Editorial

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Open AccessEditorial

Consumption of Ultra-Processed Foods and Health Harm

by Francesca Menichetti and Alessandro Leone

Nutrients 2023, 15(13), 2945; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15132945 - 28 Jun 2023

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In recent decades, research has become increasingly interested in the relationship between diet and health [...] Full article

(This article belongs to the Special Issue Consumption of Ultra-Processed Foods and Health Harm)

Research

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18 pages, 1327 KiB

Open AccessArticle

Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort)

by Celia Martinez-Perez, Rodrigo San-Cristobal, Pilar Guallar-Castillon, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Dolores Corella, Olga Castañer, Jose Alfredo Martinez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Lapetra, Lluis Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, José J. Gaforio, Pilar Matía-Martín, Josep Vidal, Clotilde Vázquez, Emilio Ros, Maira Bes-Rastrollo, Nancy Babio, Jose V. Sorlí, Camille Lassale, Beatriz Pérez-Sanz, Jessica Vaquero-Luna, María Julia Ajejas Bazán, María Concepción Barceló-Iglesias, Jadwiga Konieczna, Antonio García Ríos, María Rosa Bernal-López, José Manuel Santos-Lozano, Estefanía Toledo, Nerea Becerra-Tomás, Olga Portoles, María Dolores Zomeño, Itziar Abete, Anai Moreno-Rodriguez, Oscar Lecea-Juarez, Stephanie K. Nishi, Júlia Muñoz-Martínez, José M. Ordovás and Lidia Daimiel Show full author list Hide full author list

Nutrients 2021, 13(7), 2471; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072471 - 20 Jul 2021

Cited by 45 | Viewed by 8985

Abstract

The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification [...] Read more.

The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers. Full article

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8 pages, 239 KiB

Open AccessFeature PaperArticle

What Is the Nutritional Composition of Ultra-Processed Food Marketed in Italy?

by Giulia Lorenzoni, Rita Di Benedetto, Marco Silano and Dario Gregori

Nutrients 2021, 13(7), 2364; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072364 - 10 Jul 2021

Cited by 13 | Viewed by 3656

Abstract

The present study aimed to provide a descriptive analysis of the nutrient profile of ultra-processed foods (UPFs) marketed in Italy according to three front-of-pack labeling (FOPL) schemes implemented by France, i.e., the Nutriscore; by the United Kingdom, i.e., Multiple Traffic Lights (MTL); and [...] Read more.

The present study aimed to provide a descriptive analysis of the nutrient profile of ultra-processed foods (UPFs) marketed in Italy according to three front-of-pack labeling (FOPL) schemes implemented by France, i.e., the Nutriscore; by the United Kingdom, i.e., Multiple Traffic Lights (MTL); and by Italy, i.e., the NutrInform battery. The analysis was made in fourteen food product categories, corresponding to 124 foods. The application of the Nutriscore scheme showed that a significant proportion of foods (23%) were awarded an A or B. Furthermore, the analysis according to the MTL showed that food products that were above the threshold (“red”) for fat, saturated fats, sugars, and salt ranged from 13% to 31%. Interestingly, even though all foods considered in the analysis were UPF, they were heterogeneous in nutritional composition, as demonstrated by the FOPL schemes applied, showing that UPF represent a heterogeneous group of foods with different characteristics. Such a finding may have relevant implications for epidemiological studies that analyze the association between UPF consumption and health outcomes, suggesting the need for better characterization of the effects of UPF intake on human health. Full article

(This article belongs to the Special Issue Consumption of Ultra-Processed Foods and Health Harm)

14 pages, 318 KiB

Open AccessArticle

Consumption of Ultra-Processed Food and Its Association with Sociodemographic Characteristics and Diet Quality in a Representative Sample of French Adults

by Giovanna Calixto Andrade, Chantal Julia, Valérie Deschamps, Bernard Srour, Serge Hercberg, Emmanuelle Kesse-Guyot, Benjamin Allès, Eloi Chazelas, Mélanie Deschasaux, Mathilde Touvier, Carlos Augusto Monteiro and Renata Bertazzi Levy

Nutrients 2021, 13(2), 682; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020682 - 20 Feb 2021

Cited by 42 | Viewed by 6515

Abstract

The present study aims to describe ultra-processed food (UPF) consumption in a representative sample of French adults and to evaluate the association between UPF consumption and socioeconomic characteristics and nutritional profile of the diet. This is a cross-sectional study using food consumption data [...] Read more.

The present study aims to describe ultra-processed food (UPF) consumption in a representative sample of French adults and to evaluate the association between UPF consumption and socioeconomic characteristics and nutritional profile of the diet. This is a cross-sectional study using food consumption data from the Étude Nationale Nutrition Santé (ENNS), conducted with 2642 participants (18–74 years old), between February 2006 and March 2007 in France. Dietary data were collected through three 24-h dietary recalls. All food and beverages were classified according to the NOVA classification. The energy contribution of NOVA food groups to total energy intake was presented by categories of sociodemographic characteristics. Linear and logistic regression models were used to estimate the association between the percentage of UPF in the diet with nutritional indicators. The mean daily energy consumption of the adult French population was 2111 kcal, of which 31.1% came from UPF. This percentage was higher among younger individuals, and in the urban area, and lower among individuals with incomplete high school and individuals who were retired. The consumption of UPF was positively associated with the dietary energy density and the dietary contents of total carbohydrates, free sugar, and total and saturated fat, as well as with inadequate dietary energy density, saturated fat, free sugar, and fiber intakes. Full article

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12 pages, 708 KiB

Open AccessArticle

Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study

by Jimena Rey-García, Carolina Donat-Vargas, Helena Sandoval-Insausti, Ana Bayan-Bravo, Belén Moreno-Franco, José Ramón Banegas, Fernando Rodríguez-Artalejo and Pilar Guallar-Castillón

Nutrients 2021, 13(2), 428; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020428 - 28 Jan 2021

Cited by 38 | Viewed by 4687

Abstract

Ultra-processed food (UPF) consumption has been associated with increased risk of cardiovascular risk factors and mortality. However, little is known on the UPF effect on renal function. The aim of this study is to assess prospectively the association between consumption of UPF and [...] Read more.

Ultra-processed food (UPF) consumption has been associated with increased risk of cardiovascular risk factors and mortality. However, little is known on the UPF effect on renal function. The aim of this study is to assess prospectively the association between consumption of UPF and renal function decline. This is a prospective cohort study of 1312 community-dwelling individuals aged 60 and older recruited during 2008–2010 and followed up to December 2015. At baseline, a validated dietary history was obtained. UPF was identified according to NOVA classification. At baseline and at follow-up, serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were ascertained and changes were calculated. A combined end-point of renal decline was considered: SCr increase or eGFR decreased beyond that expected for age. Logistic regression with adjustment for potential confounders was performed. During follow-up, 183 cases of renal function decline occurred. The fully adjusted odds ratios (95% CI) of renal function decline across terciles of percentage of total energy intake from UPF were 1.56 (1.02–2.38) for the second tercile, and 1.74 (1.14–2.66) for the highest tercile; p-trend was 0.026. High UPF consumption is independently associated with an increase higher than 50% in the risk of renal function decline in Spanish older adults. Full article

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15 pages, 749 KiB

Open AccessArticle

Ultra-Processed Food Intake and Smoking Interact in Relation with Colorectal Adenomas

by Naomi Fliss-Isakov, Shira Zelber-Sagi, Dana Ivancovsky-Wajcman, Oren Shibolet and Revital Kariv

Nutrients 2020, 12(11), 3507; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113507 - 14 Nov 2020

Cited by 15 | Viewed by 3409

Abstract

Smoking and ultra-processed foods (UPFs), a substantial part of the western diet, have been suggested to have a potential carcinogenic effect, though epidemiologic data are lacking. We aimed to examine the association between high UPF intake and colorectal adenomas, and to test the [...] Read more.

Smoking and ultra-processed foods (UPFs), a substantial part of the western diet, have been suggested to have a potential carcinogenic effect, though epidemiologic data are lacking. We aimed to examine the association between high UPF intake and colorectal adenomas, and to test the interaction with smoking. In a case-control study among consecutive subjects undergoing colonoscopy in a tertiary center during 2010–2015, UPF intake and smoking were compared between cases with colorectal adenomas and controls. Within 652 participants (cases, n = 294 and controls, n = 358), high UPF intake (defined as percent of kcal from UPF above the study sample upper tertile) was positively associated with adenomas (Odds ratio (OR) = 1.75, 95% Confidence interval (CI) 1.14–2.68), advanced and proximal adenomas (OR = 2.17, 1.29–3.65 and OR = 2.38, 1.37–4.11) among the whole study sample; and with adenomas (OR = 3.54, 1.90–6.61), non-advanced adenomas (OR = 2.60, 1.20–5.63), advanced adenomas (OR = 4.76, 2.20–10.30), proximal adenomas (OR = 6.23, 2.67–14.52), and distal adenomas (OR = 2.49, 1.21–5.13) among smokers. Additionally, a dose-dependent association was observed between tertiles of UPF intake and adenomas only among smokers (p for trend < 0.001). A significant interaction between smoking and high UPF intake was detected (p for interaction = 0.004). High intake of UPFs is strongly and independently associated with colorectal adenomas, especially advanced and proximal adenoma, and interacts with smoking. Results highlight smokers as more susceptible to the negative health effects of UPF consumption on colorectal neoplasia. Full article

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Review

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13 pages, 860 KiB

Open AccessReview

The Role of Carrageenan in Inflammatory Bowel Diseases and Allergic Reactions: Where Do We Stand?

by Barbara Borsani, Raffaella De Santis, Veronica Perico, Francesca Penagini, Erica Pendezza, Dario Dilillo, Alessandra Bosetti, Gian Vincenzo Zuccotti and Enza D’Auria

Nutrients 2021, 13(10), 3402; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103402 - 27 Sep 2021

Cited by 26 | Viewed by 9636

Abstract

Carrageenan (CGN) is a high molecular weight polysaccharide extracted from red seaweeds, composed of D-galactose residues linked in β-1,4 and α-1,3 galactose-galactose bond, widely used as a food additive in processed foods for its properties as a thickener, gelling agent, emulsifier, and stabilizer. [...] Read more.

Carrageenan (CGN) is a high molecular weight polysaccharide extracted from red seaweeds, composed of D-galactose residues linked in β-1,4 and α-1,3 galactose-galactose bond, widely used as a food additive in processed foods for its properties as a thickener, gelling agent, emulsifier, and stabilizer. In recent years, with the spread of the Western diet (WD), its consumption has increased. Nonetheless, there is a debate on its safety. CGN is extensively used as an inflammatory and adjuvant agent in vitro and in animal experimental models for the investigation of immune processes or to assess the activity of anti-inflammatory drugs. CGN can activate the innate immune pathways of inflammation, alter the gut microbiota composition and the thickness of the mucus barrier. Clinical evidence suggests that CGN is involved in the pathogenesis and clinical management of inflammatory bowel diseases (IBD), indeed food-exclusion diets can be an effective therapy for disease remission. Moreover, specific IgE to the oligosaccharide α-Gal has been associated with allergic reactions commonly referred to as the “α-Gal syndrome”. This review aims to discuss the role of carrageenan in inflammatory bowel diseases and allergic reactions following the current evidence. Furthermore, as no definitive data are available on the safety and the effects of CGN, we suggest gaps to be filled and advise to limit the human exposure to CGN by reducing the consumption of ultra-processed foods. Full article

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28 pages, 1297 KiB

Open AccessEditor’s ChoiceReview

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

by Mirko Marino, Federica Puppo, Cristian Del Bo’, Valentina Vinelli, Patrizia Riso, Marisa Porrini and Daniela Martini

Nutrients 2021, 13(8), 2778; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082778 - 13 Aug 2021

Cited by 87 | Viewed by 14031

Abstract

A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this [...] Read more.

A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date. Full article

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