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Ultra-processed Foods and Drinks - NED Infobite
BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
2024
Abstract
Ultra-processed foods and drinks (UPF) are mostly or entirely lacking in whole foods and fibre and are often high is salt, fat, sugars and chemical additives. Regular consumption of these foods and drinks has been associated with obesity and metabolic dysregulation. This NED Infobite includes articles on childhood health impacts of UPF consumption and associations between UPFs and Type 2 diabetes, hypertension and low-grade inflammation.
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How did ultra-processed foods take over, and what are they doing to us
The Guardian Media Group is a global news organisation that delivers fearless, investigative journalism, free from political and commercial influence. Science Weekly is their bi-weekly podcast bringing us the latest science and environment news.
2023
Abstract
Dr Chris van Tulleken provides a fascinating insight into the history of ultra-processed food (UPF), how they are made, why they are so addictive, how they have become a major part of our diets and the impact they are having on the global obesity crisis. Having experimented himself with an 80% UPF diet for a month he knows first-hand the detrimental impact that these foods had on his health and eating habits. Key drivers for increased UPF consumption are thought to be largely attributed to marketing, poverty and inequality.
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A Systematic Review on Processed/Ultra-Processed Foods and Arterial Hypertension in Adults and Older People.
Barbosa, SS, Sousa, LCM, de Oliveira Silva, DF, Pimentel, JB, Evangelista, KCMS, Lyra, CO, Lopes, MMGD, Lima, SCVC
Nutrients. 2022;14(6)
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The NOVA system is a way of classifying the level of processing a food has undergone; ranging from un-processed to ultra-processed. Ultra-processed foods (UPFs) are nutritionally imbalanced and are often highly calorific. Processed foods (PFs) are the next level down from UPFs and usually have added salt or sugar. Both foods pose a potential health-risk if eaten in excess, with high blood pressure being a potential resulting disease. This systematic review and meta-analysis aimed to determine the relationship between the consumption of PFs and UPFs and high blood pressure in adults. The results showed that as the consumption of UPFs increased, so did the risk for high blood pressure, however this relationship was not seen with the consumption of PFs. It was concluded that the high consumption of UPFs is associated with a greater risk of developing high blood pressure in adults and older people. This study could be used by healthcare professionals to recommend a diet without UPFs to those who are at risk of high blood pressure or in those who have already been diagnosed.
Abstract
The increase in the availability of processed and ultra-processed foods has altered the eating patterns of populations, and these foods constitute an exposure factor for the development of arterial hypertension. This systematic review analyzed evidence of the association between consumption of processed/ultra-processed foods and arterial hypertension in adults and older people. Electronic searches for relevant articles were performed in the PUBMED, EMBASE and LILACS databases. The review was conducted following the PRISMA guidelines and the Newcastle-Ottawa Scale. The search of the databases led to the retrieval of 2323 articles, eight of which were included in the review. A positive association was found between the consumption of ultra-processed foods and blood pressure/arterial hypertension, whereas insufficient evidence was found for the association between the consumption of processed foods and arterial hypertension. The results reveal the high consumption of ultra-processed foods in developed and middle-income countries, warning of the health risks of such foods, which have a high energy density and are rich in salt, sugar and fat. The findings underscore the urgent need for the adoption of measures that exert a positive impact on the quality of life of populations, especially those at greater risk, such as adults and older people.
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Consumption of industrial processed foods and risk of premenopausal breast cancer among Latin American women: the PRECAMA study.
Romieu, I, Khandpur, N, Katsikari, A, Biessy, C, Torres-Mejía, G, Ángeles-Llerenas, A, Alvarado-Cabrero, I, Sánchez, GI, Maldonado, ME, Porras, C, et al
BMJ nutrition, prevention & health. 2022;5(1):1-9
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Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. This is the first study on ultra-processed food and breast cancer in young women from Latin America. In Latin America around 27% of breast cancers occur between 20 and 45 years and this is increasing. This population is currently undergoing rapid lifestyle and nutritional changes switching from a varied traditional diet (including corn tortillas, corn flour cakes, beans and other legumes, soup, homemade stew, vegetable, whole fruit) towards a more homogenous diet rich in industrial ultra-processed foods. In this case control study, the association of ultra-processed food intake to breast cancer risk was evaluated. 525 cases were included (women aged 20–45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification. The results show an adverse effect of ultra-processed food intake on the risk of breast cancer in young Latin American women. Further studies are needed to confirm the results. Given the already proven chronic adverse health effects of ultra-processed foods, a decrease in these types of foods should be encouraged.
Abstract
Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. No data are available in the Latin American population although the consumption of ultra-processed foods is increasing rapidly in this region. We evaluated the association of ultra-processed food intake to breast cancer risk in a case-control study including 525 cases (women aged 20-45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification. Overall, the major contributors to ultra-processed food intake were ready-to-eat/heat foods (18.2%), cakes and desserts (16.7%), carbonated and industrial fruit juice beverages (16.7%), breakfast cereals (12.9%), sausages and reconstituted meat products (12.1%), industrial bread (6.1%), dairy products and derivatives (7.6%) and package savoury snacks (6.1%). Ultra-processed food intake was positively associated with the risk of breast cancer in adjusted models (OR T3-T1=1.93; 95% CI=1.11 to 3.35). Specifically, a higher risk was observed with oestrogen receptor positive breast cancer (ORT3-T1=2.44, (95% CI=1.01 to 5.90, P-trend=0.049), while no significant association was observed with oestrogen receptor negative breast cancer (ORT3-T1=1.87, 95% CI=0.43 to 8.13, P-trend=0.36). Our findings suggest that the consumption of ultra-processed foods might increase the risk of breast cancer in young women in Latin America. Further studies should confirm these findings and disentangle specific mechanisms relating ultra-processed food intake and carcinogenic processes in the breast.
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Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies.
Lane, MM, Gamage, E, Travica, N, Dissanayaka, T, Ashtree, DN, Gauci, S, Lotfaliany, M, O'Neil, A, Jacka, FN, Marx, W
Nutrients. 2022;14(13)
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Poor dietary quality is well established as a potentially modifiable risk factor for mental disorders. The NOVA food classification system was recently developed to enable the categorisation of food items based on distinctive levels of processing. The aim of this study was to synthesise and provide quantitative analyses of the most up-to-date evidence assessing associations between consumption of ultra-processed food, as defined by the NOVA food classification system, and mental disorders. This study is systematic review and meta-analysis of 17 studies with a total of 385,541 participants. The studies were 15 cross-sectional and 2 prospectively designed studies. Results show that ultra-processed food consumption is bidirectionally associated with adverse mental health. In fact, greater intake of ultra-processed food was associated with increased odds of depressive and anxiety symptoms, both when these outcomes were assessed together as well as separately. Authors conclude that further prospective and experimental studies are required to better determine directionality and causality and ensure that global preventative and treatment strategies are efficacious and appropriate.
Abstract
Since previous meta-analyses, which were limited only to depression and by a small number of studies available for inclusion at the time of publication, several additional studies have been published assessing the link between ultra-processed food consumption and depression as well as other mental disorders. We aimed to build on previously conducted reviews to synthesise and meta-analyse the contemporary evidence base and clarify the associations between the consumption of ultra-processed food and mental disorders. A total of 17 observational studies were included (n = 385,541); 15 cross-sectional and 2 prospective. Greater ultra-processed food consumption was cross-sectionally associated with increased odds of depressive and anxiety symptoms, both when these outcomes were assessed together (common mental disorder symptoms odds ratio: 1.53, 95%CI 1.43 to 1.63) as well as separately (depressive symptoms odds ratio: 1.44, 95%CI 1.14 to 1.82; and, anxiety symptoms odds ratio: 1.48, 95%CI 1.37 to 1.59). Furthermore, a meta-analysis of prospective studies demonstrated that greater ultra-processed food intake was associated with increased risk of subsequent depression (hazard ratio: 1.22, 95%CI 1.16 to 1.28). While we found evidence for associations between ultra-processed food consumption and adverse mental health, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.
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What is ultra-processed food and is it bad for your health?
Atlas Biomed is a personalised health company, their mission is to combine DNA and microbiome technology with digital health data to inspire people into positive lifestyle change and lead them to a healthier future. Their blog is created by a team of doctors, researchers and experts dedicated to demystifying human health.
2022
Abstract
This blog post from Atlas Biomed provides a simple but balanced overview of food processing, including what makes a food ultra-processed and how it impacts our health. A summary of the NOVA food classification system is provided along with its pros and cons. Ultra -processed food has been linked to obesity and increased risk of cardiovascular disease, but the article highlights that not all ultra-processed food need be shunned (think kimchi!)
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Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study.
Rocha, LL, Pessoa, MC, Gratão, LHA, Carmo, ASD, Cunha, CF, Oliveira, TRPR, Mendes, LL
PloS one. 2021;16(1):e0245203
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Sugar sweetened beverages (SSB) are ultra-processed foods containing several man-made chemicals, which heavily feature in the diets of adolescents in many developing countries. This cross-sectional study of 74,589 adolescents aimed to determine health behaviour patterns that affect SSB consumption to focus education and policy efforts to reduce consumption. The results showed that most adolescents who consumed SSB’s had higher consumption of processed foods, more screen time, more days of alcoholic beverage consumption, were more likely to purchase food from the school canteen, and a smoking habit. Those who had a higher consumption of water, minimally processed foods and frequent physical activity were less likely to consume SSB’s. It was concluded that healthy habits can aid implementation of other beneficial health behaviours. This study could be used by healthcare professionals to understand the importance of adopting healthy habits to decrease SSB and ultra-processed food consumption.
Abstract
Studies on sugar-sweetened beverage consumption patterns can help in the individual and population level management of chronic non-communicable diseases and other conditions. This study aimed to identify the association between health behavior patterns and the consumption of sugar-sweetened beverages among Brazilian adolescents from a nationally representative school-based study. A cross-sectional study analyzed data from 71,553 adolescents aged 12-17 years who attended public and private schools in Brazilian cities, from the Study of Cardiovascular Risk in Adolescents. Principal component analysis was performed to identify health behavior patterns, and ordered logistic regression was performed to identify the association between health behavior patterns and sugar-sweetened beverage consumption. Sugar-sweetened beverage consumption (mL/day) was used as the dependent variable. The analyses were performed using Stata software version 14.0 with a significance level of 0.05. Patterns 2 (alcoholic beverage and smoking habit) and 3 (ultra-processed food and screen time) of health behaviors and regularly purchasing snacks in the school cafeteria increased the odds of sugar-sweetened beverage consumption, while pattern 1 (water, unprocessed and minimally processed food and physical activity) decreased these odds. The adoption of healthy habits can indirectly stimulate the adoption of other habits beneficial to health. These results indicate the importance of adopting a set of regulatory measures to reduce sugar-sweetened beverage consumption.
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The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake, Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies.
Dicken, SJ, Batterham, RL
Nutrients. 2021;14(1)
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Diet has long been a cornerstone of weight management, with dietary policies being a core feature of government and health organisation strategies to reduce obesity worldwide. Indeed, poor diets are a leading cause of preventable obesity-related death and non-communicable diseases, including cancer, cardiovascular disease and type 2 diabetes. The aim of this study was to provide novel insights into the relative impact of nutrient content and dietary patterns vs. ultra-processing on obesity and adverse health-related outcomes. This study is a review of prospective cohort studies. Findings show that adjustment for fat, sugar and sodium intake, or adjustment for adherence to a range of healthy or unhealthy dietary patterns has a minimal impact on the adverse associations between UPF intake and a diverse range of health-related outcomes. Authors conclude that their findings raise important questions regarding current policy and future research needs, suggesting that the nature and extent of processing is an important dietary dimension.
Abstract
Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional quality, is debated. Higher UPF intakes are inversely associated with fruit, vegetables, legumes and seafood consumption. Therefore, the association between UPFs and poor health could simply be from excess nutrient intake or from a less healthful dietary pattern. If so, adjustment for dietary quality or pattern should explain or greatly reduce the size of the significant associations between UPFs and health-related outcomes. Here, we provide an overview of the literature and by using a novel approach, review the relative impact of adjusting for diet quality/patterns on the reported associations between UPF intake and health-related outcomes in prospective cohort studies. We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern. Our findings suggest that the adverse consequences of UPFs are independent of dietary quality or pattern, questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.
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Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis.
Moradi, S, Hojjati Kermani, MA, Bagheri, R, Mohammadi, H, Jayedi, A, Lane, MM, Asbaghi, O, Mehrabani, S, Suzuki, K
Nutrients. 2021;13(12)
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The growing incidence of chronic non-communicable diseases such as type two diabetes mellitus (T2DM) is the major healthcare concern worldwide. The aim of this study was to build on previous work by synthesizing the findings of observational studies investigating the association between ultra-processed food (UPF) intake and the risk of T2DM. This study is a systematic review and dose-response meta-analysis of five studies. Of the five included studies, four were prospective cohort study designs and the other was cross-sectional. Results demonstrate that higher UPF intake was associated with an increased risk of T2DM. Additionally, increasing the intake of processed foods by 10% leads to a 15% increase in the risk of T2DM. A linear positive association was found between UPF intake and the risk of T2DM. Authors conclude by pointing out that to be able to estimate better the actual burden of UPF intakes, new tools should be adapted or progressed to evaluate all UPF consumption dimensions, namely food class, UPF foods specific components, their effects on health and specific processes or additives.
Abstract
(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I2 = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I2 = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (pnonlinearity = 0.13, pdose-response < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.
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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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Plain language summary
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.