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Consumption of ultra-processed foods and health status: a systematic review and meta-analysis.
Pagliai, G, Dinu, M, Madarena, MP, Bonaccio, M, Iacoviello, L, Sofi, F
The British journal of nutrition. 2021;125(3):308-318
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Ultra-processed foods (UPF) are, according to the NOVA classification, “formulations of ingredients, mostly for industrial use only, derived from a series of industrial processes”. UPF represents an important and growing part of the world’s food supply. The aim of this study was to assess the relationship between UPF consumption as defined by NOVA and health status. This study is systematic review with meta-analysis of all the cross-sectional and cohort studies published to-date. At the end of the selection process, twenty-three articles were included in the qualitative analysis and nineteen in the quantitative analysis. Results indicate the possible association between high UPF consumption, worse cardiometabolic risk profile (reported by an increased risk of overweight/obesity, elevated waist circumference, reduced high-density lipoprotein-cholesterol levels and increased risk of the metabolic syndrome), and greater risk of all-cause mortality, cardiovascular disease, cerebrovascular disease and depression. Authors conclude that their findings have important public health implications, especially for food policymakers who should discourage the consumption of UPF and promote fresh and minimally processed foods to improve health status.
Abstract
Increasing evidence suggests that high consumption of ultra-processed foods (UPF) is associated with an increase in non-communicable diseases, overweight and obesity. The present study systematically reviewed all observational studies that investigated the association between UPF consumption and health status. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science and Google Scholar was conducted, and reference lists of included articles were checked. Only cross-sectional and prospective cohort studies were included. At the end of the selection process, twenty-three studies (ten cross-sectional and thirteen prospective cohort studies) were included in the systematic review. As regards the cross-sectional studies, the highest UPF consumption was associated with a significant increase in the risk of overweight/obesity (+39 %), high waist circumference (+39 %), low HDL-cholesterol levels (+102 %) and the metabolic syndrome (+79 %), while no significant associations with hypertension, hyperglycaemia or hypertriacylglycerolaemia were observed. For prospective cohort studies evaluating a total population of 183 491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies (risk ratio (RR) 1·25, 95 % CI 1·14, 1·37; P < 0·00001), increased risk of CVD in three studies (RR 1·29, 95 % CI 1·12, 1·48; P = 0·0003), cerebrovascular disease in two studies (RR 1·34, 95 % CI 1·07, 1·68; P = 0·01) and depression in two studies (RR 1·20, 95 % CI 1·03, 1·40; P = 0·02). In conclusion, increased UPF consumption was associated, although in a limited number of studies, with a worse cardiometabolic risk profile and a higher risk of CVD, cerebrovascular disease, depression and all-cause mortality.
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Sugar- and Artificially Sweetened Beverages Consumption Linked to Type 2 Diabetes, Cardiovascular Diseases, and All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.
Meng, Y, Li, S, Khan, J, Dai, Z, Li, C, Hu, X, Shen, Q, Xue, Y
Nutrients. 2021;13(8)
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Sugary drinks and excess dietary sugars have been related to the development of many non- communicable diseases such as obesity, heart disease and type 2 diabetes (T2D). Drinks with added sweeteners as a replacement for sugar are often regarded as a healthier alternative, however the exact effect on many non-communicable diseases is unknown. This systematic review and meta-analysis of 17 cohort studies assessed the effect of sugary drinks and artificially sweetened beverages (ASB’s) on the risk of death, T2D, and heart disease. The results showed that the consumption of sugary drinks and ASB’s increased the risk of developing T2D, heart disease and death from any cause. It was concluded that long-term consumption of ASB’s and sugary drinks will have detrimental health effects. Reasons for the increased risk of T2D, heart disease and death by any cause following consumption of ASB’s still remains unclear. However relationships between poor health outcomes and sugary drinks may be due to many different mechanisms such as increased blood sugar levels encouraging obesity and an increase in blood pressure following consumption. Healthcare professionals could use this paper to recommend a diet without ASB’s and sugary drinks to prevent the development of these non-communicable diseases.
Abstract
Although studies have examined the association between habitual consumption of sugar- (SSBs) and artificially sweetened beverages (ASBs) and health outcomes, the results are inconclusive. Here, we conducted a dose-response meta-analysis of prospective cohort studies in order to summarize the relationship between SSBs and ASBs consumption and risk of type 2 diabetes (T2D), cardiovascular diseases (CVDs), and all-cause mortality. All relevant articles were systematically searched in PubMed, Embase, and Ovid databases until 20 June 2020. Thirty-four studies met the inclusion criteria and were eligible for analysis. Summary relative risks (RRs) and 95% confidence intervals (95% CI) were estimated using random effects or fixed-effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships. With each additional SSB and ASB serving per day, the risk increased by 27% (RR: 1.27, 95%CI: 1.15-1.41, I2 = 80.8%) and 13% (95%CI: 1.03-1.25, I2 = 78.7%) for T2D, 9% (RR: 1.09, 95%CI: 1.07-1.12, I2 = 42.7%) and 8% (RR: 1.08, 95%CI: 1.04-1.11, I2 = 45.5%) for CVDs, and 10% (RR: 1.10, 95%CI: 0.97-1.26, I2 = 86.3%) and 7% (RR: 1.07, 95%CI: 0.91-1.25, I2 = 76.9%) for all-cause mortality. Linear relationships were found for SSBs with T2D and CVDs. Non-linear relationships were found for ASBs with T2D, CVDs, and all-cause mortality and for SSBs with all-cause mortality. The findings from the current meta-analysis indicate that increased consumption of SSBs and ASBs is associated with the risk of T2D, CVDs, and all-cause mortality.