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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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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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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 Availability and Noncommunicable Diseases: A Systematic Review.
de Araújo, TP, de Moraes, MM, Magalhães, V, Afonso, C, Santos, C, Rodrigues, SSP
International journal of environmental research and public health. 2021;18(14)
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Ultra-processed foods (UPF) are described as “processed ingredients typically combined with the sophisticated use of additives to make them edible, palatable and habit forming.” The aim of this study was to compile and analyse studies that related UPF availability with mortality and morbidity from non-communicable diseases or their risk factors. This study is a systematic review of eleven studies. Of the 11 articles, six evaluated availability through purchase and five through sales of UPF. Results showed a positive association between UPF availability and increase of body mass index, overweight or obesity. Authors conclude that further exploration of available data is needed in order to assess the relationship between UPF and other health outcomes, such as incidence, prevalence and mortality from cardiovascular diseases, diabetes or cancer.
Abstract
Ultra-processed food (UPF) can be harmful to the population's health. To establish associations between UPF and health outcomes, food consumption can be assessed using availability data, such as purchase lists or household budget surveys. The aim of this systematic review was to search studies that related UPF availability with noncommunicable diseases or their risk factors. PRISMA guidelines were used. Searches were performed in PubMed, EBSCO, Scopus and Web of Science in February 2021. The search strategy included terms related to exposure (UPF) and outcomes (noncommunicable diseases and their risk factors). Studies that assessed only food consumption at an individual level and did not present health outcomes were excluded. Two reviewers conducted the selection process, and a third helped when disagreement occurred. The Newcastle-Ottawa Scale was used to assess the studies' quality; 998 records were analyzed. All 11 eligible studies were ecological and assessed overweight and obesity as a health outcome, only one showed no positive association with UPF availability. Two studies included the prevalence of diabetes as an outcome, however no significant association was found with UPF availability. Studies relating UPF availability and health outcomes are focused on overweight and obesity. It is necessary to further explore the relationship between other health outcomes and UPF availability using purchase or sales data.
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Effect of ultra-processed diet on gut microbiota and thus its role in neurodegenerative diseases.
Martínez Leo, EE, Segura Campos, MR
Nutrition (Burbank, Los Angeles County, Calif.). 2020;71:110609
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The consumption of ultra-processed foods has increased dramatically in recent years, resulting in an overconsumption of foods that are nutritionally only suitable to be consumed occasionally. Prolonged and short-term dietary modifications can affect the composition and diversity of the gut microbiota and in turn, dysregulation of the gut microbiota may be associated with diseases of the brain. This systematic review study aimed to determine the relationship between diets high in ultra-processed foods, gut microbiota dysregulation and how this may influence early development of brain diseases. The authors first reviewed literature surrounding the role of gut microbiota on health owing to their ability to produce signalling molecules that have various functions around the body. An imbalance in the gut microbiota can result in an overproduction of signalling molecules that contribute to an unhealthy state. These signalling molecules can also act on the brain through several ways such as the nervous, circulatory, and immune systems. The review demonstrates that high fat, high sugar diets are related to increased risk for diseases such as Alzheimer’s disease and that diets high in fibre, are related to a low incidence of brain disorders, but as very few studies have looked at this in relation to gut microbiota relationships are only speculative. It was concluded that gut microbiota dysregulation could act as a clinical indicator between brain diseases and ultra-processed foods, however further studies are needed on the relationship between diet, gut microbiota and brain diseases.
Abstract
The current dietary pattern is characterized by high consumption of ultra-processed foods and lower consumption of fiber and vegetables, environmental factors that are associated directly with the current incidence of chronic metabolic diseases. Diet is an environmental factor that influences the diversity and functionality of the gut microbiota, where dietary changes have a direct action on their homeostasis. The environment created in the gut by ultra-processed foods, a hallmark of the Western diet that are recognized as trigger factors for low-grade systemic inflammatory and oxidative changes, favor the development of neurodegenerative diseases (NDs). From a systematic search, the present review analyzes the relationship and effect of the current feeding pattern, with the dysregulation of the microbiota and its influence on the development of cognitive decline. Because diagnosis of NDs is usually at late stages, this review highlights the importance of a search for stricter public health strategies regarding access to and development of ultra-processed foods.
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Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies.
Chen, X, Zhang, Z, Yang, H, Qiu, P, Wang, H, Wang, F, Zhao, Q, Fang, J, Nie, J
Nutrition journal. 2020;19(1):86
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Unhealthy diets are recognized as a major determinant of the occurrence of non-communicable diseases (NCDs). The aim of this study was to summarize the evidence for the association between ultra-processed food (UPFs) consumption and health outcomes. This study is a systemic review of 20 published epidemiological studies (12 cohort and 8 cross-sectional studies), with a total of 334,114 participants and 10 diseases. Results indicate a positive association between UPFs consumption and risk of all-cause mortality, overall cardiovascular diseases, coronary heart diseases, cerebrovascular diseases, hypertension, metabolic syndrome, overweight and obesity, depression, irritable bowel syndrome, overall cancer, postmenopausal breast cancer, gestational obesity, adolescent asthma and wheezing, and frailty. However, on the contrary, there was not an obvious association with cardiovascular disease mortality, prostate and colorectal cancer, gestational diabetes mellitus and gestational overweight. Authors conclude that their findings encouraged a decrease in UPFs consumption and an increase in the proportion of unprocessed or minimally processed foods, such as fruits and vegetables.
Abstract
BACKGROUND Consumption of ultra-processed foods (UPFs) plays a potential role in the development of obesity and other diet-related noncommunicable diseases (NCDs), but no studies have systematically focused on this. This study aimed to summarize the evidence for the association between UPFs consumption and health outcomes. METHODS A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies. Epidemiological studies were included, and identified studies were evaluated for risk of bias.A narrative review of the synthesized findings was provided to assess the association between UPFs consumption and health outcomes. RESULTS 20 studies (12 cohort and 8 cross-sectional studies) were included in the analysis, with a total of 334,114 participants and 10 health outcomes. In a narrative review, high UPFs consumption was obviously associated with an increased risk of all-cause mortality, overall cardiovascular diseases, coronary heart diseases, cerebrovascular diseases, hypertension, metabolic syndrome, overweight and obesity, depression, irritable bowel syndrome, overall cancer, postmenopausal breast cancer, gestational obesity, adolescent asthma and wheezing, and frailty. It showed no significant association with cardiovascular disease mortality, prostate and colorectal cancers, gestational diabetes mellitus and gestational overweight. CONCLUSIONS This study indicated a positive association between UPFs consumption and risk of several health outcomes. Large-scale prospective designed studies are needed to confirm our findings.
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Inflammatory Bowel Diseases and Food Additives: To Add Fuel on the Flames!
Marion-Letellier, R, Amamou, A, Savoye, G, Ghosh, S
Nutrients. 2019;11(5)
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Inflammatory Bowel Diseases (IBDs), such as Crohn’s disease (CD) and Ulcerative Colitis (UC) are becoming increasingly common. Diet is thought to play a role in the development of IBDs. The consumption of Ultra Processed Food (UPF) is increasing and has been associated with a higher risk of some chronic diseases. Food additives may be an aspect of UPF responsible for its harmful effects. This literature review examined the role of food additives in the development and severity of IBDs. The authors discuss how common food additives such as salt, emulsifiers, stabilisers, bulking agents, sweeteners, and food colouring may promote inflammation and disrupt gut bacteria. Metals and compounds found in food packaging such as aluminium and bisphenol A (BPA) may trigger intestinal permeability and increase inflammatory markers. Much of the evidence available is based on clinical trials on animals, whilst epidemiological studies on food additives and IBD risk are still limited. The authors concluded that the majority of food consumed by IBD patients should be home-cooked in order to reduce exposure to additives in the diet.
Abstract
Inflammatory bowel diseases (IBDs) develop in genetically predisposed individuals in response to environmental factors. IBDs are concomitant conditions of industrialized societies, and diet is a potential culprit. Consumption of ultra-processed food has increased over the last decade in industrialized countries, and epidemiological studies have found associations between ultra-processed food consumption and chronic diseases. Further studies are now required to identify the potential culprit in ultra-processed food, such as a poor nutritional composition or the presence of food additives. In our review, we will focus on food additives, i.e., substances from packaging in contact with food, and compounds formed during production, processing, and storage. A literature search using PubMed from inception to January 2019 was performed to identify relevant studies on diet and/or food additive and their role in IBDs. Manuscripts published in English from basic science, epidemiological studies, or clinical trials were selected and reviewed. We found numerous experimental studies highlighting the key role of food additives in IBD exacerbation but epidemiological studies on food additives on IBD risk are still limited. As diet is a modifiable environmental risk factor, this may offer a scientific rationale for providing dietary advice for IBD patients.