/ml, p = 0.01). Based on the adjusted regression models, a 50 g/day increase in the consumption of added fats and oils were associated with 43% lower BPA serum levels, while sugar and confectionary was associated with 25% higher levels of serum BPA. We evidenced differential exposure levels by province, sex and age, but not by anthropometric or lifestyle characteristics. Further investigation is needed to understand the influence of diet in BPA exposure.
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Affiliation(s)
- Elena Salamanca-Fernández
- Andalusian School of Public Health (EASP). Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain
| | - Miguel Rodríguez-Barranco
- Andalusian School of Public Health (EASP). Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain.
| | - Juan Pedro Arrebola
- Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Department of Public Health, School of Medicine, University of Granada. Granada, Spain
| | - Fernando Vela
- Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain
| | - Caridad Díaz
- MEDINA Foundation, Center of Excellence in Research into Innovative Medicines in Andalusia, Technology Park of Health Sciences, Granada, Spain
| | - María Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Department of Health and Social Sciences, University of Murcia, Spain
| | - Sandra Colorado-Yohar
- CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Ana Jiménez-Zabala
- CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Public Health Division of Gipuzkoa, Basque Government, Avenida Navarra No 4, 20013, San Sebastián, Gipuzkoa, Spain; Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Amaia Irizar
- Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Marcela Guevara
- CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Luz María Iribarne-Durán
- Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain; Department of Radiology, School of Medicine, University of Granada. Granada, Spain
| | - José Pérez Del Palacio
- MEDINA Foundation, Center of Excellence in Research into Innovative Medicines in Andalusia, Technology Park of Health Sciences, Granada, Spain
| | - Nicolás Olea
- Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Department of Radiology, School of Medicine, University of Granada. Granada, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Maria-José Sánchez
- Andalusian School of Public Health (EASP). Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA. Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, Spain; Universidad de Granada. Granada, Spain
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Silva Meneguelli T, Viana Hinkelmann J, Hermsdorff HHM, Zulet MÁ, Martínez JA, Bressan J. Food consumption by degree of processing and cardiometabolic risk: a systematic review. Int J Food Sci Nutr 2020; 71:678-692. [DOI: 10.1080/09637486.2020.1725961] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | | | - M. Ángeles Zulet
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research (CIN), Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Center of Biomedical Research in Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - J. Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research (CIN), Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Center of Biomedical Research in Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Madrid Institute of Advanced Studies (IMDEA), IMDEA Food, Madrid, Spain
| | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, Brazil
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SOUSA LMLD, STANGARLIN-FIORI L, COSTA EHS, FURTADO F, MEDEIROS CO. Use of nutritional food labels and consumers’ confidence in label information. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective This investigation evaluated the use of food labels and consumers’ perception of the reliability of food labels nutritional information. Methods This is a transversal exploratory quantitative investigation, carried out in Curitiba, Brazil. A total of 536 students from a public institution participated in the survey answering a structured questionnaire. Descriptive analyses, Chi-Square test and Fisher’s exact test were performed considering a significance level of 5%. Results The participants’ mean age was 21.11±2.83 years, and 59.3% were female. It was noticed that 41.6% of consumers used the nutritional information sometimes and 14.7% always, mainly because they liked to know what they were buying and consuming (35.8%). Lack of patience (29.5%) and concern about the composition of the food purchased (34.2%) were the main reasons for not using the information provided. The most commonly used nutrition claim was “trans fat-free” (42.5%) and the type of food in which nutrition labeling was used most was milk and dairy products (42.0%). Frequent use of nutritional information was higher among women (p<0.01) and among those who practice physical activity (p=0.04). Many individuals relied on food labels nutritional information (61.9%), but out of these, 43.6% did not use that information at the time of purchase. There was no difference between respondents’ confidence in the information, sociodemographic and health data. Conclusion Many people still do not use the label nutrition information. Efforts should be made to change this scenario. Changes in nutrition labeling can help modify this situation, with the use of clearer label information, more easily understood, that does not raise any doubts in the consumers’ mind.
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A Nutrition Education Intervention Using NOVA Is More Effective Than MyPlate Alone: A Proof-of-Concept Randomized Controlled Trial. Nutrients 2019; 11:nu11122965. [PMID: 31817564 PMCID: PMC6950011 DOI: 10.3390/nu11122965] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 11/29/2022] Open
Abstract
The ability to classify foods based on level of processing, not only conventional MyPlate food groups, might be a useful tool for consumers faced with a wide array of highly processed food products of varying nutritional value. The objective of this study was to assess the impact of a proof-of-concept nutrition education intervention on nutrition knowledge, assessed by correct classification of foods according to MyPlate food groups, MyPlate ‘limit’ status (for fat, sugar, sodium), and level of processing (NOVA categories). We utilized a randomized, controlled design to examine the impact of a MyPlate vs. combined MyPlate + NOVA intervention vs. control group. Intervention groups received educational flyers via email and participants were assessed using electronic baseline and follow-up surveys. The MyPlate + NOVA intervention group performed at least as well as the MyPlate group on classifying conventional food groups and ‘limit’ status. Moreover, the MyPlate + NOVA group far outperformed the other groups on classifying NOVA categories. Longer-term trials are needed, but our results suggest that NOVA principles may be more easily understood and applied than those of MyPlate. Education strategies focusing on level of food processing may be effective in the context of the modern food environment.
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Royo-Bordonada MÁ, Rodríguez-Artalejo F, Bes-Rastrollo M, Fernández-Escobar C, González CA, Rivas F, Martínez-González MÁ, Quiles J, Bueno-Cavanillas A, Navarrete-Muñoz EM, Navarro C, López-García E, Romaguera D, Morales Suárez-Varela M, Vioque J. [Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way]. GACETA SANITARIA 2019; 33:584-592. [PMID: 31585770 DOI: 10.1016/j.gaceta.2019.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In Spain, one third of all children and two-thirds of adults suffer from excess weight, a condition that generates a direct excess medical cost of 2000 million Euros. Obesogenic food environments cause obesity by promoting the consumption of sugar-sweetened beverages and ultra-processed foods. Accordingly, we propose five priority policies capable of reversing the epidemic of obesity and related non-communicable diseases through the creation of healthy food environments. THE POWER (PODER IN SPANISH) OF FOOD POLICIES Advertising (Publicidad): regulation of unhealthy food and drink advertisements carried by all media and targeted at children, and prohibition of sponsorships of congresses, conferences or sports events and endorsements by scientific associations or health professionals. Supply (Oferta): promotion of a 100% healthy supply of goods on sale in vending machines sited at educational, health and sports centres. Demand (Demanda): levying a tax of at least 20% on sugar-sweetened beverages, accompanied by subsidies or reduced taxes on healthy foods and availability of drinking water free of charge at all public venues and areas. Labelling (Etiquetado): effective application of the Nutri-Score through the use of incentives, regulation and public-tender mechanisms. Reformulation (Reformulación): revising and redrawing reformulation agreements with the industry, setting more ambitious goals and mandatory compliance. A FINAL THOUGHT These five proposed interventions, all of which have been successfully applied in other countries, will serve to raise population awareness and have a positive impact on health and the economy, through reducing the health care costs of obesity and enhancing work productivity. These measures should form part of a wide-ranging transformation of the food system, with agri-food policies that foster the sustainable production of healthy foods.
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Affiliation(s)
| | - Fernando Rodríguez-Artalejo
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Maira Bes-Rastrollo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | | | - Carlos A González
- Unidad de Nutrición y Cáncer, Instituto Catalán de Oncología, Barcelona, España
| | - Francisco Rivas
- Unidad Municipal de Salud y Consumo, Ayuntamiento de Guadix, Guadix (Granada), España; Grupo de Investigación Aula Internacional de Biomedicina, Ética y Derechos Humanos (GI111), Universidad Nacional de Educación a Distancia, Madrid, España
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Department of Nutrition, Harvard TH Chan School of Public Health, Boston (Massachusetts), USA
| | - Joan Quiles
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Dirección General de Salud Pública, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, España
| | - Aurora Bueno-Cavanillas
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, España; Instituto de Investigación Biosanitaria de Granada (ibs Granada), Granada, España
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
| | - Carmen Navarro
- Departamento de Ciencias Sociosaniarias, Universidad de Murcia, Murcia, España; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, España
| | - Esther López-García
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Dora Romaguera
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, España
| | - María Morales Suárez-Varela
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Facultad de Farmacia, Universitat de Valencia, Valencia, España
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
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Altavilla C, Caballero Pérez P, Tuells J. High cooking skills do not lead to healthy mediterranean eating habits. Focus on catering students. Int J Gastron Food Sci 2019. [DOI: 10.1016/j.ijgfs.2019.100169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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