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Libardi MC, Martins CA, Ferreira JRS, Petarli GB, Cattafesta M, Bezerra OMDPA, Zandonade E, Siqueira CEG, de Abreu LC, Filippon J, Salaroli LB. Neck circumference cutoff point as a predictor of metabolic syndrome in Brazilian rural workers. PLoS One 2025; 20:e0316090. [PMID: 39775352 PMCID: PMC11706368 DOI: 10.1371/journal.pone.0316090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/05/2024] [Indexed: 01/11/2025] Open
Abstract
Neck circumference (NC) is a predictive measure for the diagnosis of Metabolic Syndrome (MS). The aim of the present study was to establish cutoff points for NC as a predictor of the presence of MS in Brazilian rural workers, based on the MS components according to the IDF and NCEP-ATP III criteria. This is a cross-sectional study carried out with rural workers in the municipality of Santa Maria de Jetibá, in the state of Espírito Santo, Brazil. The ROC curve was calculated and the cutoff points for predicting the risk of developing MS were stipulated from the NC, identified by the area under the curve, using different methods of criteria for determining MS. Sensitivity, specificity, positive and negative predictive values and Youden index were applied. The significance level adopted was 5%. The cutoff points were different for males, resulting in 39.550 cm (AUC 0.832) according to the NCEP-ATP III criterion and 39.125 cm (AUC 0.888) according to the IDF criterion. For women, the cutoffs were similar, resulting in a single cutoff of 34.725 cm (AUC 0.862 for NCEP-ATP III and 0.849 for IDF). The cutoff points defined for men and women for NC showed good sensitivity and specificity for predicting MS in the studied population. The NC measurement proved to be a simple, low-cost and accurate measure for assessing this morbidity in Brazilian rural workers.
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Affiliation(s)
- Manoela Cassa Libardi
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Cleodice Alves Martins
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Júlia Rabelo Santos Ferreira
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Glenda Blaser Petarli
- Health Sciences Center, at the Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Monica Cattafesta
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Eliana Zandonade
- Health Sciences Center, at the Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Luiz Carlos de Abreu
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Luciane Bresciani Salaroli
- Graduate Program in Collective Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
- Graduate Program Nutrition and Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
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Gálvez Espinoza P, Rodríguez Osiac L, Franch Maggiolo C, Egaña Rojas D. Rethinking the Social Determination of Food in Chile Through Practices and Interactions of Actors in Food Environments: Nonexperimental, Cross-Sectional Study. JMIR Res Protoc 2024; 13:e62765. [PMID: 39270213 PMCID: PMC11437218 DOI: 10.2196/62765] [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: 05/30/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Food environments are crucial for promoting healthy and sustainable eating and preventing obesity. However, existing food environment frameworks assume an already installed causality and do not explain how associations in food environments are established or articulated, especially from an integrative and transdisciplinary approach. This research attempts to bridge these gaps through the use of Actor-Network Theory, which traces the relationship network between human (and nonhuman) actors in order to describe how these interact and what agencies (direct or remote) are involved. OBJECTIVE This study aims to explain the practices and interactions of actors in food environments in order to approach the problem of unhealthy eating with a transdisciplinary approach. METHODS This is a nonexperimental, cross-sectional study. Due to the complexity of the study phenomena, a mixed methods approach with 4 consecutive phases will be developed in Chile. Phase 1 involves a systematic literature review of food environment evidence since 2015, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol; phase 2 involves the application of a shortened version of the Nutrition Environment Measure Scale-Perceptions adapted to Chile (NEMS-P-Ch) in 2 neighborhoods with different socioeconomic levels; in phase 3, six focus groups in each neighborhood will be conducted to address social determinants such as gender, employment status, and migration; and in phase 4, participant observation and in-depth interviews will be used to analyze the direct and empirical exploration of the actors in their daily interaction with food environments. The triangulation and complementarity of the data will allow us to create a practical model about the practices and interactions of actors in their food environments, which reflects the complexity and transdisciplinary nature of the study. RESULTS We have advanced in phases 1-3 of the study. In phase 1, a total of 109 manuscripts are being revised for data extraction. In phase 2, we applied the NEMS-P-Ch to 785 people, 49.4% (388/785) of whom belong to a low socioeconomic neighborhood. Participants from phase 2 are being contacted to participate in the focus groups (phase 3). By the end of July, we have conducted 6 focus groups with 5-11 participants. CONCLUSIONS This study will provide a comprehensive understanding of how individuals interact with their food environments, offering deep insights into the factors influencing their food-related decisions. In addition, the study aims to develop a model that more accurately reflects reality by examining not only the food environments themselves but also the interactions among various stakeholders within these environments and their daily practices. The findings of this study will offer evidence-based insights to inform public policies tailored to the specific territories and communities under investigation or those with similar characteristics. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/62765.
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Affiliation(s)
| | | | | | - Daniel Egaña Rojas
- Department of Primary Care and Family Health, Universidad de Chile, Santiago, Chile
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Costa RM, Oliveira AG, Torres KG, Souza AM, Pereira GS, Bezerra IWL. Quantitative Assessment of the Inadequate Intake of Macronutrients, Minerals, and Vitamins Associated with Ultra-Processed Food Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:888. [PMID: 39063465 PMCID: PMC11276910 DOI: 10.3390/ijerph21070888] [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: 05/23/2024] [Revised: 06/27/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Studies indicate that ultra-processed food (UP) consumption correlates negatively with essential vitamin and mineral intake and positively with sodium and lipid intake. The objective of this study was to explore the relationship between UP consumption and deviations from nutritional guidelines. An observational, cross-sectional analytical study was conducted on a probability sample of manufacturing workers in the state of Rio Grande do Norte, Brazil. Food consumption was assessed with a 24 h recall survey, and nutrient intake inadequacies were calculated as the difference between individuals' intake of energy, macronutrients, minerals and vitamins, and the dietary reference intakes for individuals of the same sex and age group, and then analyzed for trends across the percentage contribution of UP to total energy intake with nonparametric multiple regression adjusted for covariates. The study included 921 workers from 33 industries, 55.9% male, with a mean age of 32 years. Overall, the study population exhibited deficits in energy, all macronutrients, and in some micronutrients. With increasing UP contribution to total energy intake, there is a trend towards a greater intake of energy (p < 0.001), total, saturated, monounsaturated, and trans fats (p < 0.001), n6-polyunsaturated fatty acids (p = 0.03), carbohydrates (p < 0.001), calcium (p = 0.008), and manganese (p < 0.001), thiamin (p < 0.001), and vitamin B6 (p = 0.01); however, this comes with a negative consequence in terms of reducing the protein consumption (p = 0.037), fiber (p = 0.035), copper (p = 0.033), and vitamin E (p = 0.002) intake. The results show that correcting energy and micronutrient deficiencies by increasing UP consumption can also lead to a decrease in diet quality.
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Affiliation(s)
- Raiane M. Costa
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Antonio G. Oliveira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
- Pharmacy Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Karina G. Torres
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Anissa M. Souza
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Gabriela S. Pereira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Ingrid W. L. Bezerra
- Nutrition Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Aljahdali AA, Rossato SL, Baylin A. Ultra-processed foods consumption among a USA representative sample of middle-older adults: a cross-sectional analysis. Br J Nutr 2024; 131:1461-1472. [PMID: 38174358 PMCID: PMC10950447 DOI: 10.1017/s0007114523003033] [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: 08/11/2023] [Revised: 11/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
The study evaluated the association between ultra-processed foods (UPF) and nutrient intake and identified the socio-demographic characteristics associated with UPF consumption among a nationally representative sample of middle-older adults. Dietary assessment was collected in 2013 using a validated FFQ. The Nova system was used to classify food and drinks into UPF. The percentage of dietary energy from UPF was calculated and used throughout the analyses, and average nutrient intake across quintiles of UPF was evaluated. The determinants associated with the dietary caloric contribution of UPF intake were investigated using linear regression models. A cross-sectional analysis of a nationally representative study of Americans over the age of 50, the Health and Retirement Study, was conducted. The analysis included 6220 participants. The mean age was 65 (se 0·28) years, with 55 % being female. UPF intake accounted for 51 % (se 0·25) of total intake. An increase in the percentage of (%UPF) consumption was correlated with an increase in calories, carbohydrates, saturated fat and sugar, and a decrease in fibre, vitamins and minerals. %UPF intake was inversely associated with being Hispanic, higher income, physical activity, vegetarian diet and Mediterranean diet but positively associated with very low food insecurity. UPF represented half of the calories consumed. A higher %UPF intake was associated with a lower nutrient profile, suggesting decreasing %UPF intake as a strategy to improve the nutritional quality of middle-older adults. A few socio-demographic factors were associated with %UPF, which would help in planning strategies to reduce UPF consumption.
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Affiliation(s)
- Abeer Ali Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Global Public Health, University of Michigan, Ann Arbor, MI, USA
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Vlassopoulos A, Katidi A, Noutsos S, Kapsokefalou M. Precision Food Composition Data as a Tool to Decipher the Riddle of Ultra-Processed Foods and Nutritional Quality. Foods 2024; 13:1259. [PMID: 38672931 PMCID: PMC11049098 DOI: 10.3390/foods13081259] [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: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Epidemiology supports a link between ultra-processed foods (UPFs) and health, mediated mainly through the clustering of foods with suboptimal nutrient profiles within UPFs. However, successful NOVA categorization requires access to a food's ingredient list, which we hypothesized can impact both UPF identification and the link between processing and composition. METHODS Foods (n = 4851) in the HelTH branded food composition database were classified as NOVA1-4, with or without using the ingredient lists (generic and branded approach, respectively), to identify differences in NOVA classification (chi-square test) and the estimated average nutritional composition of each NOVA group (Kruskal-Willis U test). RESULTS Using the ingredients list increased UPF identification by 30%. More than 30% of foods commonly assumed to be minimally processed (NOVA1-plain dairy, frozen vegetables, etc.) were reclassified as UPFs when using ingredient lists. These reclassified foods, however, had nutritional compositions comparable to NOVA1 foods and better than UPFs for energy, fat, sugars, and sodium (p < 0.001). In fact, UPFs did not show a uniform nutritional composition covering foods from Nutri-Score A (~10%) to Nutri-Score E (~20%). CONCLUSIONS The assumption that all UPFs have the same unfavorable nutritional composition is challenged when NOVA is applied using the appropriate branded food composition database.
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Affiliation(s)
- Antonis Vlassopoulos
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (A.K.); (S.N.); (M.K.)
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Sekyi E, Agyapong NAF, Eshun G. Food consumption by NOVA food classification, metabolic outcomes, and barriers to healthy food consumption among university students. Food Sci Nutr 2024; 12:1983-1994. [PMID: 38455168 PMCID: PMC10916562 DOI: 10.1002/fsn3.3894] [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: 03/17/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 03/09/2024] Open
Abstract
The NOVA food classification system is a simple tool that can be used to assess the consumption levels of different categories of foods based on their level of processing. The degree to which food is processed has a significant impact on health outcomes. In Ghana, no study exists on the consumption of the different NOVA food groups among tertiary students and how it relates to their metabolic outcomes. This study assessed the frequency of food intake according to the NOVA classification and how they relate to body mass index, waist circumference, and blood pressure. The barriers to the consumption of healthy foods among students were also assessed. This was a cross-sectional study conducted among 352 students of the Takoradi Technical University. Questionnaire was used to obtain sociodemographic information as well as data on perceived barriers to healthy food consumption. Food frequency questionnaire was used to obtain data on dietary intake. The weight, height, waist circumference, waist-to-hip ratio, and blood pressure of all participants were measured. Chi-square was used to compare categorical variables between males and females and to determine the association between the frequency of food intake according to the NOVA classification and metabolic indicators. The prevalence of overweight and obesity was 23.8%. More than half (51.1%) of the students had elevated blood pressure. The majority of study participants (54.2%) had a high frequency of consumption of both unprocessed and ultra-processed foods. Male students who frequently consumed ultra-processed foods (1-6 times/day) had significantly high blood pressure. High consumption of both ultra-processed and unprocessed foods was also associated with elevated blood pressure among male students. Limited time to prepare healthy meals and the high cost of unprocessed foods were among barriers to which most students strongly agreed to. Establishment of canteens that provide affordable healthy foods, teaching students time management, and nutrition education can mitigate barriers to healthy food consumption.
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Affiliation(s)
- Elizabeth Sekyi
- Department of Hospitality ManagementTakoradi Technical UniversityTakoradiGhana
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Guy Eshun
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
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Kébé SD, Diouf A, Sylla PMDD, Kane K, Dos Santos Costa C, Leite FHM, Andrade GC, Badiane A, Moubarac JC, Idohou-Dossou N, Monteiro CA. Assessment of ultra processed foods consumption in Senegal: validation of the Nova-UPF screener. Arch Public Health 2024; 82:4. [PMID: 38200567 PMCID: PMC10777632 DOI: 10.1186/s13690-024-01239-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Ultra-processed foods (UPF), as proposed by the Nova food classification system, are linked to the development of obesity and several non-communicable chronic diseases and deaths from all causes. The Nova-UPF screener developed in Brazil is a simple and quick tool to assess and monitor the consumption of these food products. The aim of this study was to adapt and validate, against the 24-hour dietary recall, this short food-based screener to assess UPF consumption in the Senegalese context. METHODS The tool adaptation was undertaken using DELPHI methodology with national experts and data from a food market survey. Following the adaptation, sub-categories were renamed, restructured and new ones introduced. The validation study was conducted in the urban area of Dakar in a convenience sample of 301 adults, using as a reference the dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake obtained via 24-hour recall. Association between the Nova-UPF score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants' classification according to quintiles of Nova-UPF score and quintiles of the dietary share of UPF. RESULTS The results show a linear and positive association (p-value < 0.001) between intervals of the Nova-UPF score and the average dietary share of UPF. There was a near perfect agreement in the distribution of individuals according to score's quintiles and UPF dietary share quintiles (Pabak index = 0.84). CONCLUSION The study concluded that the score provided by the Nova-UPF screener adapted to the Senegalese context is a valid estimate of UPF consumption.
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Affiliation(s)
- Saliou Diombo Kébé
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal.
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Papa Mamadou Dit Doudou Sylla
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
- Laboratoire des sciences Biologiques, Agronomiques, Alimentaires et de Modélisation des Systèmes complexes, Université Gaston Berger, Saint-Louis, Sénégal
| | - Kalidou Kane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Caroline Dos Santos Costa
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Fernanda Helena Marrocos Leite
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Abdou Badiane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | | | - Nicole Idohou-Dossou
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Carlos Augusto Monteiro
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
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Cordova R, Viallon V, Fontvieille E, Peruchet-Noray L, Jansana A, Wagner KH, Kyrø C, Tjønneland A, Katzke V, Bajracharya R, Schulze MB, Masala G, Sieri S, Panico S, Ricceri F, Tumino R, Boer JM, Verschuren W, van der Schouw YT, Jakszyn P, Redondo-Sánchez D, Amiano P, Huerta JM, Guevara M, Borné Y, Sonestedt E, Tsilidis KK, Millett C, Heath AK, Aglago EK, Aune D, Gunter MJ, Ferrari P, Huybrechts I, Freisling H. Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100771. [PMID: 38115963 PMCID: PMC10730313 DOI: 10.1016/j.lanepe.2023.100771] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/21/2023]
Abstract
Background It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes. Methods This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases. Findings After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk. Interpretation Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity. Funding Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
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Affiliation(s)
- Reynalda Cordova
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Vivian Viallon
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Emma Fontvieille
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Anna Jansana
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Cecilie Kyrø
- Danish Cancer Institute Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Institute Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rashmita Bajracharya
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS Ragusa, Italy
| | - Jolanda M.A. Boer
- Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - W.M.Monique Verschuren
- Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Daniel Redondo-Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada 18011, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada 18012, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Amiano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Bio Gipuzkoa Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - José María Huerta
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council-IMIB, Murcia, Spain
| | - Marcela Guevara
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, Pamplona 31003, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona 31008, Spain
| | - Yan Borné
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, The Faculty of Medicine, Lund University, Malmö, Sweden
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, The Faculty of Medicine, Lund University, Malmö, Sweden
| | - Konstantinos K. Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Elom K. Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
| | - Marc J. Gunter
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
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Cremonini ACP, Ferreira JRS, Martins CA, do Prado CB, Petarli GB, Cattafesta M, Salaroli LB. Metabolic Syndrome and Associated Factors in Farmers in Southeastern Brazil: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6328. [PMID: 37510560 PMCID: PMC10379224 DOI: 10.3390/ijerph20146328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Metabolic syndrome is a strong predictor of cardiovascular disease thus the objective of the study was to verify the prevalence of metabolic syndrome in farmers, as well as to verify the association with sociodemographic, work and lifestyle factors. (2) Methods: Cross-sectional, observational study, conducted with 790 individuals. For the diagnosis of metabolic syndrome, the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria were used. Pearson's chi-square test and binary logistic regression were used to verify factors associated with metabolic syndrome (3) Results: The prevalence of MS according to the IDF criteria was 16.3% overall, with 9.7% of women (95% CI: 6.66-16.16) and 6.6% of men (95% CI: 5.17-11.97). According to the NCEP/ATP III criterion, it was 12.3% overall, with 7.5% corresponding to women (95% CI: 6.62-13.13) and 4.8% to men (95% CI: 3.5-8.70). With regard to the conditions that make up metabolic syndrome, it was found that high density lipoprotein, high blood pressure and high waist circumference were the most prevalent. (4) Conclusions: The prevalence of metabolic syndrome is considerable in the population when compared to other regions, both rural and urban, in Brazil.
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Affiliation(s)
| | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Cleodice Alves Martins
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Glenda Blaser Petarli
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Monica Cattafesta
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
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do Prado CB, Martins CA, Cremonini ACP, Ferreira JRS, Cattafesta M, Almeida-de-Souza J, Zandonade E, Bezerra OMDPA, Salaroli LB. Cut Points of the Conicity Index and Associated Factors in Brazilian Rural Workers. Nutrients 2022; 14:4487. [PMID: 36364746 PMCID: PMC9654182 DOI: 10.3390/nu14214487] [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: 10/06/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of metabolic syndrome and to associate it with characteristic sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: A cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cut-off points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p < 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 h a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity, while the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers. Therefore, there is a need to improve eating habits and promote healthier eating environments for individuals, respecting traditional food culture, mainly to contain the advance of MS in rural areas.
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Affiliation(s)
- Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Cleodice Alves Martins
- Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | | | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Monica Cattafesta
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Juliana Almeida-de-Souza
- Centro de Investigação de Montanha (CIMO), Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-25 Bragança, Portugal
| | - Eliana Zandonade
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Olívia Maria de Paula Alves Bezerra
- Departament of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Collective Health and Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil;
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Mota BG, Barp M, Guimarães RA, Rosso CFW, Rocha BS, Nunes CADB, Pagotto V. Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220016. [PMID: 35830064 DOI: 10.1590/1980-549720220016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities. METHODS Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables. RESULTS Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community. CONCLUSION The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.
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Affiliation(s)
- Brenda Godoi Mota
- Universidade Federal de Goiás, School of Nursing - Goiânia (GO), Brazil
| | - Milara Barp
- Universidade Federal de Goiás, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
| | - Rafael Alves Guimarães
- Universidade Federal de Goiás, School of Nursing, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
| | | | | | | | - Valéria Pagotto
- Universidade Federal de Goiás, School of Nursing, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
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Cattafesta M, Petarli GB, Zandonade E, Bezerra OMDPA, de Abreu SMR, Salaroli LB. Prevalence and determinants of obesity and abdominal obesity among rural workers in Southeastern Brazil. PLoS One 2022; 17:e0270233. [PMID: 35797372 PMCID: PMC9262245 DOI: 10.1371/journal.pone.0270233] [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: 09/09/2021] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.
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Affiliation(s)
- Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | - Glenda Blaser Petarli
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | - Eliana Zandonade
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | | | - Sandra Marlene Ribeiro de Abreu
- Research Center in Physical Activity, Health and Leisure (CIAFEL) of Faculty of Sports-University of Porto (FADEUP), Laboratory for Integrative and Translational Research in Population Health (ITR), and Faculty of Sports, Research Center on Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
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Mota BG, Barp M, Guimarães RA, Rosso CFW, Rocha BS, Nunes CADB, Pagotto V. Prevalência de diabetes mellitus autorreferido e fatores associados em população rural e tradicional de Goiás: estudo transversal. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220016.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Identificar a prevalência e os fatores associados ao diabetes mellitus em comunidades rurais. Métodos: Estudo transversal desenvolvido em 115 comunidades rurais distribuídas em 45 municípios do Estado de Goiás, sendo: 13 ribeirinhas, 51 quilombolas e 63 assentamentos de reforma agrária. Realizou-se amostragem probabilística, e os participantes foram selecionados de forma aleatória. A variável desfecho foi diabetes mellitus autorreferido, enquanto as de exposição foram sociodemográficas, estilo de vida, condições de saúde e acesso a serviços de saúde. Utilizou-se regressão múltipla para verificar a associação entre variáveis de estudo. Resultados: Entre os 2.537 participantes, a prevalência geral de diabetes foi de 9,8%, sendo 13,5% nos ribeirinhos, 10,0% nos quilombolas e 9,3% nos assentados. Os fatores associados ao diabetes foram a autopercepção negativa de saúde, ser ex-fumante, hipertensão arterial, hipercolesterolemia e residir em comunidade ribeirinha. Conclusão: Os resultados reforçam a necessidade de fortalecer estratégias para prevenção e controle da diabetes e suas complicações em populações rurais, especialmente entre os ribeirinhos.
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Martini D, Godos J, Bonaccio M, Vitaglione P, Grosso G. Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples. Nutrients 2021; 13:3390. [PMID: 34684391 PMCID: PMC8538030 DOI: 10.3390/nu13103390] [Citation(s) in RCA: 218] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 02/08/2023] Open
Abstract
Excessive consumption of ultra-processed foods (UPFs), as described by the NOVA classification system, represents a potential threat to human health. The nutritional composition of UPFs may explain their observed adverse effects. The present study aimed to provide a quantitative meta-analysis of nationally representative surveys on the consumption of UPFs and the dietary/nutrient composition of respondents' diets. A systematic search for relevant studies published prior to July 2021 was conducted via electronic databases. The studies that provided the dietary/nutrient composition of foods categorized according to the NOVA classification system were selected. The association between UPFs and other dietary variables was modelled using ordinary least squares linear regression based on aggregated data extracted from the selected articles. Consumption of UPFs represented up to 80% of total caloric intake in the US and Canada, with confectionery and sugar-sweetened beverages being the most consumed items. When considered in relation to other food groups, an inverse linear relation between UPFs and less-processed foods was evident. Increased UPF intake correlated with an increase in free sugars, total fats, and saturated fats, as well as a decrease in fiber, protein, potassium, zinc, and magnesium, and vitamins A, C, D, E, B12, and niacin. In conclusion, the data indicate that increased UPF consumption negatively affects the nutritional quality of diets.
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Affiliation(s)
- Daniela Martini
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, 20133 Milan, Italy;
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy;
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy;
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
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Marino M, Puppo F, Del Bo’ C, Vinelli V, Riso P, Porrini M, Martini D. A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms. Nutrients 2021; 13:2778. [PMID: 34444936 PMCID: PMC8398521 DOI: 10.3390/nu13082778] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 02/06/2023] Open
Abstract
A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.
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Affiliation(s)
| | | | - Cristian Del Bo’
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20123 Milan, Italy; (M.M.); (F.P.); (V.V.); (P.R.); (M.P.); (D.M.)
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Ferreira de Almeida TL, Petarli GB, Cattafesta M, Zandonade E, Bezerra OMDPA, Tristão KG, Salaroli LB. Association of Selenium Intake and Development of Depression in Brazilian Farmers. Front Nutr 2021; 8:671377. [PMID: 34095192 PMCID: PMC8173156 DOI: 10.3389/fnut.2021.671377] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/14/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: Depression and deficiency in the consumption of micronutrients are a public health problem, especially in the rural population. The deficiency in selenium consumption affects mental health, contributing to the development of major depressive disorders. Thus, this study aimed to evaluate selenium intake and its association with depressive symptoms in farmers in southeastern Brazil. Material and Methods: Epidemiological, cross-sectional, and analytical study with 736 farmers aged between 18 and 59. A semistructured questionnaire was used to collect sociodemographic, lifestyle and clinical condition data. For evaluation of food intake, three 24-h recalls were applied, and for identification of depressive episodes, the Mini-International Neuropsychiatric Interview was conducted. Results: A total of 16.1% (n = 119) of the farmers presented symptoms of major depressive episodes, 5.8% (n = 43) presented symptoms of current depressive episodes, and 10.3% (n = 76) presented symptoms of recurrent major depressive episodes. Sociodemographic factors associated with depression were gender (p < 0.001), marital status (p = 0.004), and socioeconomic class (p = 0.015). The consumption of high doses of selenium was associated with a reduction of ~54% in the chances of occurrence of depression (OR = 0.461; 95% CI = 0.236-0.901). Conclusion: High selenium intake is associated with a lower prevalence of depression even after adjusting for sociodemographic variables, lifestyle, and pesticide intoxication. The findings of this study contributed to highlighting the high prevalence of depression in rural areas and its relationship with selenium intake.
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Affiliation(s)
| | - Glenda Blaser Petarli
- Clinical Nutrition Unit of the Cassiano Antonio Moraes Hospital (HUCAM) of the Federal University of Espírito Santo, Vitória, Brazil
| | - Monica Cattafesta
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Eliana Zandonade
- Department of Statistics and the Graduate Program in Collective Health at the Federal University of Espírito Santo, Vitória, Brazil
| | | | | | - Luciane Bresciani Salaroli
- Department of Integrated Health Education, Postgraduate Program in Nutrition and Health, Postgraduate Program in Collective Health of the Federal University of Espírito Santo, Vitória, Brazil
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