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

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

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

PARTICIPANTS/SETTING

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

MAIN OUTCOME MEASURES

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

STATISTICAL ANALYSIS

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

RESULTS

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

CONCLUSIONS

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

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

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