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Impact of the consumption of ultra-processed foods on children, adolescents and adults' health: scope review.
Louzada, MLDC, Costa, CDS, Souza, TN, Cruz, GLD, Levy, RB, Monteiro, CA
Cadernos de saude publica. 2022;(suppl 1):e00323020
Abstract
The aim of this study was to conduct a literature scope review of the association between the consumption of ultra-processed foods and health outcomes. The search was carried out in the PubMed, Web of Science and LILACS databases. Studies that assessed the association between the consumption of ultra-processed foods, identified on the NOVA classification, and health outcomes were eligible. The review process resulted in the selection of 63 studies, which were analyzed in terms of quality using a tool from the National Institutes of Health. The outcomes found included obesity, metabolic risk markers, diabetes, cardiovascular diseases, cancer, asthma, depression, frailty, gastrointestinal diseases and mortality indicators. The evidence was particularly consistent for obesity (or indicators related to it) in adults, whose association with the consumption of ultra-processed foods was demonstrated, with dose-response effect, in cross-sectional studies with representative samples from five countries, in four large cohort studies and in a randomized clinical trial. Large cohort studies have also found a significant association between the consumption of ultra-processed foods and the risk of cardiovascular diseases, diabetes and cancer - even after adjusting for obesity. Two cohort studies have shown an association of ultra-processed foods consumption with depression and four cohort studies with all-cause mortality. This review summarized the studies' results that described the association between the consumption of ultra-processed foods and various non-communicable diseases and their risk factors, which has important implications for public health.
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2.
Brazilian obesity prevention and control initiatives.
Jaime, PC, da Silva, AC, Gentil, PC, Claro, RM, Monteiro, CA
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2013;:88-95
Abstract
Obesity prevalence in the Brazilian adult population is 12.5% among men and 16.9% among women. Obesity control has been a subject of concern in Brazilian health policies since the publication of the National Food and Nutrition Policy in 1999. The initiatives include a comprehensive national intersectorial plan for obesity prevention and control focused on confronting its social and environmental causes, development of a food and nutrition education framework aimed at intersectorial public policies in the food and nutritional security field, promotion and provision of healthy food in school environments (linked to family farming), structuring nutrition actions in primary healthcare in the national healthcare system, promoting community physical activity, food regulation and control, and encouragement of public participation and food control. We conclude that several initiatives have been developed in Brazil to deal with the challenge of implementing an intergovernmental, intersectorial response to reverse the rising overweight and obesity rates. The success of this response will depend on a governance model that promotes joint and integrated action by different sectors and active participation of society to consolidate the actions, places and laws that protect health and promote healthy lifestyles.
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3.
Ultra-processed products are becoming dominant in the global food system.
Monteiro, CA, Moubarac, JC, Cannon, G, Ng, SW, Popkin, B
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2013;:21-8
Abstract
The relationship between the global food system and the worldwide rapid increase of obesity and related diseases is not yet well understood. A reason is that the full impact of industrialized food processing on dietary patterns, including the environments of eating and drinking, remains overlooked and underestimated. Many forms of food processing are beneficial. But what is identified and defined here as ultra-processing, a type of process that has become increasingly dominant, at first in high-income countries, and now in middle-income countries, creates attractive, hyper-palatable, cheap, ready-to-consume food products that are characteristically energy-dense, fatty, sugary or salty and generally obesogenic. In this study, the scale of change in purchase and sales of ultra-processed products is examined and the context and implications are discussed. Data come from 79 high- and middle-income countries, with special attention to Canada and Brazil. Results show that ultra-processed products dominate the food supplies of high-income countries, and that their consumption is now rapidly increasing in middle-income countries. It is proposed here that the main driving force now shaping the global food system is transnational food manufacturing, retailing and fast food service corporations whose businesses are based on very profitable, heavily promoted ultra-processed products, many in snack form.
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4.
[Sodium intake and metabolic syndrome: a systematic review].
Sarno, F, Jaime, PC, Ferreira, SR, Monteiro, CA
Arquivos brasileiros de endocrinologia e metabologia. 2009;(5):608-16
Abstract
Recent studies have shown that sodium intake restrictions may increase insulin resistance (IR) and induce changes on serum lipoproteins and on inflammation markers that are similar to those found in metabolic syndrome (MS). We performed a systematic review of literature regarding the effects of restricting sodium intake on MS or on IR. Nine articles were included in the review. Restriction of sodium consumption was associated with increase insulin resistance in two articles and with decrease in three others. In seven of nine articles, salt intake restriction determined blood pressure reduction, and in two articles adverse effects on markers of MS were found. Most studies showed beneficial effects of moderate sodium intake restriction, associated or not to others nutritional modifications or increased physical activity. Further studies are needed to evaluate the effects of moderate sodium consumption reductions on MS and IR.
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5.
Socioeconomic status and obesity in adult populations of developing countries: a review.
Monteiro, CA, Moura, EC, Conde, WL, Popkin, BM
Bulletin of the World Health Organization. 2004;(12):940-6
Abstract
A landmark review of studies published prior to 1989 on socioeconomic status (SES) and obesity supported the view that obesity in the developing world would be essentially a disease of the socioeconomic elite. The present review, on studies conducted in adult populations from developing countries, published between 1989 and 2003, shows a different scenario for the relationship between SES and obesity. Although more studies are necessary to clarify the exact nature of this relationship, particularly among men, three main conclusions emerge from the studies reviewed: 1. Obesity in the developing world can no longer be considered solely a disease of groups with higher SES. 2. The burden of obesity in each developing country tends to shift towards the groups with lower SES as the country's gross national product (GNP) increases. 3. The shift of obesity towards women with low SES apparently occurs at an earlier stage of economic development than it does for men. The crossover to higher rates of obesity among women of low SES is found at a GNP per capita of about US$ 2500, the mid-point value for lower-middle-income economies. The results of this review reinforce the urgent need to: include obesity prevention as a relevant topic on the public health agenda in developing countries; improve the access of all social classes in these countries to reliable information on the determinants and consequences of obesity; and design and implement consistent public actions on the physical, economic, and sociocultural environment that make healthier choices concerning diet and physical activity feasible for all. A significant step in this direction was taken with the approval of the Global Strategy on Diet, Physical Activity and Health by the World Health Assembly in May 2004.
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6.
The challenge of improving food and nutrition in Latin America.
Uauy, R, Monteiro, CA
Food and nutrition bulletin. 2004;(2):175-82
Abstract
The Latin American Region has exhibited a marked increase in the consumption of high-energy-density foods (high in fats and sugars) and a decrease in physical activity, with rising trends of sedentary life among the urban population. Social and economic progress led to a decline in infectious diseases, while higher income fostered the consumption of meats, fats and oils, and sugar and reduced the consumption of grains and legumes. The result has been a gradual increase in life expectancy at birth and a greater burden of disease linked to obesity and other nutrition-related chronic diseases (diabetes, cardiovascular disease, certain types of cancer, and osteoporosis). The region is currently facing the challenge of a double disease burden--the unresolved problem of malnutrition caused by nutritional deficits on the one hand, and the steady increase in chronic disease on the other. The need to develop policies and programs that make the healthy choice the easy choice in terms of diet and physical activity is presented. These should encompass not only individual choices, but also environmental factors that condition food and physical activity behavior. Food supply, and hence consumption, is largely driven by the productivity of the food-production chain; demand and consumption are determined by the way food is produced, processed, distributed, marketed, and advertised. These factors are beyond the consumer's control, and they operate to maximize profit, not health. Public health policies should focus not only on the demand side, but also on the supply of more healthful food products. Examples of potential interventions to increase the demand for healthful foods and the supply of healthier choices are presented and discussed.