1.
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
-
-
-
Free full text
Plain language summary
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.
2.
Food processing and cardiometabolic risk factors: a systematic review.
Santos, FSD, Dias, MDS, Mintem, GC, Oliveira, IO, Gigante, DP
Revista de saude publica. 2020;54:70
-
-
-
Free full text
Plain language summary
Cardiovascular diseases (CVD) comprise the main cause of mortality in the world and approximately three quarters of deaths occur in low- and middle-income countries. The aim of this study was to assess the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. This study is a systematic review of eleven studies. Five studies (46%) had a sample size greater than 10,000 participants and the smallest sample identified evaluated 302 individuals. Results indicate that the consumption of UPF can have an unfavourable impact on the health of individuals, especially contributing to increase the body mass index. The cardiometabolic risk factors identified were overweight or obesity, arterial hypertension and metabolic syndrome. Authors conclude that their findings may contribute to strengthening scientific evidence that underlies public policies related to the area of food and nutrition and the coping with cardiovascular diseases.
Abstract
OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.
3.
Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis.
Uusitupa, M, Khan, TA, Viguiliouk, E, Kahleova, H, Rivellese, AA, Hermansen, K, Pfeiffer, A, Thanopoulou, A, Salas-Salvadó, J, Schwab, U, et al
Nutrients. 2019;11(11)
-
-
-
Free full text
Plain language summary
With Type 2 Diabetes growing globally this paper analyses whether T2D is preventable with lifestyle measures including diet. Seven RCTs were included for review with a total of 4090 participants, and 2466 incidents of T2D, and were chosen on the basis that the lifestyle interventions included both physical exercise and diet (typically Mediterranean Diet). They found that diet and lifestyle intervention reduced the risk of T2D by 47%. Sustained risk reduction was also found in follow-up studies up to 10 years later with participants maintaining improved blood glucose control. Lifestyle interventions may also reduce risk factors for cardiovascular disease. Weight reduction was considered a cornerstone of preventing T2D and adherence to lifestyle changes a key element in long term prevention. Dietary foods reviewed include processed meats, white rice and sugars which correlated highly with T2D whilst leafy greens, berries, wholegrains, legumes, dietary fibre and yoghurt correlate with a lower risk of T2D. Dietary patterns of skipping breakfast and snacking correlate higher with T2D. Different criteria for evaluating physical activity estimate that it reduces risk factors by 50%. In conclusion there is high evidence that lifestyle factors which optimise diet, increase physical activity and promote weight reduction are preventative factors for T2D and can be sustained long term.
Abstract
Prevention of type 2 diabetes (T2D) is a great challenge worldwide. The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications.
4.
A Systematic Review of the Association of Skipping Breakfast with Weight and Cardiometabolic Risk Factors in Children and Adolescents. What Should We Better Investigate in the Future?
Monzani, A, Ricotti, R, Caputo, M, Solito, A, Archero, F, Bellone, S, Prodam, F
Nutrients. 2019;11(2)
-
-
-
Free full text
Plain language summary
Childhood obesity is a major public health issue across the world. The incidence of skipping breakfast among children and adolescent is rising. Numerous studies have shown a positive relationship between skipping breakfast and overweight or obesity. The aim of the study was to analyse the association of skipping breakfast with body weight and metabolic outcomes in the paediatric population. The study is a systemic review focusing on studies published in the last ten years. 39 articles were included for analysis and data from a total of 286,804 children and adolescents were reported. The systemic review demonstrates that children and adolescents who skip breakfast are at higher risk to be or become overweight or obese. Authors conclude that skipping breakfast may be a potential marker of lifestyle behaviours in children and adolescents that promote overweight or obesity and metabolic diseases.
Abstract
The incidence of skipping breakfast in pediatric subjects is rising, and a relationship with overweight (OW) and obesity (OB) has been shown. Associations with cardiovascular outcomes and skipping breakfast in adults have been reported. The purpose of this systematic review was to summarize the association of skipping breakfast with body weight and metabolic outcomes in the pediatric population. We searched relevant databases (2008⁻2018) and identified 56 articles, of which 39 were suitable to be included, basing on inclusion criteria (observational; defined breakfast skipping; weight and/or metabolic outcomes). Overall, 286,804 children and adolescents living in 33 countries were included. The definitions of OW/OB, skipping breakfast, and the nutrient assessment were highly heterogeneous. Confounding factors were reported infrequently. The prevalence of skipping breakfast ranged 10⁻30%, with an increasing trend in adolescents, mainly in girls. Skipping breakfast was associated with OW/OB in the 94.7% of the subjects. The lack of association was shown mainly in infants. Moreover, 16,130 subjects were investigated for cardiometabolic outcomes. Skipping breakfast was associated with a worse lipid profile, blood pressure levels, insulin-resistance, and metabolic syndrome. Five studies reported a lower quality dietary intake in breakfast skippers. This review supports skipping breakfast as an easy marker of the risk of OW/OB and metabolic diseases, whether or not it is directly involved in causality. We encourage intervention studies using standardized and generalizable indicators. Data on confounders, time of fasting, chronotypes, and nutrition quality are needed to establish the best practice for using it as a tool for assessing obesity risk.
5.
New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT.
Albert Pérez, E, Mateu Olivares, V, Martínez-Espinosa, RM, Molina Vila, MD, Reig García-Galbis, M
Nutrients. 2018;10(7)
-
-
-
Free full text
Plain language summary
Metabolic Syndrome is the term used to group a cluster of health concerns including overweight, obesity, hypertension, elevated cholesterol, blood glucose intolerance and insulin resistance which together can contribute to the development of Type II Diabetes and Cardiovascular Disease. Diagnosis is usually given if a patient has three or more of these conditions however the diagnosis in children and adolescents is often inconsistent, and so guidelines for therapeutic strategies for metabolic syndrome also vary greatly. This review looked at 9 studies of children aged up to 19 years old, all diagnosed with metabolic syndrome, and given dietary, physical, psychological, and pharmacological interventions, to try and understand what the best clinical approach might be. It was found that a balanced diet combined with aerobic and resistance exercise helped to significantly reduce body mass, more so than the trials which included treatment with Metformin. A balance diet included calorie restriction and carbohydrate reduction, carefully planned around the daily exercise program of 2-3 resistance sessions each week and frequent cardio sessions of differing intensity and duration. They concluded that a minimum of 6 months was needed to reach optimal weight loss and body fat loss. Overall, the findings of this study support diet and physical exercise as beneficial clinical interventions, whilst the use of medication is still unclear.
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.