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Yao X, Luo XY, Tai YH, Wang K, Shang JW. What was the global burden of kidney cancer attributable to high body mass index from 1990 to 2019? There existed some points noteworthy. Front Nutr 2024; 11:1358017. [PMID: 38903629 PMCID: PMC11188334 DOI: 10.3389/fnut.2024.1358017] [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: 12/19/2023] [Accepted: 05/13/2024] [Indexed: 06/22/2024] Open
Abstract
Purpose With the prevalence of high body mass index (HBMI) increasing over the past 30 years, it is essential to examine the impact of obesity on kidney cancer. This study aims to explore the attributable burden of kidney cancer associated with HBMI and its proportion at different levels. Methods and materials The data used in this research were obtained from the Global Burden of Diseases Study 2019. We utilized DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate the burden of kidney cancer attributable to HBMI, which was measured by age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR). Correlation analysis was conducted by the Spearman rank order correlation method. The temporal trends were analyzed by estimating the estimated annual percentage change (EAPC). Results Globally in 2019, there were a total of 31.7 thousand deaths and 751.89 thousand disability-adjusted life years (DALYs) attributable to kidney cancer caused by HBMI, increased by 183.1 and 164%, respectively. Over the period from 1990 to 2019, the burden of kidney cancer attributable to HBMI increased in all regions, with the most significant increases occurring in Low-middle socio-demographic index (SDI) and Low SDI regions. At the national level, countries with lower SDI had lower ASMR and ASDR compared to developed nations. However, the EAPC values, which indicate the rate of increase, were significantly higher in these countries than in developed nations. Furthermore, across all years from 1990 to 2019, males experienced a greater and more rapidly increasing burden of kidney cancer attributable to HBMI than females. Conclusion As the population grows and dietary patterns shift, the burden of kidney cancer attributable to HBMI is expected to become even more severe. Males and developed regions have borne a heavier burden from 1990 to 2019. However, the EAPC values for both ASMR and ASDR were higher in males but not in regions with higher SDI values.
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Affiliation(s)
- Xue Yao
- Department of Ambulance Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiao-yan Luo
- Department of Ambulance Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Yang-hao Tai
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Kang Wang
- Department of Ambulance Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Ji-wen Shang
- Department of Ambulance Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Kunz S, Pivecka N, Dietachmair C, Florack A. Seeing is misbelieving: Consumers wrongly believe that unhealthy food tastes better when there is more of it. Appetite 2024; 197:107295. [PMID: 38485060 DOI: 10.1016/j.appet.2024.107295] [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: 09/05/2023] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
Recent studies have shown that people can believe that unhealthy foods taste better, even if healthy and unhealthy foods are equally as tasty. Specifically, when tasty and unhealthy foods are frequent in one context but rare in another, people perceive unhealthy foods to taste better, even if health and taste are unrelated. Given that people often consume food in one context, the current study investigated whether false beliefs about the health-taste relationship in foods can also occur in just one single context, in which either healthy or unhealthy foods are predominant, when there is no contrasting context where the respective other food is predominant. In two experiments (N = 342), we presented participants with pictures of meals from a single context and varied the frequency of healthy and unhealthy foods between participants. Although healthy and unhealthy foods tasted equally as good, participants believed that (un)healthy foods tasted better when there were more of them. This research demonstrates that health-taste beliefs might be changed by increasing the relative frequency of healthy foods in the environment overall, not by just offering some healthy and tasty foods.
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Affiliation(s)
- Sonja Kunz
- Department of Occupational, Economic, and Social Psychology, Faculty of Psychology, University of Vienna, Austria.
| | - Niklas Pivecka
- Department of Occupational, Economic, and Social Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Clara Dietachmair
- Department of Occupational, Economic, and Social Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Arnd Florack
- Department of Occupational, Economic, and Social Psychology, Faculty of Psychology, University of Vienna, Austria
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Meine GC, Picon RV, Espírito Santo PA, Sander GB. Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2024; 119:1056-1065. [PMID: 38832708 DOI: 10.14309/ajg.0000000000002826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 04/14/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model. RESULTS Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer. DISCUSSION The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.
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Affiliation(s)
- Gilmara Coelho Meine
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Gastroenterology, Department of Internal Medicine, Universidade Feevale, Novo Hamburgo, Brazil
| | - Rafael Veiga Picon
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Guilherme Becker Sander
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Kermani-Alghoraishi M, Behrouzi A, Hassannejad R, Sarrafzadegan N, Nouri F, Boshatam M, Roohafza H, Haghighatdoost F, Sadeghi M. Ultra-processed food consumption and cardiovascular events rate: An analysis from Isfahan Cohort Study (ICS). Nutr Metab Cardiovasc Dis 2024; 34:1438-1447. [PMID: 38555244 DOI: 10.1016/j.numecd.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND AIMS The contribution of ultra-processed foods (UPFs) to daily energy intake and, therefore, their health effects may vary between countries. We aimed to investigate the association between UPFs and the incidence risk of cardiovascular events (CVEs) and cardiovascular mortality in the Isfahan cohort study. METHODS AND RESULTS In 2001, 6504 participants aged ≥35 years were enrolled and followed until 2017. Dietary intake was assessed using a validated food frequency questionnaire, and the NOVA system was applied for UPF classification. Any new case of CVE, including fatal and non-fatal myocardial infarction (MI) or stroke, unstable angina (UA), and CVD death, was recorded. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through Cox proportional hazards regression models. A total number of 819 CVE, 164 MI, 348 UA, 172 strokes, and 181 cardiovascular deaths were recorded during 61352.5 person-years of follow-up. The median (IQR) of UPF consumption was 2.47 (1.00-5.23) times/week. In the fully adjusted model, individuals in the fourth quartile of UPFs had no higher risk for incident MI and UA (HR = 1.12, 95% CI: 0.87, 1.46; P for trend = 0.364), stroke (HR = 0.93, 95% CI: 0.58, 1.46; P for trend = 0.601), cardiovascular mortality (HR = 0.95, 95% CI: 0.61, 1.47; P for trend = 0.596), and CVE (HR = 1.08, 95% CI: 0.88,1.34; P for trend = 0.515) in comparison with those in the first quartile. CONCLUSION This mid-term prospective cohort study provides no evidence for a significant association between UPF and CVE risk. Longer studies are required to confirm this association.
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Affiliation(s)
- Mohammad Kermani-Alghoraishi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Behrouzi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoureh Boshatam
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Pries AM, Bassetti E, Badham J, Baker P, Blankenship J, Dunford EK, Kupka R. TEMPORARY REMOVAL: Ultraprocessing and presence of additives in commercially produced complementary foods in seven Southeast Asian countries: a cross-sectional study. Am J Clin Nutr 2024:S0002-9165(24)00393-9. [PMID: 38816268 DOI: 10.1016/j.ajcnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/01/2024] Open
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Alissa M Pries
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand.
| | | | | | - Philip Baker
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Elizabeth K Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Roland Kupka
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand
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Karupaiah T. TEMPORARY REMOVAL: Monitoring commercially available complementary foods for the infant and young child in Southeast Asia: Accountability and the way forward. Am J Clin Nutr 2024:S0002-9165(24)00467-2. [PMID: 38816267 DOI: 10.1016/j.ajcnut.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Tilakavati Karupaiah
- Food Security and Nutrition Impact Lab, Taylor's University, Subang Jaya, Selangor, Malaysia; School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University, Petaling Jaya, Selangor, Malaysia.
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Menon A, Patel N, Arulprasad R, Mouttoulatchoumy D, Lakshminarayanan S. Influence of ultra-processed food in the diet of South Indian young adults: an explanatory mixed method study. Eur J Nutr 2024:10.1007/s00394-024-03429-4. [PMID: 38795126 DOI: 10.1007/s00394-024-03429-4] [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: 06/24/2023] [Accepted: 04/17/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India. METHODS This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling. RESULTS Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework. CONCLUSION UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage.
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Affiliation(s)
- Athira Menon
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - Namita Patel
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - R Arulprasad
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - D Mouttoulatchoumy
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - Subitha Lakshminarayanan
- Department of Preventive and Community Medicine, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
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Palu A, Santos JA, Silatolu AM, Deo A, Bell C, Waqa G, Webster J, McKenzie BL. Energy, nutrient and overall healthiness of processed packaged foods in Fiji, a comparison between 2018 and 2020. BMC Public Health 2024; 24:1383. [PMID: 38783234 PMCID: PMC11112809 DOI: 10.1186/s12889-024-18787-1] [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: 01/08/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
In Fiji, packaged foods are becoming increasingly available. However, it is unknown if nutrition composition of these foods has changed. This study aims to assess changes in energy, nutrient content and healthiness of packaged foods by comparing data from five major supermarkets in Fiji in 2018 and 2020. Foods were categorised into 14 groups; nutrient composition information was extracted and healthiness assessed using Health Star Rating (HSR). Descriptive statistics and a separate matched products analysis was conducted summarising differences in nutrient content and HSR. There was limited evidence of change in the nutrient content of included products however, there was a small reduction in mean saturated fat in the snack food category (-1.0 g/100 g, 95% CI -1.6 to -0.4 g/100 g). The proportion of products considered healthy based on HSR, increased in the convenience foods category (28.4%, 95% CI 8.3 to 48.5) and decreased in non-alcoholic beverages (-35.2%, 95% CI -43.6 to -26.9). The mean HSR score increased in the fruit and vegetables category (0.1 (95% CI 0.1, 0.2)) and decreased for non-alcoholic beverages (-1.1 (-1.3, -0.9)) and the sauces, dressings, spreads, and dips category (-0.3 (-0.3, -0.2)). Strengthened monitoring of the food supply is needed to improve the healthiness of foods available.
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Affiliation(s)
- Aliyah Palu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Ana Moala Silatolu
- Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases, Fiji National University, Tamavua Campus, Suva, Fiji
| | | | - Colin Bell
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases, Fiji National University, Tamavua Campus, Suva, Fiji
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Briar L McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
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Busse KR, Lee Mayol NR, Ammerman AS, Avery CL, Martin SL, Adair LS. Ultraprocessed Food Intake during the Transition to Adulthood Varies According to Sociodemographic Characteristics and Maternal Intake in Cebu, Philippines. J Nutr 2024:S0022-3166(24)00235-9. [PMID: 38697516 DOI: 10.1016/j.tjnut.2024.04.032] [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: 11/16/2023] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Ultraprocessed foods (UPFs) are associated with elevated risk of noncommunicable disease, but little is known about UPF intake and the individual-, household-, and community-level factors associated with it among adolescents in low- or middle-income countries. OBJECTIVES We estimated the association of UPF intake across adolescence with sociodemographic characteristics and maternal UPF intake in a Filipino cohort. METHODS Data were from 4 waves (1994-2005) of the Cebu Longitudinal Health and Nutrition Survey (n = 2068); participants were aged 11, 15, 18, and 21 y. Foods from 24-h recalls were classified using NOVA. We used two-part multilevel models to estimate time-varying associations of the odds and amount (percentage daily kilocalories) of UPF intake with sociodemographic characteristics and maternal UPF intake (none, below median among UPF-consuming mothers ["low"], at or above median ["high"]). RESULTS Median UPF intake (interquartile range [IQR]) among adolescents was 7.3% (IQR: 0, 17.2%) of daily kilocalories at age 11 y and 10.6% (IQR: 3.6, 19.6%) at 21 y. The odds and amount of adolescent UPF intake were positively associated with female sex, years of schooling, and household wealth and inversely associated with household size. The odds-but not amount-of adolescent UPF intake was positively associated with maternal education and urbanicity and inversely associated with the distance from a household's primary store/market. The association between odds of adolescent UPF intake and school enrollment was positive in adolescence but disappeared in early adulthood. Compared with offspring whose mothers did not consume UPFs, the odds of UPF intake among those whose mothers had low or high UPF intake was greater in adolescence, but there was no association once offspring became adults. At all ages, maternal UPF intake was positively associated with the amount of offspring intake. CONCLUSIONS Adolescent UPF intake varied across sociodemographic characteristics and was positively associated with maternal UPF intake, but not after adolescents entered adulthood.
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Affiliation(s)
- Kyle R Busse
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
| | - Nanette R Lee Mayol
- USC-Office of Population Studies Foundation, University of San Carlos, Cebu City, Philippines
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Christy L Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
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Nyarko E, Bartelmeß T. Drivers of consumer food choices of multinational corporations' products over local foods in Ghana: a maximum difference scaling study. Global Health 2024; 20:22. [PMID: 38500144 PMCID: PMC10949566 DOI: 10.1186/s12992-024-01027-x] [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: 06/06/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers' food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers' preference for multinational foods over local foods in the urban Accra region of Ghana. METHOD This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations' products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations' product preferences and the associated trade-offs. RESULT The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutritional value were the most significant factors driving consumer preference for multinational food corporations' products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods. CONCLUSION The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study's findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns.
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Affiliation(s)
- Eric Nyarko
- Department of Statistics and Actuarial Science, School of Physical and Mathematical Sciences, University of Ghana, Box LG 115, Accra, Legon, Ghana
| | - Tina Bartelmeß
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Fritz-Hornschuch-Strasse 13, Kulmbach, Germany.
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Huang X, He Y, Xu H, Shen Y, Pan X, Wu J, Chen K. Association between sociodemographic status and the T2DM-related risks in China: implication for reducing T2DM disease burden. Front Public Health 2024; 11:1297203. [PMID: 38259760 PMCID: PMC10801005 DOI: 10.3389/fpubh.2023.1297203] [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: 10/17/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Analyzing the association between sociodemographic status and the type 2 diabetes mellitus (T2DM)-related risks in China to reduce the disease burden of T2DM. Methods We downloaded data from the Global Burden of Disease Study 2019 to estimate the disease burden of T2DM in China. Secondary analyses were performed by year, age, gender, summary exposure value (SEV), and sociodemographic index (SDI). Results In China, it is estimated that 3.74 (3.44-4.10) million incidence, 90.0 (82.3-98.5) million prevalence, 168.4 (143.2-194.0) thousand deaths, and 9.6 (7.6-11.9) million DALYs occurred in 2019, showing an increase of 96.8, 156.7, 162.8, and 145.4% compared to 1990. An inverse U-shaped curve was observed for the correlations between T2DM-related burden and SDI. A heavier burden was found in males. The top four risk factors were high body mass index (HBMI), dietary risks, air pollution and tobacco. HBMI, as the key risk, accounted for half of the disease burden of T2DM in China. Lower degree of SEV and higher level of attributable T2DM-related burden could be found in main risks, meaning their critical role of them in the development and progression of T2DM. An inverse U-shaped curve could be found in the association between age-standardized incidence, mortality, DALYs rate, and SDI. Conclusion The disease burden of T2DM has rapidly increased in China. Gender disparities, different age distributions and inconsistent socioeconomic levels all played an important role in it. The key risk was HBMI. With the improvement of socioeconomic level, the main risk factors for T2DM have changed from environmental factors to lifestyle factors. Targeted control and preventative strategies to address adjustable risk factors could put an end to this soaring burden.
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Affiliation(s)
- Xin Huang
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yinhui He
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Haiyan Xu
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yuyan Shen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Junyun Wu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Kai Chen
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
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Shateri Z, Eskandarzadeh S, Nouri M, Jahromi SE, Mansouri F, Babajafari S. The role of ultra-processed food consumption in protein-energy wasting and sarcopenia development in patients with chronic kidney diseases. BMC Nephrol 2024; 25:4. [PMID: 38172690 PMCID: PMC10763225 DOI: 10.1186/s12882-023-03409-6] [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: 06/28/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The effect of ultra-processed foods (UPFs) on chronic kidney disease (CKD) has been studied in some studies. The present study aimed to investigate the association between UPF consumption and the risk of protein-energy wasting (PEW) and sarcopenia in patients with CKD in the Iranian population. METHODS The current cross-sectional study included 110 patients with CKD referred to two clinics in Shiraz, Iran. The International Society of Renal Nutrition and Metabolism (ISRNM) criteria and the Asian Working Group for Sarcopenia (AWGS) guideline were considered for the diagnosis of PEW and sarcopenia, respectively. The valid semi-quantitative food frequency questionnaire was used to assess participants' dietary intake. The logistic regression was used to examine the association of UPFs with PEW and sarcopenia. RESULTS We observed no significant association between sarcopenia and PEW with UPFs in the crude model. After adjusting for confounders, we observed a significantly higher odds of sarcopenia in the upper versus lower median of UPF intake (odds ratio (OR) = 3.59, 95% confidence interval (CI): 1.02-12.62, P = 0.046). CONCLUSIONS Our findings suggest a positive relationship between UPF intake and sarcopenia among CKD patients. Therefore, reducing the intake of UPFs may decrease the odds of sarcopenia in patients suffering from CKD.
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Affiliation(s)
- Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Sevda Eskandarzadeh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Nouri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrokh Ezzatzadegan Jahromi
- Department of Medicine, School of Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mansouri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Siavash Babajafari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Clinical Nutrition, Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Jindarattanaporn N, Kelly B, Phulkerd S. A comparative analysis of unhealthy food and beverage television advertising to children in Thailand, between 2014 and 2022. Global Health 2024; 20:2. [PMID: 38167506 PMCID: PMC10759748 DOI: 10.1186/s12992-023-01007-7] [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: 05/22/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Food marketing is a key factor that influences children's dietary behaviors. This study assessed the nature and extent of food and beverage advertising on television (TV) in 2014 and 2022 in Thailand. METHODS TV was recorded for one week in March 2014 and in May 2022 from 7-9am and 3-7 pm on weekends, and 3-7 pm on weekdays across two channels (64 h recorded each year). The nutrient profile model from Bureau of Nutrition, Ministry of Public Health Thailand was used to classify food and non-alcoholic beverages as: Group A ('healthy'), Group B ('less unhealthy') or Group C ('unhealthy'). RESULTS In 2014, 475 food advertisements were identified, with on average of 6.3 unhealthy food advertisements per hour. In 2022, 659 food advertisements were identified, with an average of 9.2 unhealthy food advertisement per hour. In both time periods, the most frequently advertised food products were non-alcoholic beverages. The rate of unhealthy food advertising per hour of broadcast was significantly higher than for other moderately unhealthy and healthy foods, and was also significantly higher in 2022 than in 2014. CONCLUSIONS Food and beverage advertising on Thai television is predominantly promotes unhealthy foods and, in particular, sugar-sweetened beverages. Therefore, Thai Government should enact new legislation to protect children from food TV ads in order to control both the frequency and nature of unhealthy TV food marketing to protect the health of Thai children.
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Affiliation(s)
- Nongnuch Jindarattanaporn
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand
| | - Bridget Kelly
- Early Start, School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Salaya Campus, 999 Phutthamonthon 4 Road, Phutthamonthon, 73170, Nakhon Pathom, Thailand.
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Mai TMT, Tran QC, Nambiar S, Gallegos D, Van der Pols JC. Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 2:e13514. [PMID: 37010142 PMCID: PMC10984611 DOI: 10.1111/mcn.13514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
Childhood overweight and obesity are rapidly increasing in urban Vietnam. Dietary patterns are understudied for their association with obesity risk in these children, and it is unclear which parental and societal factors should be targeted in prevention efforts. The study assessed child characteristics, dietary patterns, parental and societal factors for associations with childhood overweight and obesity status in Ho Chi Minh City, Vietnam. A sample of 221 children aged 9-11 years was randomly selected from four Ho Chi Minh City primary schools. Weight, height and waist circumference were measured using standardized methods. Three 24-h dietary recalls were collected from 124 children, which were used to assess dietary patterns using principal component analysis (PCA). Parents completed a questionnaire about child, parental and societal factors. The overall prevalence of obesity was 31.7% and of combined overweight and obesity 59.3%. Three main dietary patterns from 10 food groups were identified by PCA: traditional (grains, vegetables, meat and meat alternatives), discretionary (snacks and sweetened beverages), and industrialized (fast food and processed meat). Children with higher discretionary diet scores had higher odds of being overweight. Being a boy, screen time over 2 h/day, parental underestimation of child weight status, father's obesity, and household income in the lowest quintile were positively associated with childhood obesity. Future intervention programmes in Vietnam need to consider targeting children's unhealthy diets and parental perceptions of child weight status, as well as focusing on upstream approaches that reduce inequities contributing to childhood obesity and concomitant dietary patterns.
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Affiliation(s)
- Thi My Thien Mai
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Ho Chi Minh City Center for Disease ControlHo Chi Minh CityVietnam
| | - Quoc Cuong Tran
- Department of Nutrition and Food Safety, Faculty of Public HealthPham Ngoc Thach Medical UniversityHo Chi Minh CityVietnam
| | - Smita Nambiar
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
| | - Danielle Gallegos
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Woolworths Centre for Childhood Nutrition ResearchQueensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Jolieke C. Van der Pols
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
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15
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Vuong VT, Fiorella KJ, Jones AD, Thi Trinh H, Khoury CK, Huynh TTT, Hoang KT, Nguyen KT. The association between food environment, diet quality and malnutrition in low- and middle-income adult populations across the rural-Urban gradient in Vietnam. J Hum Nutr Diet 2023; 36:2201-2218. [PMID: 37792904 DOI: 10.1111/jhn.13242] [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: 02/01/2023] [Accepted: 08/25/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Economic reforms and trade liberalisation in Vietnam have transformed the food environment, influencing dietary patterns and malnutrition status. The present study focuses on the relationship between food environments (proximity and density of food outlets) and malnutrition (underweight, overweight, obesity) through diet quality in adult populations across urban, periurban and rural areas of Vietnam. METHODS We evaluated food environment by geospatial mapping of food outlets through a transect walk across the "food ecosystem" from rural to urban areas. Diet quality was assessed using the Diet Quality Index - Vietnamese (DQI-V) comprising Variety, Adequacy, Moderation and Balance components. Malnutrition status was determined using body mass index. We performed a mediation analysis utilising mixed effect models to control for neighbourhood clustering effects. Confounders included age, education, income and nutrition knowledge score. RESULTS Analysis of data from 595 adult participants (mean ± SD age: 31.2 ± 6.4 years; 50% female) found that longer distance to the nearest food outlet was associated with higher overall DQI-V (β = 2.0; 95% confidence interval = 0.2-3.8; p = 0.036) and the Moderation component (β = 2.6; 95% confidence interval = 1.2-4.0; p = 0.001). Outlet density shows a negative association with the odds of underweight among women (odds ratio = 0.62; 95% confidence interval = 0.37-0.96). However, we did not observe statistically significant relationships between diet quality and malnutrition. Education and nutrition knowledge scores were positively associated with diet diversity, while income was negatively associated with diet moderation. CONCLUSIONS The findings of the present study have important implications for nutrition and dietetics practice in Vietnam and globally. It emphasises the need to consider various dimensions of sustainable diets, including economic, health and socio-cultural/political factors. Longer distances to food outlets are associated with higher diet quality, whereas lower food outlet density increases the odds of underweight among women. This poses challenges in balancing modernisation and its adverse effects on sustainable food systems. Socio-economic status consistently correlated with diet quality and malnutrition, necessitating further research to promote healthy diets across socio-economic strata.
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Affiliation(s)
- Vy Thao Vuong
- Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Kathryn J Fiorella
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | | | - Huong Thi Trinh
- Department of Mathematics and Statistics, Thuongmai University, Hanoi, Vietnam
| | | | - Tuyen Thi Thanh Huynh
- The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
| | - Ky The Hoang
- WorldFish, Penang, Malaysia and The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
| | - Kien Tri Nguyen
- The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
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Norov B, Cristobal-Maramag C, Van Minh H, Long KQ, Huse O, Nkoroi A, Luvsanjamba M, Phuong DH, Kupka R, Lobstein T, Jewell J, Castro MC, Oliver N, Watson F. Prevention of childhood overweight and obesity in Mongolia, the Philippines and Vietnam: identifying priority actions. Health Promot Int 2023; 38:daad187. [PMID: 38156876 PMCID: PMC10756053 DOI: 10.1093/heapro/daad187] [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] [Indexed: 01/03/2024] Open
Abstract
Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of overweight. This study aimed to address existing knowledge gaps and to identify priority policy options in Mongolia, the Philippines and Vietnam. A landscape analysis approach was adopted using methods set out in a UNICEF global toolkit. Quantitative and qualitative data were compiled from a range of global and national sources on childhood overweight and obesity, risk factors and policy responses. Key informant interviews and validation workshops were undertaken with key food and nutrition stakeholders from government and non-government organizations to identify priority policy options for the prevention of overweight and obesity among children. Overweight and obesity among children are increasing in all three countries. Associated risk factors are related to maternal nutrition, birthweight, breastfeeding, as well as diets and physical activity shaped by increasingly obesogenic environments. Key informants identified undefined policy approaches, poor community understanding and food and beverage industry influence as barriers to addressing overweight and obesity. Key policy priorities include restricting the marketing of unhealthy food and beverages, unhealthy food and beverage taxation, introduction of front-of-pack nutrition labels and improving school nutrition environments. Mongolia, the Philippines and Vietnam are all facing an increasing burden of childhood overweight and obesity. Despite differing national contexts, similar environmental factors are driving this rise. A suite of evidence-based policies can effectively be introduced to address obesogenic environments.
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Affiliation(s)
- Bolormaa Norov
- Nutrition Department, National Center for Public Health, Peace Ave 46, Ulaanbaatar 13381, Mongolia
| | - Cherry Cristobal-Maramag
- Health and Nutrition Unit, Nutrition Center of the Philippines, Launchpad Coworking 214-215 Commercenter, East Asia Drive cor. Commerce Avenue, Filinvest Corporate City, Alabang Muntinlupa City, The Philippines
| | - Hoang Van Minh
- Hanoi University of Public Health, 1A Đ. Đức Thắng, Đông Ngạc, Bắc Từ Liêm, Hà Nội, Vietnam
| | - Khương Quỳnh Long
- Hanoi University of Public Health, 1A Đ. Đức Thắng, Đông Ngạc, Bắc Từ Liêm, Hà Nội, Vietnam
| | - Oliver Huse
- Deakin University, Geelong Australia, Global Obesity Centre for Preventive Health and Nutrition, Institute for Health Transformation, 1 Gheringhap St 3220
- East Asia and Pacific Regional Office, UNICEF, 19 Pra Athit Rd, Chana Songkhram, Pra Nakhon, Bangkok 10200, Thailand
| | - Alice Nkoroi
- Philippines Country Office, UNICEF, 14th Floor, North Tower, Rockwell Business Center Sheridan, Sheridan Street corner United Street, Highway Hills, Mandaluyong City 1550, Philippines
| | - Munkhjargal Luvsanjamba
- Mongolia Country Office, UNICEF, UN House, United Nations street-14, Ulaanbaatar 14201, Mongolia
| | - Do Hong Phuong
- Vietnam Country Office, UNICEF, The Green One UN House, 304 Kim Ma, Ba Dinh District, Hanoi, Vietnam
| | - Roland Kupka
- East Asia and Pacific Regional Office, UNICEF, 19 Pra Athit Rd, Chana Songkhram, Pra Nakhon, Bangkok 10200, Thailand
| | - Tim Lobstein
- Policy Section, World Obesity Federation, 5th Floor, 38 Chancery Lane, London, WC2A 1EN, UK
- The Boden Initiative, University of Sydney, John Hopkins Dr, Camperdown, Sydney, 2050, NSW, Australia
| | - Jo Jewell
- Nutrition Section, UNICEF, 3 United Nations Plaza, New York, NY 10017, USA
| | - Mary Christine Castro
- Health and Nutrition Unit, Nutrition Center of the Philippines, Launchpad Coworking 214-215 Commercenter, East Asia Drive cor. Commerce Avenue, Filinvest Corporate City, Alabang Muntinlupa City, The Philippines
| | - Nikka Oliver
- Health and Nutrition Unit, Nutrition Center of the Philippines, Launchpad Coworking 214-215 Commercenter, East Asia Drive cor. Commerce Avenue, Filinvest Corporate City, Alabang Muntinlupa City, The Philippines
| | - Fiona Watson
- East Asia and Pacific Regional Office, UNICEF, 19 Pra Athit Rd, Chana Songkhram, Pra Nakhon, Bangkok 10200, Thailand
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Huse O, Backholer K, Nguyen P, Calibo A, Guirindola M, Desnacido JP, Sacks G, Bell AC, Peeters A, Angeles-Agdeppa I, Ananthapavan J. A comparative analysis of the cost-utility of the Philippine tax on sweetened beverages as proposed and as implemented. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100912. [PMID: 37780636 PMCID: PMC10534259 DOI: 10.1016/j.lanwpc.2023.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
Background In response to increasing overweight and obesity, the Philippine government introduced a tax on sweetened beverages (SBs) in 2018. Evidence suggests that the beverage industry influenced the final tax design, making it more favourable for industry than the initially proposed bill. This study aimed to compare the relative health and economic benefits of the proposed SB tax with the implemented SB tax. Methods Philippine dietary consumption data were combined with price elasticity data from Mexico and data from Australia adapted to the Philippine context to estimate reductions in SB purchases and changes in body mass index (BMI) following the implementation of the tax. A multi-state, multiple-cohort Markov model was used to estimate the change in health-adjusted life years (HALYs) due to reduction in the epidemiology of obesity-related diseases, healthcare cost savings and government taxation revenue, resulting from both the proposed and implemented tax policies, over the lifetime of the 2018 Philippine population. Findings The proposed and implemented taxes were modelled to be dominant (cost-saving and improving health). Intervention costs were modelled to be PHP305.2 million (M) (approximately US$6M). Compared to the proposed tax, the implemented tax was modelled to result in a 43.0% smaller reduction in targeted beverage intake (51.1 ml/person/day vs. 89.7 ml/person/day), a 43.5% smaller reduction in BMI (0.35 kg/m2 vs. 0.62 kg/m2), 39.7% fewer HALYs gained (2,503,118 vs. 4,149,030), 39.9% fewer healthcare cost savings (PHP16.4 billion (B) vs. PHP27.3B), and 27.7% less government taxation revenue (PHP426.3B vs. PHP589.4B). Interpretation While the implemented tax in the Philippines will benefit population health, it is likely to yield less benefit than the proposed tax. The influence of the food and beverage industry on policy processes has the potential to lessen the benefits of population NCD prevention policies. Funding OH was supported to conduct this research by an Australian Government Research Training Program Stipend Scholarship. The funding body had no role in data collection and analysis, or manuscript preparation.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anthony Calibo
- Child Health Division, Department of Health, Medical Specialist IV, Disease Prevention and Control Bureau, Manila (2011-2020), Philippines
- Institute of Pediatrics and Child Health, St. Luke's Medical Center, Quezon City, Philippines
| | - Mildred Guirindola
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Josie P. Desnacido
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Andrew Colin Bell
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Jaithri Ananthapavan
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Bandy L, Jewell J, Luick M, Rayner M, Li Y, Shats K, Jebb S, Chang S, Dunford E. The development of a method for the global health community to assess the proportion of food and beverage companies' sales that are derived from unhealthy foods. Global Health 2023; 19:94. [PMID: 38041091 PMCID: PMC10690999 DOI: 10.1186/s12992-023-00992-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Corporate engagement with food and beverage companies who produce food associated with health harms is a divisive topic in the global nutrition community, with high-profile cases of conflict of interest increasingly coming under scrutiny. There is a need for an agreed method to support health organizations in deciding whether and how to engage with large food and beverage manufacturers. AIM The aim of this study was to develop a method to quantify the proportion of sales from food and beverage companies that are derived from unhealthy foods to support organizations in determining which companies might be considered high-risk for engagement. METHODS The 2015 WHO Euro nutrient profile model was applied to 35,550 products from 1294 brands manufactured by the top 20 global food and beverage companies from seven countries (Australia, Brazil, China, India, South Africa, UK and USA). For the purpose of this study, products that met the WHO Euro criteria were classified as "healthier" and those that failed were classified as "unhealthy". Products were grouped by brand and weighted by the brand's value sales for 2020. The primary outcome was the proportion of each company's sales that were classified as unhealthy and healthier by company and category. RESULTS Overall, 89% of the top 20 companies' brand sales were classified as unhealthy. For every USD$10 spent on the top 20 companies' brands, only $1.10 was spent on products considered healthier. All companies saw the majority of their sales come from unhealthy foods, including soft drinks, confectionery and snacks. None of Red Bull or Ferrero's sales were classified as healthier and less than 5% of total sales were healthier for Mondelēz, Mars, and PepsiCo. Some companies had higher proportions of sales deriving from healthier products, including Grupo Bimbo (48%), Danone (34%) and Conagra (32%), although the majority of their sales were still derived from unhealthy foods. DISCUSSION The results presented in this study highlight the reliance the leading food and beverage companies have on sales of unhealthy products that are contributing to diet-related disease globally. The method and steps we have laid out here could be used by organizations in the global health community to identify companies that have conflicts of interest when it comes to engaging with governments, international organizations and public health bodies on issues of policy and regulation.
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Affiliation(s)
- Lauren Bandy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Jo Jewell
- UNICEF, 3 United Nations Plaza, New York, USA
| | - Madison Luick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yuan Li
- The George Institute for Global Health, Beijing, China
- The George Institute for Global Health, UNSW, Sydney, Australia
| | | | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Suying Chang
- UNICEF Office for China, 12 Sanlitun Road, Chaoyang District, Beijing, China
| | - Elizabeth Dunford
- The George Institute for Global Health, UNSW, Sydney, Australia
- Department of Nutrition, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Mediratta S, Ghosh S, Mathur P. Intake of ultra-processed food, dietary diversity and the risk of nutritional inadequacy among adults in India. Public Health Nutr 2023; 26:2849-2858. [PMID: 37781767 PMCID: PMC10755415 DOI: 10.1017/s1368980023002112] [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: 01/07/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE This study assessed diet diversity and consumption of ultra-processed foods and explored its impact on macronutrient intake and risk of micronutrient inadequacy. DESIGN Cross-sectional, non-probability snowball sampling. SETTING Nutrient intake was assessed using 24-h dietary recall method and diet diversity through FAO-diet diversity score (DDS). Mann-Whitney U test was used to assess differences in risk of inadequacy across gender. Spearman's rank correlation assessed associations between energy contributed by ultra-processed food and risk of nutrient inadequacy. PARTICIPANTS A total of 589 adults (20-40 years) belonging to upper-middle and high-income groups. RESULTS The average individual DDS was 4·4 ± 0·6. Most of the participants (>80 %) had intakes less than national recommendations of pulses/eggs/flesh foods, milk/milk products, fruits, vegetables and nuts. Ultra-processed foods contributed to 17 % of total energy intake, 12 % of protein, 17 % of carbohydrate, 29 % of added sugar, 20 % of total fat and 33 % of Na intake. The average risk of nutrient inadequacies for Zn (98 % v. 75 %), folate (67 % v. 22 %) and niacin (83 % v. 44 %) was higher among males than females (P < 0·001). The average risk of nutrient inadequacies for Fe (58 % v. 7 %), vitamin B6 (95 % v. 90 %) and vitamin A (68 % v. 44 %) was higher among females than males (P < 0·001). There was a positive correlation between energy contributed by ultra-processed food and risk of niacin (ρ = 0·136, P = 0·001) and folate (ρ = 0·089, P = 0·049) inadequacy. CONCLUSION Reformulating ultra-processed food to reduce fat, sugar and salt and increase micronutrients and behaviour change communication strategies that promote dietary diversity will improve micronutrient adequacy and diet quality.
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Affiliation(s)
- Srishti Mediratta
- Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, New Delhi, India
| | - Santu Ghosh
- Department of Biostatistics, St John’s Medical College, Bangalore, India
| | - Pulkit Mathur
- Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, Sikandra Road, Mandi House, New Delhi, 110001, India
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Bellows AC, Raj S, Pitstick E, Potteiger MR, Diemont SAW. Foraging Wild Edibles: Dietary Diversity in Expanded Food Systems. Nutrients 2023; 15:4630. [PMID: 37960283 PMCID: PMC10647252 DOI: 10.3390/nu15214630] [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: 09/11/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
Human food foraging in community forests offers extensive and expandable sources of food and high-quality nutrition that support chronic disease prevention and management and are underrepresented in US diets. Despite severe gaps in non-commercial "wild food" data, research in Syracuse, NY, identified substantial amounts of five key antioxidant phytochemicals in locally available, forageable foods with the potential to augment local dietary diversity and quality. Findings endorse the need for micro- and macro-nutrient research on an expanded range of forageable foods, community nutrition education on those foods, an expanded study on antioxidant phytochemical function, and the inclusion of forageables in the food system definition.
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Affiliation(s)
- Anne C. Bellows
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY 13244, USA; (S.R.); (E.P.)
| | - Sudha Raj
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY 13244, USA; (S.R.); (E.P.)
| | - Ellen Pitstick
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY 13244, USA; (S.R.); (E.P.)
| | - Matthew R. Potteiger
- Department of Landscape Architecture, College of Environmental Science and Forestry, State University of New York, Syracuse, NY 13210, USA;
| | - Stewart A. W. Diemont
- Department of Environmental Biology, College of Environmental Science and Forestry, State University of New York, Syracuse, NY 13210, USA;
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21
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Hussain BM, Juul F, Deierlein AL, Parekh N. Ultra-processed food intake among South Asians in the United States: Specific vulnerabilities of a growing immigrant population group. Nutr Rev 2023:nuad126. [PMID: 37862438 DOI: 10.1093/nutrit/nuad126] [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] [Indexed: 10/22/2023] Open
Abstract
South Asians are among the fastest growing immigrant population groups in the United States. Their traditional diets are rich in minimally processed fruits, vegetables, grains, herbs, and spices. However, the proliferation of ultra-processed foods (highly processed, industrially manufactured formulations) around the globe may compromise the nutrition profile of South Asians, threatening to increase their risk of noncommunicable diseases. This commentary discusses the rise in ultra-processed food consumption among South Asians in the United States and hypothesizes that South Asians may be especially vulnerable to the effects of ultra-processed foods due to their unique cardiovascular disease risk profiles. Using these emerging data, we propose several strategies for preventing the overconsumption of ultra-processed foods among South Asian Americans. These include the implementation of policies to encourage the consumption of whole foods over ultra-processed foods and the development of culturally tailored interventions, which include promoting consumption of traditional diets, improving affordability of healthful, culturally appropriate foods, and cultivating healthier food environments for South Asians living in the United States.
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Affiliation(s)
- Bridget Murphy Hussain
- Public Health Program, Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT, USA
| | - Filippa Juul
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY, USA
| | - Andrea L Deierlein
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Niyati Parekh
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Hoveidaei AH, Nakhostin-Ansari A, Chalian M, Roshanshad A, Khonji MS, Mashhadiagha A, Pooyan A, Citak M. Burden of knee osteoarthritis in the Middle East and North Africa (MENA): an epidemiological analysis from 1990 to 2019. Arch Orthop Trauma Surg 2023; 143:6323-6333. [PMID: 37005934 DOI: 10.1007/s00402-023-04852-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/18/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Knee is the most affected joint in osteoarthritis (OA) and accounts for almost four-fifths of the burden of OA globally. We aimed to explore the prevalence, incidence, trends, and burden of knee OA during 1990-2019 in the Middle East and North Africa (MENA) region, using the Global Burden of Disease (GBD) study data. METHODS This is an epidemiological study based on the GBD data from 1990 to 2019 on knee OA in MENA countries. The prevalence, incidence, and years lived with disability (YLD) numbers of knee OA were obtained for both genders. Similarly, age-standardized rates of these indexes per 100,000 people and the proportion of total YLD caused by knee OA in each country and for the MENA region were evaluated. RESULTS The prevalence of knee osteoarthritis in the MENA region increased 2.88-fold, from 6.16 million cases to 17.75 million, between 1990 and 2019. Furthermore, in 2019, knee osteoarthritis accounted for approximately 1.69 million (95% UI 1.46-1.95) incident cases in MENA. The age-standardized prevalence was higher in women between 1990 (3.94% [95% UI 3.39-4.55] in women and 3.24% [95% UI 2.79-3.72] in men) and 2019 (4.44% [95% UI 3.83-5.10] in women and 3.66% [3.14-4.21] in men). Total YLDs due to knee osteoarthritis increased by more than 2.88-fold, rising from 196.29 thousand [95% UI 97.17-399.29] in 1990 to 564.66 thousand [95% UI 275.06-1,150.68] in 2019. In the year 2019, Kuwait, Turkey, and Oman had the highest age-standardized prevalence (4.42% [95% UI 3.79-5.08]), YLD (132.41 [95% UI 65.79-267.56] per 100 000), and increase (21.17%) in YLD compared with 1990 in MENA region, respectively. CONCLUSION The prevalence of and YLDs due to knee OA in MENA has escalated over the last three decades. Considering the expanding burden of knee OA in MENA, policymakers should be more concerned to implement preventive strategies.
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Affiliation(s)
- Amir Human Hoveidaei
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Chalian
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA
| | - Amirhossein Roshanshad
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Saeid Khonji
- Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirali Mashhadiagha
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atefe Pooyan
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA
| | - Mustafa Citak
- Department of Orthopaedic Surgery, ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany.
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Pan F, Zhang T, Mao W, Zhao F, Luan D, Li J. Ultra-Processed Food Consumption and Risk of Overweight or Obesity in Chinese Adults: Chinese Food Consumption Survey 2017-2020. Nutrients 2023; 15:4005. [PMID: 37764788 PMCID: PMC10537323 DOI: 10.3390/nu15184005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Overweight and obesity have increased rapidly in the past few decades in China, and less research has focused on the association between the consumption of ultra-processed foods (UPFs) and overweight or obesity in Chinese adults. The objective of this study was to determine the relationship of UPF consumption with the risk of overweight or obesity in Chinese adults. Residents aged 18 years and above who participated in the nationally representative survey Chinese Food Consumption Survey in 2017-2020 were included in this study. Dietary intake data were collected via non-consecutive three-day 24 h dietary recalls and weighing household foods and condiments. According to the NOVA food classification system, UPFs were classified depending on the purpose and extent of food processing. Multiple logistic regression and multivariate-adjusted restricted cubic spline (RCS) regressions were performed to estimate the association between UPF consumption (categorized into quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4)) and risk of overweight or obesity. A total of 38,658 adults aged 18 years and above participated in the present study. The prevalence of overweight and obesity in adults was 33.0% (95% CI: 32.91-33.10) and 9.6% (95% CI 9.55-9.67), respectively. After a multivariable adjustment, the risk of overweight or obesity was increased by 10% in Q3 (OR: 1.10, 95% CI: 1.04-1.17) compared to Q1 as a reference. Women (OR: 1.10, 95% CI: 1.01-1.20) and adults living in small and medium-sized cities (OR: 1.13, 95% CI: 1.01-1.26) with higher UPF consumption had higher odds of overweight or obesity. Nevertheless, the effect of higher UPF consumption on the risk of overweight or obesity was relatively weak for overall adults in China. The top three categories of subgroups consumption of UPFs were 1: sugar-sweetened beverages; 2: sauces, cheeses, spreads, and gravies; and 3: ultra-processed breads and breakfast cereals. These findings provide evidence that higher UPF consumption was positively associated with overweight or obesity, which was defined based on Chinese criteria among women and adults living in small and medium-sized cities in China. Further studies, such as intervention trials, are needed to identify the mechanism of correlation between the consumption of UPFs and health-related outcomes in Chinese adults. From a public health perspective, with the prevalence of overweight and obesity growing and the increase in UPF consumption in Chinese adults, it is necessary to promote healthy food intake and a balanced diet through active nutritional education actions for overweight and obesity prevention and control.
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Affiliation(s)
- Feng Pan
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Tongwei Zhang
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Weifeng Mao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Fanglei Zhao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Dechun Luan
- Liaoning Center for Disease Control and Prevention, Shenyang 110005, China
| | - Jianwen Li
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
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Shim JS, Ha KH, Kim DJ, Kim HC. Ultra-Processed Food Consumption and Obesity in Korean Adults. Diabetes Metab J 2023; 47:547-558. [PMID: 37095686 PMCID: PMC10404531 DOI: 10.4093/dmj.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/27/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGRUOUND This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults. METHODS We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity). RESULTS Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared. CONCLUSION Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Shu L, Zhang X, Zhou J, Zhu Q, Si C. Ultra-processed food consumption and increased risk of metabolic syndrome: a systematic review and meta-analysis of observational studies. Front Nutr 2023; 10:1211797. [PMID: 37360294 PMCID: PMC10288143 DOI: 10.3389/fnut.2023.1211797] [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: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background Although higher consumption of ultra-processed food (UPF) has been linked to a higher risk of metabolic syndrome (MetS), the results remain controversial. Herein, we performed a systematic review and meta-analysis of observational studies to clarify the relationship between UPF consumption defined by the NOVA framework and risk of MetS. Methods An extensive literature search on PubMed, ISI Web of Science, EBSCO and China National Knowledge Infrastructure (CNKI) databases was conducted to search for the relevant articles published priori to January 2023, and newly published articles between January 2023 and March 2023 were re-searched. Random-effects or fixed-effects models were adopted to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). The between-study heterogeneity was explored using the Cochran's Q test and I-square (I2). Publication bias was investigated using the visual inspection of asymmetry in funnel plots and Begg's and Egger's tests. Results Nine studies (six cross-sectional and three prospective cohort studies) totaling 23,500 participants with 6,192 MetS cases were included in the final analysis. The pooled effect size for the highest vs. lowest categories of UPF consumption indicated a positive association with the risk of MetS (RR: 1.25, 95%CI: 1.09-1.42, P < 0.0001). Subgroup analyses revealed a positive association between consumption of UPF and MetS risk in cross-sectional studies (RR: 1.47, 95%CI: 1.16-1.87, P = 0.002), and no significant association in cohort studies (RR: 1.10, 95%CI: 0.96-1.27, P = 0.104), respectively. In addition, a more significant association between UPF consumption and increased risk of MetS was found in the subgroups of study quality <7 (RR: 2.22; 95%CI: 1.28-3.84, P = 0.004) than study quality ≥7 (RR: 1.20; 95%CI: 1.06-1.36, P = 0.005). Similarly, when we performed analyses separately by sample size, there was a significant association between UPF consumption and MetS risk in sample size ≥5,000 (RR: 1.19; 95%CI: 1.11-1.27, P < 0.0001), and in sample size <5,000 (RR: 1.43; 95%CI: 1.08-1.90, P = 0.013), respectively. Conclusions Our findings suggest that higher consumption of UPF is significantly associated with an increased risk of MetS. Further longitudinal studies are needed to confirm the effect of UPF consumption on MetS.
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Affiliation(s)
- Long Shu
- Department of Nutrition, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
| | - Xiaoyan Zhang
- Department of Nutrition, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
| | - Jianying Zhou
- Department of Digestion, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
| | - Qin Zhu
- Department of Nutrition, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
- Department of Digestion, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
| | - Caijuan Si
- Department of Nutrition, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, China
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26
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Rousham E, Clark M, Latham M, Oo SP, Read S, Griffiths P, Blankenship J, Goudet S. Resilience and vulnerabilities of urban food environments in the Asia-Pacific region. MATERNAL & CHILD NUTRITION 2023:e13513. [PMID: 37097115 DOI: 10.1111/mcn.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/26/2023]
Abstract
Rapid urbanisation in the Asia-Pacific region is associated with complex changes to urban food environments. The impact of changing food environments on food purchasing and consumption and the diets and nutritional status of vulnerable groups, especially women and young children, is not well researched in low- and middle-income country cities. This paper aimed to examine: the risks and opportunities for healthy diets for low income populations offered by modernising urban centres; the concept of food deserts in relation to urban food environments in the Asia-Pacific region and how these could be mitigated; and measures to strengthen the resilience of food environments in the region using a case study of the impact of COVID-19 on informal food vendors. Our findings indicate that the dynamic changes in urban food environments in the Asia- Pacific region need to be understood by examining not only modern retail food outlets but also wet markets and informal food outlets, including street foods. Efforts should be made to ensure both modern and traditional outlets provide complementary platforms for convenient, affordable and accessible nutritious foods for urban populations. The resilience of urban food environments to environmental, physical and socio-economic shocks can be strengthened by shortening food supply chains and maximising food production in cities. Support mechanisms targeting urban informal food outlets and street vendors can also strengthen resilience and improve food security. Further research is needed on the impact of urbanising food environments on consumer choices, preferences, diets and health outcomes.
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Affiliation(s)
- Emily Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | | | | | | | - Paula Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jessica Blankenship
- Nutrition Section, UNICEF East Asia and the Pacific Regional Office, Bangkok, Thailand
| | - Sophie Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Nutrition Research, Dikoda, London, UK
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Gaucher-Holm A, Wood B, Sacks G, Vanderlee L. The structure of the Canadian packaged food and non-alcoholic beverage manufacturing and grocery retailing sectors through a public health lens. Global Health 2023; 19:18. [PMID: 36906536 PMCID: PMC10008568 DOI: 10.1186/s12992-023-00917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Corporate power has been recognized as an important influence on food environments and population health more broadly. Understanding the structure of national food and beverage markets can provide important insight into the power held by leading corporations. This study aimed to descriptively analyze the structure of the Canadian food and beverage manufacturing and grocery retailing sectors as of 2020/21. METHODS Packaged food manufacturers, non-alcoholic beverage manufacturers and grocery retailers with ≥ 1% market share in 2020/21 in Canada as per Euromonitor International were identified and characterized. Proportion of market share held by public vs private, multinational vs national, and foreign multinational companies was assessed for the 3 sectors. The concentration of 14 packaged food, 8 non-alcoholic beverage and 5 grocery retailing markets was assessed using the Herfindahl-Hirschman Index (HHI) and the four firm concentration ratio (CR4) (HHI > 1800 and CR4 > 60 suggest high market concentration). Company ownership structure was also assessed, including common ownership of public companies by three of the largest global asset managers using data from Refinitiv Eikon, a financial market database. RESULTS The Canadian non-alcoholic beverage manufacturing sector, and, to a lesser extent, the packaged food manufacturing sector were dominated by foreign multinational companies, in contrast with the grocery retailing sector which was dominated by national companies. Market concentration varied across sectors and markets but was substantially greater within the retailing (median CR4 = 84; median HHI = 2405) and non-alcoholic beverage sectors (median CR4 = 72; median HHI = 1995) compared to the packaged food sector (median CR4 = 51; median HHI = 932). There was considerable evidence of common ownership across sectors. Overall, the Vanguard Group Inc owned at least 1% of shares in 95% of publicly listed companies, Blackrock Institutional Trust Company 71%, and State Street Global Advisors (US) 43%. CONCLUSIONS The Canadian packaged food and non-alcoholic beverage manufacturing and grocery retailing sectors include several consolidated markets, with a high degree of common ownership by major investors. Findings suggest that a small number of large corporations, particularly in the retailing sector, have extensive power to influence Canadian food environments; their policies and practices warrant substantial attention as part of efforts to improve population diets in Canada.
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Affiliation(s)
- Alexa Gaucher-Holm
- École de nutrition, Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2425 rue de l'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Benjamin Wood
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Lana Vanderlee
- École de nutrition, Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2425 rue de l'Agriculture, Québec, QC, G1V 0A6, Canada.
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Pereira TN, Bortolini GA, Campos RDF. Barriers and Facilitators Related to the Adoption of Policies to Reduce Ultra-Processed Foods Consumption: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4729. [PMID: 36981638 PMCID: PMC10048733 DOI: 10.3390/ijerph20064729] [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: 01/12/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Cost-effective regulatory and fiscal interventions are recommended to address non-communicable diseases. While some countries are advancing regarding these actions, others have found it difficult to approve them. AIM to conduct a scoping review to answer the question "What factors have influenced the adoption of food taxes, front-of-pack labeling and restrictions on marketing to children?". METHODS A scoping review was developed from four databases. Studies that described and analyzed policy processes were included. Analysis was performed to identify the barriers and enablers mentioned under the guidance of Swinburn et al., Huang et al., Mialon et al., and Kingdon. RESULTS 168 documents were identified, describing experiences from five regions or groups and 23 countries, which have generated 1584 examples of 52 enablers (689 examples; 43.5%) and 55 barriers (895 examples; 56.5%) that may have influenced policies. The main enablers were related to the government environment and governance and to civil society strategies. Corporate political activity strategies were the main examples of barriers. CONCLUSIONS This scoping review consolidated barriers and facilitators related to policies aimed at reducing ultra-processed foods consumption, demonstrating that factors related to the actions of governments and civil society are the main facilitators. On the other hand, as the most interested actor in promoting the consumption of these products, the strategies adopted by the companies that produce these products constitute the main barrier to these policies in all the studied countries and should be overcome.
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Affiliation(s)
| | - Gisele Ane Bortolini
- Food and Nutrition National Coordination, Ministry of Health, Brasilia 70058-900, Brazil
| | - Roberta de Freitas Campos
- Center for Studies on Bioethics and Diplomacy in Health, Oswaldo Cruz Foundation, Brasilia 70910-900, Brazil
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Huse O, Reeve E, Zambrano P, Bell C, Peeters A, Sacks G, Baker P, Backholer K. Understanding the corporate political activity of the ultra - processed food industry in East Asia: a Philippines case study. Global Health 2023; 19:16. [PMID: 36879312 PMCID: PMC9986662 DOI: 10.1186/s12992-023-00916-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and how the ultra - processed food industry seeks to influence food- and nutrition - related policy processes in the Philippines, a lower - middle income country in East Asia. METHODS Semi - structured key informant interviews were conducted with ten representatives from the Philippines government and non - government organisations closely involved with nutrition policy making in the Philippines. Interview schedules and data analysis were guided by the policy dystopia model, which we used to identify the instrumental and discursive strategies used by corporate actors to influence policy outcomes. RESULTS Informants were of the view that ultra - processed food companies in the Philippines sought to delay, prevent, water - down and circumvent implementation of globally recommended food and nutrition policies by engaging in a range of strategies. Discursive strategies included various tactics in which globally recommended policies were framed as being ineffective or highlighting potential unintended negative impacts. Instrumental strategies included: directly engaging with policymakers; promoting policies, such as industry - led codes and practices, as substitutes for mandatory regulations; presenting evidence and data that industry has generated themselves; and offering gifts and financial incentives to government individuals and agencies. CONCLUSIONS In the Philippines, the ultra - processed food industry engaged in overt activities designed to influence food and nutrition policy processes in their favour. A range of measures to minimise industry influence on policy processes should be introduced, to ensure that implemented food and nutrition policies align with best practice recommendations.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Erica Reeve
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Paul Zambrano
- Alive & Thrive Southeast Asia, FHI 360, Manila, Philippines
| | - Colin Bell
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phillip Baker
- Faculty of Health, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
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Katre A, Raddatz B. Low-Income Families' Direct Participation in Food-Systems Innovation to Promote Healthy Food Behaviors. Nutrients 2023; 15:nu15051271. [PMID: 36904271 PMCID: PMC10005603 DOI: 10.3390/nu15051271] [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: 01/29/2023] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Low-income families, especially those who reside in food deserts, face significant systemic barriers regarding their ability to access affordable and nutritious food. The food behaviors exhibited by low-income families are a reflection of the shortcomings of the built environment and conventional food system. Policy and public-health initiatives to improve food security have, thus far, failed to deliver interventions that simultaneously address multiple pillars of food security. Centering the voices of the marginalized and their place-based knowledge may result in the development of food-access solutions that are a much better fit for the population that they intend to serve. Community-based participatory research has emerged as a solution to better meet the needs of communities in food-systems innovation, but little is known about the extent to which direct participation improves nutritional outcomes. The purpose of this research is to answer the following question: how can food-access solutions authentically engage marginalized community members in food-system innovation, and if participation is related to changes in their food behaviors, how is it related? This action research project leveraged a mixed-methods approach to analyze nutritional outcomes and define the nature of participation for 25 low-income families who reside in a food desert. Our findings suggest that nutritional outcomes improve when major barriers to healthy food consumption are addressed, for example, time, education, and transportation. Furthermore, participation in social innovations can be characterized by the nature of involvement as either a producer or consumer, actively or inactively involved. We conclude that when marginalized communities are at the center of food-systems innovation, individuals self-select their level of participation, and when primary barriers are addressed, deeper participation in food-systems innovation is associated with positive changes in healthy food behaviors.
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Affiliation(s)
- Aparna Katre
- College of Arts Humanities and Social Sciences, University of Minnesota Duluth, 1201 Ordean Court, Duluth, MN 55812, USA
- Correspondence:
| | - Brianna Raddatz
- College of Education and Human Service Professions, University of Minnesota Duluth, 1201 Ordean Court, Duluth, MN 55812, USA
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Headey DD, Ecker O, Comstock AR, Ruel MT. Poverty, price and preference barriers to improving diets in sub-Saharan Africa. GLOBAL FOOD SECURITY 2023; 36:100664. [PMID: 36937376 PMCID: PMC10015269 DOI: 10.1016/j.gfs.2022.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
Suboptimal diets are the most important preventable risk factor for the global burden of non-communicable diseases. The EAT-Lancet reference diet was therefore developed as a benchmark for gauging divergence from healthy eating standards. However, no previous research has comprehensively explored how and why this divergence exists in poorer countries undergoing nutrition transitions. This study therefore analyzes dietary patterns and drivers of the demand for nutritious foods using nationally representative household surveys from Ethiopia, Kenya, Tanzania, and Uganda. We show how barriers to dietary convergence stem from combinations of poverty, high relative food prices and weak preferences for some specific healthy foods. The article concludes by discussing interventions for strengthening consumer demand for healthy diets in Africa.
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Hu W, Zhai C, Sun H, Gong X, Cui L, Cai L, Zong Q, Yu G, Wang F, Zou Y. The global burden of disease attributable to metabolic risks in 204 countries and territories from 1990 to 2019. Diabetes Res Clin Pract 2023; 196:110260. [PMID: 36682584 DOI: 10.1016/j.diabres.2023.110260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/21/2023]
Abstract
AIM Our study aimed to survey the burden of disease attributed to metabolic risks (MRs) and secondary MR from 1990 to 2019. METHODS Using methodological framework of the Global Burden of Disease Study 2019, we reported the global number, age-standardized rate and population attributable fraction of deaths and disability adjusted life years related to MRs and secondary MR. Furthermore, we analyzed the global burden caused by MRs and secondary MR in detail by gender, age, region, country, disease and Socio-demographic Index level. RESULTS The number (million) of deaths and DALYs caused by MRs was 18.6 and 462.8 in 2019, with an increase of 43.6 % and 75.0 % since 1990. However, the ASR of deaths and DALYs attributed to MRs had a decrease of 23.3 % and 17.0 % since 1990. The burden caused by MRs and secondary MR raised with age, and the burden was the heaviest in low - and middle-income countries, especially in Middle East & North Africa. For diseases, the heaviest burden attributed to MRs was observed in ischemic heart disease, followed by stroke. CONCLUSION The burden of disease attributed to MRs has continued to rise in the past 30 years, particularly for men and low-middle SDI regions. Therefore, the government should take corresponding actions to reduce the impact of MRs on population health.
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Affiliation(s)
- Wanqin Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chunxia Zhai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hongyu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - XingYu Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Liangyu Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Lin Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qiqun Zong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Guanghui Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
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Phulkerd S, Thongcharoenchupong N, Chamratrithirong A, Gray RS, Pattaravanich U, Ungchusak C, Saonuam P. Socio-demographic and geographic disparities of population-level food insecurity during the COVID-19 pandemic in Thailand. Front Public Health 2023; 10:1071814. [PMID: 36711351 PMCID: PMC9880195 DOI: 10.3389/fpubh.2022.1071814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction This study investigated the prevalence of food insecurity, and the association between socio-demographic and geographic factors and food insecurity in Thailand during the COVID-19 pandemic. Methods The study extracted data on 5,066 persons age 15 years or older from a nationally-representative sample survey of Thai households, conducted during June-December 2021. The respondents were asked about food insecurity, socio-demographic characteristics, debt, and role of the primary household food provider. Binary logistic regression analysis was used to investigate the association between the variables and food insecurity. Results Of the total sample, 28.6% had food insecurity. The highest probability of having food insecurity (p < 0.001) was observed in persons age 15-29 years, with no formal education, and in the lowest quartile of income. The highest probability of having food insecurity was found among respondents residing in the northeast, which is the poorest and with the least development status among geographic regions in Thailand. Respondents who reported having onerous personal debt and being the main household food provider were 1.4 and 2.3 times as likely to have food insecurity as those with no debt and not being the main food provider, respectively (p < 0.001). Conclusion This suggests that government attention is required in developing policies and strategies to improve food security through addressing the socio-economic determinants, and buffer the negative impact of a national crisis on diets. Investment to improve household income and raise the educational profile of the population is needed. Addressing the regional disparities in food security requires area-specific measures which target the most vulnerable population groups.
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Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand,*Correspondence: Sirinya Phulkerd ✉
| | | | | | | | - Umaporn Pattaravanich
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Chantana Ungchusak
- Healthy Lifestyle Promotion Section of Thai Health Promotion Foundation, Bangkok, Thailand
| | - Pairoj Saonuam
- Healthy Lifestyle Promotion Section of Thai Health Promotion Foundation, Bangkok, Thailand
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Liang S, Wang L, Wu X, Hu X, Wang T, Jin F. The different trends in the burden of neurological and mental disorders following dietary transition in China, the USA, and the world: An extension analysis for the Global Burden of Disease Study 2019. Front Nutr 2023; 9:957688. [PMID: 36698474 PMCID: PMC9869872 DOI: 10.3389/fnut.2022.957688] [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: 05/31/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The highly processed western diet is substituting the low-processed traditional diet in the last decades globally. Increasing research found that a diet with poor quality such as western diet disrupts gut microbiota and increases the susceptibility to various neurological and mental disorders, while a balanced diet regulates gut microbiota and prevents and alleviates the neurological and mental disorders. Yet, there is limited research on the association between the disease burden expanding of neurological and mental disorders with a dietary transition. Methods We compared the disability-adjusted life-years (DALYs) trend by age for neurological and mental disorders in China, in the United States of America (USA), and across the world from 1990 to 2019, evaluated the dietary transition in the past 60 years, and analyzed the association between the burden trend of the two disorders with the changes in diet composition and food production. Results We identified an age-related upward pattern in disease burden in China. Compared with the USA and the world, the Chinese neurological and mental disorders DALY percent was least in the generation over 75 but rapidly increased in younger generations and surpassed the USA and/or the world in the last decades. The age-related upward pattern in Chinese disease burdens had not only shown in the presence of cardiovascular diseases, neoplasms, and diabetes mellitus but also appeared in the presence of depressive disorders, Parkinson's disease, Alzheimer's disease and other dementias, schizophrenia, headache disorders, anxiety disorders, conduct disorders, autism spectrum disorders, and eating disorders, successively. Additionally, the upward trend was associated with the dramatic dietary transition including a reduction in dietary quality and food production sustainability, during which the younger generation is more affected than the older. Following the increase in total calorie intake, alcohol intake, ratios of animal to vegetal foods, and poultry meat to pulses, the burdens of the above diseases continuously rose. Then, following the rise of the ratios of meat to pulses, eggs to pulses, and pork to pulses, the usage of fertilizers, the farming density of pigs, and the burdens of the above disease except diabetes mellitus were also ever-increasing. Even the usage of pesticides was positively correlated with the burdens of Parkinson's disease, schizophrenia, cardiovascular diseases, and neoplasms. Contrary to China, the corresponding burdens of the USA trended to reduce with the improvements in diet quality and food production sustainability. Discussion Our results suggest that improving diet quality and food production sustainability might be a promising way to stop the expanding burdens of neurological and mental disorders.
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Affiliation(s)
- Shan Liang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Key Laboratory of Microbial Physiological and Metabolic Engineering, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China,*Correspondence: Shan Liang,
| | - Li Wang
- Department for the History of Science and Scientific Archaeology, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaoli Wu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Xu Hu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Tao Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Feng Jin
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China,Feng Jin,
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Kityo A, Lee SA. The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort. PLoS One 2023; 18:e0285314. [PMID: 37141249 PMCID: PMC10159145 DOI: 10.1371/journal.pone.0285314] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
The relationship between ultra-processed food (UPF) intake and mortality is unknown in Asian countries, yet the intake of UPF is on the rise in these countries. This study examined the association of UPF intake with all-cause, cancer and cardiovascular disease (CVD) mortality. Participants were 113,576 adults who responded to a 106-item food frequency questionnaire during recruitment of the 2004-2013 Health Examinees (HEXA) study, a prospective cohort study in Korea. UPF were defined using the NOVA classification and evaluated as quartiles of the proportion of UPF in the diet (% total food weight). Multivariable Cox regression and restricted cubic spline models were used to examine the association of UPF intake with all-cause and cause specific mortality. A total of 3456 deaths were recorded during a median follow-up of 10.6 (interquartile range, 9.5-11.9) years. There was no evidence of an association of UPF intake with all-cause, cancer or CVD mortality comparing the highest with the lowest quartiles of UPF intake (all-cause mortality, men: hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.95-1.22; women: HR 0.95, 95% CI 0.81-1.11; cancer mortality, men: HR 1.02, 95% confidence interval [CI] 0.84-1.22; women: HR 1.02, 95% CI 0.83-1.26; CVD mortality, men: HR 0.88, 95% CI 0.64-1.22; women: HR 0.80, 95% CI 0.53-1.19). However, the risk of all-cause mortality increased in both men and women with high consumption of ultra-processed red meat and fish (men, HR 1.26, 95% CI 1.11-1.43); women, HR 1.22 95% CI 1.05-1.43); and in men with high consumption of ultra-processed milk (HR 1.13, 95% CI 1.01-1.26); and soymilk drink (HR 1.12, 95% CI 1.00-1.25). We found no evidence of an association between total UPF intake and all-cause, cancer or CVD mortality, but ultra-processed red meat and fish in both sexes, and milk and soymilk drinks in men were positively associated with all-cause mortality.
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Affiliation(s)
- Anthony Kityo
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
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Huse O, Reeve E, Bell C, Sacks G, Baker P, Wood B, Backholer K. Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia. BMJ Glob Health 2022; 7:bmjgh-2022-010386. [PMID: 36593644 PMCID: PMC9730366 DOI: 10.1136/bmjgh-2022-010386] [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: 08/10/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their activities in LMICs in East Asia, among the world's most highly populated yet under-researched countries, to illustrate the ways in which these activities may negatively influence health outcomes. METHODS We adopted a theoretically-guided qualitative research design and documentary analysis method. Data sources included: industry documents and web pages, marketing case studies obtained from the World Advertising Research Centre, media reports, global trade summaries and websites of industry associations. To guide data analysis, we synthesised a conceptual framework from existing commercial determinants of health literature, to describe ways in which the market and non-market activities of TCCC influence health. RESULTS TCCC leverages subsidiary companies and investments in international networks to expand its supply chains. The company engages in frequent political activities to minimise the implementation of nutrition policies that may impact profits. The company markets products, particularly on digital and mobile devices, often targeting children, adolescents and mothers, and undertakes public relations activities related to human rights, environmental sustainability and community and economic supports, and these public relations activities are often integrated into marketing campaigns. The identified activities of TCCC are frequently in direct contrast to efforts to improve the healthfulness of population diets in East Asia LMICs. CONCLUSIONS A public health analysis of the market and non-market activities of corporations active in unhealthy commodity industries needs to be broad in scope to cover the diverse set of strategies used to increase their market power and influence. Governments should consider a suite of policy options to attenuate these commercial determinants of unhealthy diets.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Erica Reeve
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Koios D, Machado P, Lacy-Nichols J. Representations of Ultra-Processed Foods: A Global Analysis of How Dietary Guidelines Refer to Levels of Food Processing. Int J Health Policy Manag 2022; 11:2588-2599. [PMID: 35184508 PMCID: PMC9818109 DOI: 10.34172/ijhpm.2022.6443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/15/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally. METHODS Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework. RESULTS 99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs. CONCLUSION Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.
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Affiliation(s)
- Daniela Koios
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Srour B, Kordahi MC, Bonazzi E, Deschasaux-Tanguy M, Touvier M, Chassaing B. Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. Lancet Gastroenterol Hepatol 2022; 7:1128-1140. [PMID: 35952706 DOI: 10.1016/s2468-1253(22)00169-8] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
Epidemiological studies have suggested a role for ultra-processed foods in numerous chronic inflammatory diseases such as inflammatory bowel diseases and metabolic syndrome. Preclinical and clinical studies are accumulating to better decipher the effects of various aspects of food processing and formulation on the aetiology of chronic, debilitating inflammatory diseases. In this Review, we provide an overview of the current data that highlight an association between ultra-processed food consumption and various chronic diseases, with a focus on epidemiological evidence and mechanistic insights involving the intestinal microbiota.
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Affiliation(s)
- Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Melissa C Kordahi
- INSERM U1016, Mucosal microbiota in chronic inflammatory diseases, CNRS UMR 8104, Université de Paris, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Erica Bonazzi
- INSERM U1016, Mucosal microbiota in chronic inflammatory diseases, CNRS UMR 8104, Université de Paris, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Benoit Chassaing
- INSERM U1016, Mucosal microbiota in chronic inflammatory diseases, CNRS UMR 8104, Université de Paris, Paris, France; NACRe Network-Nutrition and Cancer Research Network, Jouy-en-Josas, France.
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Simple and rapid detection of ractopamine in pork with comparison of LSPR and LFIA sensors. J Food Drug Anal 2022; 30:590-602. [PMID: 36753367 PMCID: PMC9910298 DOI: 10.38212/2224-6614.3410] [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: 01/10/2022] [Accepted: 03/25/2022] [Indexed: 11/27/2022] Open
Abstract
This study developed a simple and rapid strategic technique to detect ractopamine (chemical growth-promoting agent) in pork. Two highly sensitive and specific gold nanoparticle-based portable sensors, i.e., localized surface plasmon resonance (LSPR) sensors, and lateral flow immunoassay (LFIA) strips were developed to detect veterinary drug residues in food products, that have detrimental effects on humans. Optimization studies were conducted on several sensor devices to improve sensitivity. Each sensor comprised functionalized gold nanoparticles conjugated with ractopamine antibodies. The LSPR sensor chip achieved excellent detection sensitivity = 1.19 fg/mL and was advantageous for quantitative analysis due to its wide dynamic range. On the other hand, LFIA strips provided visual test confirmation and achieved 2.27 ng/mL detection sensitivity, significantly less sensitive than LSPR. The complementary sensors help overcome each other's shortcomings with both the techniques offering ease of use, affordability and rapid diagnosis. Thus, these sensors can be applied on-site for routine screening of harmful drug residues in pork meat. They also provide useful direction for advanced technologies to enhance assay performance for detecting various other food drug contaminants.
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Market concentration and the healthiness of packaged food and non-alcoholic beverage sales across the European single market. Public Health Nutr 2022; 25:3131-3136. [PMID: 36073156 PMCID: PMC9991654 DOI: 10.1017/s1368980022001926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the relationship between market concentration and diversity, as indicators of market structure, and the healthiness of food and beverage sales across Europe. DESIGN Market share (MS) data per country were used to calculate market concentration, assessed by the four-firm concentration ratio and market diversity, and by the number of companies with ≥1 % MS and the number of companies uniquely present in one European country. The healthiness of food sales was assessed by applying the NOVA classification (level of processing). Simple and multiple linear regressions were performed to assess the relationship between market concentration, diversity and the healthiness of food and beverage sales. SETTING The European single market. PARTICIPANTS The twenty-seven European single market member states for which Euromonitor sales data were available at the most fine-grained Euromonitor packaged food and non-alcoholic beverage product subcategory level. RESULTS Increased market concentration with a country and a product category fixed effect significantly predicted increased sales of ultra-processed packaged food products. There was insufficient data variability in the level of processing of non-alcoholic beverage product categories to formulate conclusions for non-alcoholic beverages. Increased market diversity in turn significantly predicted reduced country-level sales of ultra-processed products. CONCLUSIONS The results indicated a relationship between market structure and the healthiness of packed food products sold on the European market. However, more research with detailed nutritional data is warranted to document and quantify this interaction.
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Trends in food consumption according to the degree of food processing among the UK population over 11 years. Br J Nutr 2022:1-8. [DOI: 10.1017/s0007114522003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Although ultra-processed foods represent more than half of the total energy consumed by the UK population, little is known about the trend in food consumption considering the degree of food processing. We evaluated the trends of the dietary share of foods categorised according to the NOVA classification in a historical series (2018–2019) among the UK population. Data were acquired from the NDNS, a survey that collects diet information through a 4-d food record. We used adjusted linear regression to estimate the dietary participation of NOVA groups and evaluated the linear trends over the years. From 2008 to 2019, we observed a significant increase in the energy share of culinary ingredients (from 3·7 to 4·9 % of the total energy consumed; P-trend = 0·001), especially for butter and oils; and reduction of processed foods (from 9·6 to 8·6 %; P-trend = 0·002), especially for beer and wine. Unprocessed or minimally processed foods (≅30 %, P-trend = 0·505) and ultra-processed foods (≅56 %, P-trend = 0·580) presented no significant change. However, changes in the consumption of some subgroups are noteworthy, such as the reduction in the energy share of red meat, sausages and other reconstituted meat products as well as the increase of fruits, ready meals, breakfast cereals, cookies, pastries, buns and cakes. Regarding the socio-demographic characteristics, no interaction was observed with the trend of the four NOVA groups. From 2008 to 2019 was observed a significant increase in culinary ingredients and a reduction in processed food. Furthermore, it sheds light on the high share of ultra-processed foods in the contemporary British diet.
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Framing Political Issues in Food System Transformative Changes. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The paper addresses political issues related to policy interventions for food system sustainability. It presents the results of a literature review, which explores how the concept of power has been used so far by scholars of food system dynamics. Articles numbering 116 were subjected to an in-depth qualitative analysis, which allowed the identification of three main strands of the literature with respect to food and power issues: (1) marketing and industrial organisation literature, dealing with the economic power exercised by economic actors in contexts of noncompetitive market structures; (2) articles addressing the power issue from a political economy perspective and by using an interdisciplinary approach; (3) heterogenous studies. The results of the review witness a growing interest for the analysis of food systems, political issues, and the need of a wider use of analytical tools and concepts offered by social sciences for the study of power in sustainability policy design.
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Sinha S, Haque M. Obesity, Diabetes Mellitus, and Vascular Impediment as Consequences of Excess Processed Food Consumption. Cureus 2022; 14:e28762. [PMID: 36105908 PMCID: PMC9441778 DOI: 10.7759/cureus.28762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 12/15/2022] Open
Abstract
Regular intake of ready-to-eat meals is related to obesity and several noninfectious illnesses, such as cardiovascular diseases, hypertension, diabetes mellitus (DM), and tumors. Processed foods contain high calories and are often enhanced with excess refined sugar, saturated and trans fat, Na+ andphosphate-containing taste enhancers, and preservatives. Studies showed that monosodium glutamate (MSG) induces raised echelons of oxidative stress, and excessive hepatic lipogenesis is concomitant to obesity and type 2 diabetes mellitus (T2DM). Likewise, more than standard salt intake adversely affects the cardiovascular system, renal system, and central nervous system (CNS), especially the brain. Globally, excessive utilization of phosphate-containing preservatives and additives contributes unswervingly to excessive phosphate intake through food. In addition, communities and even health experts, including medical doctors, are not well-informed about the adverse effects of phosphate preservatives on human health. Dietary phosphate excess often leads to phosphate toxicity, ultimately potentiating kidney disease development. The mechanisms involved in phosphate-related adverse effects are not explainable. Study reports suggested that high blood level of phosphate causes vascular ossification through the deposition of Ca2+ and substantially alters fibroblast growth factor-23 (FGF23) and calcitriol.
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Cetthakrikul N, Kelly M, Baker P, Banwell C, Smith J. Effect of baby food marketing exposure on infant and young child feeding regimes in Bangkok, Thailand. Int Breastfeed J 2022; 17:64. [PMID: 36050746 PMCID: PMC9435428 DOI: 10.1186/s13006-022-00503-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Baby food marketing undermines breastfeeding by influencing women’s attitudes and decision-making favourably toward commercial baby food. This study aimed to explore the effects of various baby food marketing techniques on Thai mothers’ opinions about commercial milk formulas (CMF) and commercial complementary foods (CCF) and their infant and young child feeding behaviours. Methods This study used a cross-sectional survey employing the World Health Organization (WHO) NetCode Toolkit Protocol for Periodic Assessment, and the United Nations International Children’s Emergency Fund (UNICEF) Multiple Indicator Cluster Survey to collect data on mothers’ experience with and their opinion on the various types of marketing of CMF and CCF, and their feeding behaviour. Data collection used structured interviews of mothers with children aged two years or below attending 33 health facilities in Bangkok. Univariable and multivariable regression analysis then investigated links between mothers’ reported exposure to baby food marketing and their infant and young child feeding behaviours, employing a semantic scale and considering key sociodemographic and other variables. Results Three hundred and thirty mothers were surveyed in Bangkok. Around 90% reported experiencing exposure to at least one type of baby food marketing during the previous six months, mostly from electronic media. More than half of the women had positive opinions of CMF. Virtually all children had been breastfed initially, but 74.6% were given CMF and 72.8% stopped breastfeeding before six months. Multivariable analysis showed that mothers who lived in a couple were significantly less likely to favour CMF, and mothers in middle-income households and those who had received advice about CMF from others were more likely to have a favourable opinion. Mothers in formal employment were over six times more likely to feed formula than those not in employment. Women who experienced baby food marketing at health facilities were four times more likely to feed CMF to their children than those not experiencing such marketing. Conclusions Specific types of baby food marketing were strongly linked to mothers’ opinions on and use of CMF in Bangkok, Thailand. It is recommended that breastfeeding policies in health facilities and employment are fully implemented and enforced. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00503-7.
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Affiliation(s)
- Nisachol Cetthakrikul
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia. .,International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand.
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Julie Smith
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
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The Intake of Ultra-Processed Foods and Prevalence of Chronic Kidney Disease: The Health Examinees Study. Nutrients 2022; 14:nu14173548. [PMID: 36079805 PMCID: PMC9460585 DOI: 10.3390/nu14173548] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/19/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
Emerging evidence links several health outcomes to the consumption of ultra-processed food (UPF), but few studies have investigated the association between UPF intake and kidney function. This cross-sectional study investigated the prevalence of chronic kidney disease (CKD) in relation to UPF intake in Korea. Data were obtained from the 2004−2013 Health Examinees (HEXA) study. The intake of UPF was assessed using a 106-item food frequency questionnaire and evaluated using the NOVA classification. The prevalence of CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/m2. Poisson regression models were used to compute the prevalence ratios (PR) of CKD according to quartiles of the proportion of UPF intake (% food weight). A total of 134,544 (66.4% women) with a mean age of 52.0 years and an eGFR of 92.7 mL/min/m2 were analysed. The median proportion of UPF in the diet was 5.6%. After adjusting for potential confounders, the highest quartile of UPF intake was associated with the highest prevalence of CKD (PR 1.16, 95% CI 1.07−1.25), and every IQR (6.6%) increase in the proportion of UPF in the diet was associated with a 6% higher prevalence of CKD (PR 1.06, 95% CI 1.03−1.09). Furthermore, the highest consumption of UPF was inversely associated with eGFR (Q4 vs. Q1: β −1.07, 95% CI −1.35, −0.79; per IQR increment: (β −0.45, 95% CI −0.58, −0.32). The intake of UPF was associated with a high prevalence of CKD and a reduced eGFR. Longitudinal studies in the Korean population are needed to corroborate existing findings in other populations.
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Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14153242. [PMID: 35956418 PMCID: PMC9370797 DOI: 10.3390/nu14153242] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes.
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Babashahi M, Omidvar N, Joulaei H, Zargaraan A, Veisi E, Kelishadi R. Food Products with the Child-Targeted Packaging in Food Stores around Primary Schools in Tehran, Iran. JOURNAL OF PREVENTION (2022) 2022; 43:513-527. [PMID: 35476310 DOI: 10.1007/s10935-022-00679-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
The local retail food environment around schools can have an important role in encouraging children to low-quality food choices; and may act as a potential risk factor in their diet. Thus, evaluating the food environment is essential for adopting policies and programs that support healthy nutrition in children. This study aimed to investigate the frequency and nutritional characteristics of packaged processed/ultra-processed food and beverage products with child-oriented marketing attributes in food stores around primary schools in Tehran, Iran. This cross-sectional study was conducted on 239 food stores located within a 500-meter buffer around 64 primary schools in Tehran province. The presence of marketing strategies directed at children and nutrition information from traffic light labels of packaged foods available in these stores were extracted. Data were analyzed overall and separately for the subset of foods placed on front shelves at the entrance of stores. Among 445 discrete food products marketed to children via their packaging, 198 (44.49%) were placed on shelves in front of the stores entrance. Potato chips and bulky cereals group had the highest energy density (507.15 ± 44.05 Kcal/100gr). Due to the color code of traffic light labels, 100% of fruit juices had high levels of sugar. Of potato chips and bulky cereals, 89.38% were assigned a red color traffic light for total fat levels. Moreover, 62.50% of processed fruit and vegetables contained high levels of salt. The level of trans-fatty acids were not high in any of the food products. The high amount of sugar, salt, and fat in a remarkable proportion of food products marketed to children can be considered a risk factor for children's health. Initiation and implementation of appropriate policies to control the food environment around schools in Iran is recommended.
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Affiliation(s)
- Mina Babashahi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elnaz Veisi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Islam MR, Rahman SM, Rahman MM, Pervin J, Rahman A, Ekström EC. Gender and socio-economic stratification of ultra-processed and deep-fried food consumption among rural adolescents: A cross-sectional study from Bangladesh. PLoS One 2022; 17:e0272275. [PMID: 35901170 PMCID: PMC9333446 DOI: 10.1371/journal.pone.0272275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Although consumption of ultra-processed and deep-fried foods among adolescents is a global health concern, little is known about its gender and socio-economic stratification in rural settings of low- and middle-income countries. We, thus, aimed to describe ultra-processed and deep-fried food consumption among rural adolescents by gender and socio-economic factors, and to explore their relative importance in shaping consumption. Methods This cross-sectional study drew on data from a household survey in Matlab, a rural sub-district in Bangladesh. The analytic sample comprised 2463 adolescents. We assessed consumption of four ultra-processed food groups: ready-to-eat or “instant” foods; confectionery, sweets and similar packaged products; savory snacks; sugar-sweetened beverage; and of deep-fried foods with a 24-hour, qualitative recall. Asset scores were constructed. Proportion of consumption was calculated and compared by gender and household wealth. Logistic regression models were fitted to isolate socio-demographic variables associated with consumption. Results Approximately 83% (81.5–84.4) adolescents consumed at least one ultra-processed or deep-fried item. Confectioneries were the most consumed (53.5%), whereas sugar-sweetened beverage was the least consumed (12%) group. Boys had greater odds of consumption than girls for all food groups. The association was strongest for sugar-sweetened beverage (adjusted odds ratio = 2.57; 95% CI: 1.97, 3.37), followed by deep-fried foods (adjusted odds ratio = 1.96; 95% CI: 1.66, 2.32) and ready-to-eat foods (adjusted odds ratio = 1.85; 95% CI: 1.45, 2.38). Belonging to the richest households was associated with ready-to-eat food consumption (adjusted odds ratio = 1.55; 95% CI: 1.12, 2.16). Adolescents with higher educational attainment had lower odds of consuming sugar-sweetened beverage (adjusted odds ratio = 0.73; 95% CI: 0.54, 0.98). Conclusion Consumption of packaged confectioneries, savory snacks, and deep-fried foods appeared common, while SSB consumption was relatively low. Role of gender was pre-eminent as consumption was more likely among boys across the food groups. This may disproportionately expose them to the risk of diet-related non-communicable diseases.
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Affiliation(s)
| | - Syed Moshfiqur Rahman
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Monjur Rahman
- International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jesmin Pervin
- International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anisur Rahman
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Mackenbach JD, Ibouanga EL, van der Veen MH, Ziesemer KA, Pinho MGM. Relation between the food environment and oral health-systematic review. Eur J Public Health 2022; 32:606-616. [PMID: 35849329 PMCID: PMC9341680 DOI: 10.1093/eurpub/ckac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background There is increasing evidence that the food environment, i.e. the availability, accessibility, price and promotion of foods and beverages, has a significant influence on oral health through food consumption. With this systematic literature review, we systematically summarize the available evidence on relations between the food environment and oral health outcomes in children and adults. Methods English-language studies were identified through a systematic literature search, executed by a medical information specialist, on OVID/Medline, Embase, Web of Science and CINAHL. Title and abstract screening, full-text screening and quality assessment [using the Quality Assessment with Diverse Studies (QuADS) tool] were done independently by two authors. Results Twenty-three studies were included, of which 1 studied the consumer food environment (food labeling), 3 the community food environment (e.g. number of food stores in the community), 5 the organizational food environment (availability of healthy foods and beverages in schools), 2 the information environment (television advertisements) and 13 government and industry policies related to the food environment (e.g. implementation of a sugar-sweetened beverage tax). Almost all studies found that unhealthy food and beverage environments had adverse effects on oral health, and that policies improving the healthiness of food and beverage environments improved—or would improve in case of a modeling study—oral health. Conclusions This systematic literature review provides evidence, although of low to moderate quality and available in a low quantity only, that several aspects of the food environment, especially policies affecting the food environment, are associated with oral health outcomes.
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Affiliation(s)
- Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Amsterdam, The Netherlands
| | - Elodie L Ibouanga
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Departments of Preventive Dentistry and Pediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,Department of Oral hygiene, University for Applied Sciences Inholland, Amsterdam, The Netherlands
| | | | - Maria G M Pinho
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Amsterdam, The Netherlands
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Gaupholm J, Papadopoulos A, Asif A, Dodd W, Little M. The influence of food environments on dietary behaviour and nutrition in Southeast Asia: A systematic scoping review. Nutr Health 2022; 29:231-253. [PMID: 35850565 PMCID: PMC10114263 DOI: 10.1177/02601060221112810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Food environments are crucial spaces within the food system for understanding and addressing many of the shared drivers of malnutrition. In recent years, food environment research has grown rapidly, however, definitions, measures, and methods remain highly inconsistent, leading to a body of literature that is notably heterogeneous and poorly understood, particularly within regions of the Asia-Pacific. Aim: This scoping review aims to synthesize the nature, extent, and range of published literature surrounding the role of the food environment on influencing dietary behaviour and nutrition in Southeast Asia. Methods: A systematic search of 5 databases was conducted following PRISMA guidelines for scoping reviews. Eligible studies included peer-reviewed research with adult participants living in Southeast Asia that examined the food environment as a determinant of dietary behaviour or nutrition. Results: A total of 45 articles were included. Overall, studies indicated that dietary behaviours in Southeast Asia were primarily driven by social, cultural, and economic factors rather than physical (e.g. geographical) features of food environments. Food price and affordability were most consistently identified as key barriers to achieving healthy diets. Conclusion: This work contributes to the establishment of more robust conceptualizations of food environments within diverse settings which may aid future policymakers and researchers identify and address the barriers or obstacles impacting nutrition and food security in their communities. Further research is needed to strengthen this knowledge, particularly research that explicitly explores the macro-level mechanisms and pathways that influence diet and nutrition outcomes.
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Affiliation(s)
- Josephine Gaupholm
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Aiza Asif
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Warren Dodd
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Matthew Little
- School of Public Health and Social Policy, 574711University of Victoria, Victoria, BC, Canada
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