To identify the energy contributions of NOVA food groups in the Mexican diet and the associations between individual sociodemographic characteristics and the energy contribution of ultra-processed ...foods (UPF).
We classified foods and beverages reported in a 24 h recall according to the NOVA food framework into: (i) unprocessed or minimally processed foods; (ii) processed culinary ingredients; (iii) processed foods; and (iv) UPF. We estimated the energy contribution of each food group and ran a multiple linear regression to identify the associations between sociodemographic characteristics and UPF energy contribution.
Mexican National Health and Nutrition Survey 2012.
Individuals ≥1 years old (n 10 087).
Unprocessed or minimally processed foods had the highest dietary energy contribution (54·0 % of energy), followed by UPF (29·8 %), processed culinary ingredients (10·2 %) and processed foods (6·0 %). The energy contribution of UPF was higher in: pre-school-aged children v. other age groups (3·8 to 12·5 percentage points difference (pp)); urban areas v. rural (5·6 pp); the Central and North regions v. the South (2·7 and 8·4 pp, respectively); medium and high socio-economic status v. low (4·5 pp, in both); and with higher head of household educational level v. without education (3·4 to 7·8 pp).
In 2012, about 30 % of energy in the Mexican diet came from UPF. Our results showed that younger ages, urbanization, living in the North region, high socio-economic status and high head of household educational level are sociodemographic factors related to higher consumption of UPF in Mexico.
Background
Coeliac disease (CeD), a common autoimmune condition, requires strict adherence to a gluten‐free diet (GFD). Adherence to the GFD has been associated with quality of life (QOL). However, ...there may be other diet‐related concerns, such as overall diet patterns, including diet quality or ultra‐processed food (UPF) consumption, possibly associated with QOL among people with CeD following a GFD that have not been examined.
Methods
Diet quality was determined based on 24‐h diet recalls of a cross‐sectional prospectively recruited sample of 80 participants (50 adults and 30 teens) with biopsy‐confirmed CeD (‘Study Sample’) using the Healthy Eating Index and Alternate Mediterranean Diet score. The amount of UPF consumed was assessed using Nova, a food processing classification system. QOL was measured using Celiac Disease‐Specific Quality of Life (CDQOL) and Celiac Disease Pediatric‐Specific Quality of Life (CDPQOL). The Study Sample's diet patterns were compared with National Health and Nutrition Examination Survey (NHANES) groups (25 adults reporting prior CeD and GFD; 51 adults with new CeD and no GFD; 15,777 adults and 2296 teens without CeD). The relationship of the Study Sample's diet patterns with CDQOL/CDPQOL was assessed using analysis of covariance.
Results
The Study Sample's diet patterns were suboptimal but generally favourable compared with all NHANES groups. Compared to Study Adults with the highest tertile of UPF, those with the lowest tertile had significantly higher CDQOL (mean: 67.6 vs. 78.3, p < 0.001). Compared to Study Teens with the lowest tertile of AMED, those with the highest tertile had significantly higher CDPQOL (mean: 67.0 vs. 79.9, p < 0.01).
Conclusions
Maintaining high diet quality and minimising UPF may be important for CeD‐specific QOL among individuals with CeD maintaining a GFD.
In a sample with coeliac disease, diet quality was moderately high, with concerning amounts of ultra‐processed foods (UPFs). They consumed higher‐quality diets and less UPFs than the representative population. A higher quality of life was associated with a higher diet quality and less UPF consumption.
Key points
In a sample with coeliac disease, diet quality was moderately high, with concerning amounts of ultra‐processed foods (UPFs).
They consumed higher‐quality diets and less UPFs than the representative population.
Higher quality of life was associated with a higher diet quality and less UPF consumption.
Processed and ultra-processed foods (UPF) consumption has been associated with development of noncommunicable chronic diseases (NCD). This systematic review aims to summarise and discuss evidence of ...the relationship between food consumption according to degree of food processing and cardiometabolic risk. Data search was conducted in databases as PubMed, Bireme and Science Direct until July 2018. Studies have shown a positive association of UPF consumption with excess body weight, hypertension, dyslipidemia and metabolic syndrome features. However, disparities found in the studies analysed regarding dietary assessment, confounding factors and differences in food classifications makes comparisons between studies difficult. In conclusion, current evidences indicate the need to monitor UPF intake in global population. However, more studies are necessary to interpret better these associations with similar methodologies used in the studies. As well as longitudinal analyses can help to improve comparisons between outcomes and establish cause-effect relationship between UPF intake and cardiometabolic risk.
To measure change in price of food groups over time (1995-2030) in Brazil, considering the Brazilian Dietary Guidelines' recommendations.
Data from the Household Budget Survey (2008-2009 HBS) and the ...National System of Consumer Price Indexes (NSCPI) were used to create a data set containing monthly prices for the foods and beverages most consumed in the country (n 102), from January 1995 to December 2017. Data on price of foods and beverages from 2008-2009 HBS (referring to January 2009) were used to calculate real price over time using the monthly variation in prices from NSCPI. All prices were deflated to December 2017. Foods and beverages were classified following the Brazilian Dietary Guidelines' recommendations. The monthly price for each food group and subgroup was used to analyse changes in prices from 1995 to 2017 and to forecast prices up to 2030 using fractional polynomial models.
Brazil.
National estimates of foods and beverages purchased for Brazil.
In 1995, ultra-processed foods were the most expensive group (R$ 6·51/kg), followed by processed foods (R$ 6·44/kg), then unprocessed or minimally processed foods and culinary ingredients (R$ 3·45/kg). Since the early 2000s, the price of ultra-processed foods underwent successive reductions, becoming cheaper than processed foods and reducing the distance between it and the price of the other group. Forecasts indicate that unhealthy foods will become cheaper than healthy foods in 2026.
Food prices in Brazil have changed unfavourably considering the Brazilian Dietary Guidelines' recommendations. This may imply a decrease in the quality of the population's diet.
Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This ...manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.
Global food systems are no longer sustainable for health, the environment, animal biodiversity and wellbeing, culinary traditions, socioeconomics, or small farmers. The increasing massive consumption ...of animal foods has been identified as a major determinant of unsustainability. However, today, the consumption of ultra-processed foods (UPFs) is also questioned. The main objective of this review is therefore to check the validity of this new hypothesis. We first identified the main ingredients/additives present in UPFs and the agricultural practices involved in their provision to agro-industrials. Overall, UPF production is analysed regarding its impacts on the environment, biodiversity, animal wellbeing, and cultural and socio-economic dimensions. Our main conclusion is that UPFs are associated with intensive agriculture/livestock and threaten all dimensions of food system sustainability due to the combination of low-cost ingredients at purchase and increased consumption worldwide. However, low-animal-calorie UPFs do not produce the highest greenhouse gas emissions (GHGEs) compared to conventional meat and dairy products. In addition, only reducing energy dense UPF intake, without substitution, might substantially reduce GHGEs. Therefore, significant improvement in food system sustainability requires urgently encouraging limiting UPF consumption to the benefit of mildly processed foods, preferably seasonal, organic, and local products.
In the agri‐food chain, while the impact of producers and consumers on sustainability has been well studied, food processing has been less explored. This position paper aims to discuss the potential ...of food processing to address all food and nutrition security (FNS) outcomes in order to achieve improved food system sustainability. First, FNS dimensions and the four pillars of agro‐food industry sustainability are defined, with a focus on ultra‐processed foods. Second, the food matrix concept is developed as a new paradigm to holistically address all FNS. It is concluded that food processing should become more involved in circular food systems and bioeconomy, and that we need to relocate food production, processing, and consumption to be more aligned with regional food production specificities. For this, minimal processing to preserve food matrices should be preferred. Therefore, the strong current tendency to develop reductionist and siloed innovative solutions to improve the sustainability of food systems should be questioned.
Concerns have been raised about the potential health impact of ultra-processed foods (UPF) in the diet. Our objective was to investigate the contribution of UPF in the diet in a large French ...population and its association with sociodemographic factors and dietary patterns.
Cross-sectional analysis of dietary data from 74 470 participants in the web-based NutriNet-Santé cohort. UPF were identified in repeated 24 h records and the proportion (in weight) of UPF in the total diet (UPFp) was computed for each participant. Associations of sociodemographic characteristics and UPFp in quartiles were assessed using multivariate multinomial logistic regression. Food group consumption and nutrient intakes across quartiles of UPFp were estimated using linear regression adjusted for sociodemographic factors and energy intake.
France.
UPF contributed 18·4 % of the foods consumed in weight and 35·9 % of total energy intake. Higher UPFp consumption was independently associated with male gender, younger age, lower education, smoking, and overweight and obesity (all P<0·0001). Participants in the highest UPFp quartile consumed lower amounts of fruit and vegetables (difference between quartile 4 and quartile 1 of UPFp, Δ=-180·3 g/d) and higher amounts of sweet products (Δ=68·5 g/d) and soft drinks (Δ=98·6 g/d; all P<0·0001). They had higher intakes of energy (Δ=610 kJ/d (145·7 kcal/d)) and added sugar (Δ=17·1 g/d), and lower intakes of fibre (Δ=-4·04 g/d), β-carotene (Δ=-1019·6 μg/d) and Ca (Δ=-87·8 mg/d; all P<0·0001).
UPF represent an important part of the diet in adults from the French general population and are associated with unbalanced nutritional intakes.
Front-of-pack labels can improve the ability of consumers to identify which foods are healthier, making them a useful public health tool. Nutri-Score is a front-of-pack labelling system adopted by ...several European countries. This system ranks foods according to their nutritional quality, but does not consider other dimensions such as the degree of food processing. The aim of this study is to compare the nutritional quality (as assessed by Nutri-Score) and the ultra-processing (as assessed by the NOVA classification) of foods in the Open Food Facts database. A simple correspondence analysis was carried out to study the relationship between the two systems. Ultra-processed foods (NOVA 4) were found in all Nutri-Score categories, ranging from 26.08% in nutritional category A, 51.48% in category B, 59.09% in category C, 67.39% in category D to up to 83.69% in nutritional category E. Given the negative effect that the consumption of ultra-processed foods has on different aspects of health, front-of-pack labelling with Nutri-Score should at least be accompanied by complementary labelling indicating the level of processing, such as the NOVA classification.
•We assess market food environments’ role for child diets and nutrition in Malawi.•We develop a new methodology to characterize local market food environments.•There are large differences in market ...food environments across the rural-urban continuum.•Access to more varied foods improves child diets and nutrition.•Lightly and moderately processed food variety’s effects are larger than fresh food variety.
Child malnutrition remains a widespread public health problem in sub-Saharan Africa. Providing access to nutritious foods for all is key, but it is not clear how this can be achieved in various local contexts. Here, we analyze the role of markets and food environments for child diets and nutrition in Malawi along a rural-urban continuum. We develop a new methodology to characterize food environments in terms of the variety of fresh and processed foods available in local market settings. Geocoded data of market food variety are combined with individual-level child diet and anthropometric data collected through a household survey. We find large differences in food environments, diets, and nutrition outcomes between urban, rural, and remote locations. The spatially-explicit analysis shows that market food variety is positively associated with dietary diversity and negatively associated with stunting, also after controlling for confounding factors. Strikingly, processed food variety has more favorable associations with child nutrition than fresh food variety, suggesting that lightly and moderately processed foods are important sources of nutrients in the local settings. Our findings stress the importance of improving the functioning of markets for nutritious foods, especially in rural areas. Conceptually, we add to the literature on measuring food environments.
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