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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 comprehens...

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... search strategy identified 1165 records. 563 articles were screened by titles and abstracts after duplicates removed. Of the 55 full-texts assessed for eligibility, 20 published epidemiological studies (12 cohort and 8 cross-sectional studies) were included into the systematic review, with a total of 334,114 participants and 10 diseases ( Fig. 1). An overview of the characteristics of included studies was provided in Table 1. All studies were published between 2015 and 2019, with a sample size ranging from 785 to 109,104. Six studies were conducted in Spain, while 5 in France, 4 in Canada, 3 in America and 2 in Brazil. The median follow-up ranged from 3.5 to 19 years in cohort ...

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... This has created a higher preference for convenience foods that are often highly processed and contain excessive sugar, salt and saturated fat. In addition, with increased urban incomes, preferences for and consumption of animal-source and ultra-processed foods increase 76,77 . While these dietary shifts have led to lower micronutrient deficiencies among the affluent urban population, in the longer run, they have also led to a substantial rise in cardiometabolic diseases due to imbalanced and unhealthy diets and lower physical activity [78][79][80][81][82][83] . ...
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Over the past 50 years, food systems worldwide have shifted from predominantly rural to industrialized and consolidated systems, with impacts on diets, nutrition and health, livelihoods, and environmental sustainability. We explore the potential for sustainable and equitable food system transformation (ideal state of change) by comparing countries at different stages of food system transition (changes) using food system typologies. Historically, incomes have risen faster than food prices as countries have industrialized, enabling a simultaneous increase in the supply and affordability of many nutritious foods. These shifts are illustrated across five food system typologies, from rural and traditional to industrial and consolidated. Evolving rural economies, urbanization and changes in food value chains have accompanied these transitions, leading to changes in land distribution, a smaller share of agri-food system workers in the economy and changes in diets. We show that the affordability of a recommended diet has improved over time, but food systems of all types are falling short of delivering optimal nutrition and health outcomes, environmental sustainability, and inclusion and equity for all. Six ‘outlier’ case studies (Tajikistan, Egypt, Albania, Ecuador, Bolivia and the United States of America) illustrate broad trends, trade-offs and deviations. With the integrated view afforded by typologies, we consider how sustainable transitions can be achieved going forward.
... Additionally, it can negatively affect the microbiome, specifically related to proinflammatory processes (25). Therefore, it is important to highlight the complex relationships between modifiable factors (such as diet and physical activity) in the search for nutrients that prevent or limit this disease (26). ...
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Background The gut microbiota can impact older adults’ health, especially in patients with frailty syndrome. Understanding the association between the gut microbiota and frailty syndrome will help to explain the etiology of age-related diseases. Low-grade systemic inflammation is a factor leading to geriatric disorders, which is known as “inflammaging”. Intestinal dysbiosis has a direct relationship with low-grade systemic inflammation because when the natural gut barrier is altered by age or other factors, some microorganisms or their metabolites can cross this barrier and reach the systemic circulation. Objectives This review had two general goals: first, to describe the characteristics of the gut microbiota associated with age-related diseases, specifically frailty syndrome. The second aim was to identify potential interventions to improve the composition and function of intestinal microbiota, consequently lessening the burden of patients with frailty syndrome. Methods A search of scientific evidence was performed in PubMed, Science Direct, and Redalyc using keywords such as “frailty”, “elderly”, “nutrient interventions”, “probiotics”, and “prebiotics”. We included studies reporting the effects of nutrient supplementation on frailty syndrome and older adults. These studies were analyzed to identify novel therapeutic alternatives to improve gut microbiota characteristics as well as subclinical signs related to this condition. Results The gut microbiota participates in many metabolic processes that have an impact on the brain, muscles, and other organs. These processes integrate feedback mechanisms, comprising their respective axis with the intestine and the gut microbiota. Alterations in these associations can lead to frailty. We report a few interventions that demonstrate that prebiotics and probiotics could modulate the gut microbiota in humans. Furthermore, other nutritional interventions could be used in patients with frailty syndrome. Conclusion Probiotics and prebiotics may potentially prevent frailty syndrome or improve the quality of life of patients with this disorder. However, there is not enough information about their appropriate doses and periods of administration. Therefore, further investigations are required to determine these factors and improve their efficacy as therapeutic approaches for frailty syndrome.
... This result is cause for concern, as some of these were among the most frequently posted recipes. To cook healthily, the Dietary Guidelines for the Brazilian Population recommends the avoidance of UP foods [3], as high consumption of UP foods has been associated with chronic non-communicable diseases and all-cause mortality [5][6][7]. UP food consumption has been associated with a poor dietary intake (excess calories from free sugars and unhealthy saturated fats, poor in fibre, and an intake of many micronutrients) [40]. Additionally, recent research shows that the majority of the associations between UP food consumption, obesity, and health-related outcomes can be attributed to UP foods on their own, regardless of diet quality or pattern [41]. ...
Article
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Social media platforms are readily accessible sources of information about cooking, an activity deemed crucial for the improvement of a population’s diet. Previous research focused on the healthiness of the content shared on websites and blogs, but not on social media such as YouTube®. This paper analysed the healthiness of 823 culinary recipes retrieved from 755 videos shared during a six-month period on ten popular Brazilian YouTube® cooking channels. Recipes were categorized by type of preparation. To assess recipes’ healthiness, ingredients were classified according to the extension and purpose of industrial processing, in order to identify the use of ultra-processed foods. Additionally, a validated framework developed from criteria established in both editions of the Dietary Guidelines for the Brazilian Population was employed. Recipes for cakes and baked goods, puddings, snacks and homemade fast foods, which were among the most frequently posted, contained the lowest proportion of unprocessed/minimally processed ingredients and the highest proportion of ultra-processed ingredients. Recipes containing whole cereals, fruits, legumes, nuts, and seeds were scarce. Results indicate that users should be critical about the quality of recipes shared on YouTube® videos, also indicating a need for strategies aimed at informing individuals on how to choose healthier recipes or adapt them to become healthier.
... While there is extensive evidence from several systematic reviews and meta-analyses [56,57,[70][71][72] linking UPFs to health outcomes in adults, research is more limited in pediatric populations. In 2017-2018, UPFs contributed greater than two-thirds of energy intake among US children and adolescents, a 5.6% increase over the prior 20 years [73]. ...
Article
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Purpose of Review The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities. Recent Findings In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. Summary UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health — though further mechanistic studies are needed.
... For example, results of a randomized controlled trial demonstrated that an ultra-processed diet caused weight gain in adults relative to an unprocessed diet despite being matched for calories (7). Cross-sectional studies reported similar findings linking higher intakes of ultra-processed foods to increased prevalence of obesity in both adults and children (8)(9)(10)(11)(12). Similar associations between ultra-processed food intakes and anthropometric measures or related risk markers have been identified in longitudinal studies in adults (13)(14)(15)(16)(17) and children (18)(19)(20). ...
... 11 Frozen dishes, burgers, pizzas, sandwiches and other pre-prepared products bought in fast-food outlets. 12 Ready-to-eat and frozen French fries, onion rings, hash browns, mash potatoes and other potato products. 13 Ice cream, chocolate milk, flavored yogurt, milkshakes. ...
Article
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Adopting a healthy diet remains central for the prevention of obesity. In adults, higher intake of ultra-processed food is associated with a greater risk of overweight and obesity. However, little is known about the degree of food processing and its association with anthropometric measures in families with preschool-aged children, a critical period for the development of dietary patterns. This cross-sectional study included preschool-aged children (n = 267) between 1.5 and 5 years of age and their parents (n = 365) from 242 families enrolled in the Guelph Family Health Study. Dietary assessment was completed using ASA24-Canada-2016. Foods and beverages were classified based on their degree of food processing using the NOVA Classification (unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods). Associations between the energy contribution (% kcal) of each NOVA category and anthropometric measures were examined using linear regression models with generalized estimating equations, adjusted for sociodemographic variables. The energy contribution of ultra-processed foods was the highest relative to the other NOVA categories among parents (44.3%) and children (41.3%). The energy contribution of unprocessed or minimally processed foods was 29.1% for parents and 35.3% for children, processed foods was 24.0% for parents and 21.3% for children, and processed culinary ingredients was 2.6% for parents and 2.1% for children. Ultra-processed foods (% kcal) were positively associated with BMI (β = 0.04, 95% CI: 0.01–0.07, P = 0.02), waist circumference (β = 0.11, 95% CI: 0.03–0.18, P = 0.008) and body weight (β = 0.13, 95% CI: 0.03–0.22, P = 0.01) in parents, but not children. Unprocessed foods (% kcal) were negatively associated with waist circumference in parents (β = −0.09, 95% CI: 0.18–0.01, P = 0.03) and children (β = −0.03, 95% CI: 0.05–0.01, P = 0.01), as well as body weight (β = −0.12, 95% CI: 0.23–0.00, P = 0.04) in parents. The degree of food processing primarily influenced anthropometric outcomes in parents. Nevertheless, diets of children were similar, suggesting that such exposure in families may eventually lead to outcomes observed in parents.
... They contain fractions of whole foods or chemically modified substances, such as high-fructose corn syrup, hydrogenated oils, and hydrolysed proteins, and food additives, such as thickeners and emulsifiers, that are rarely or never used in the kitchen [8]. Thus, UPF intake has been linked to several non-communicable diseases and mortality [16]. A few longitudinal studies have reported a positive association between UPF intake and CKD in the Netherlands [17], Spain [18], and the US [19]. ...
... The intake of UPF was associated with a decline in eGFR in the Netherlands [17]. UPF has also been previously associated with CKD risk factors [16,27,28]. ...
Article
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Emerging evidence links several health outcomes to the consumption of ultra-processed food (UPF), but few studies have investigated the association between UPF intake and kidney function. This cross-sectional study investigated the prevalence of chronic kidney disease (CKD) in relation to UPF intake in Korea. Data were obtained from the 2004–2013 Health Examinees (HEXA) study. The intake of UPF was assessed using a 106-item food frequency questionnaire and evaluated using the NOVA classification. The prevalence of CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/m2. Poisson regression models were used to compute the prevalence ratios (PR) of CKD according to quartiles of the proportion of UPF intake (% food weight). A total of 134,544 (66.4% women) with a mean age of 52.0 years and an eGFR of 92.7 mL/min/m2 were analysed. The median proportion of UPF in the diet was 5.6%. After adjusting for potential confounders, the highest quartile of UPF intake was associated with the highest prevalence of CKD (PR 1.16, 95% CI 1.07–1.25), and every IQR (6.6%) increase in the proportion of UPF in the diet was associated with a 6% higher prevalence of CKD (PR 1.06, 95% CI 1.03–1.09). Furthermore, the highest consumption of UPF was inversely associated with eGFR (Q4 vs. Q1: β −1.07, 95% CI −1.35, −0.79; per IQR increment: (β −0.45, 95% CI −0.58, −0.32). The intake of UPF was associated with a high prevalence of CKD and a reduced eGFR. Longitudinal studies in the Korean population are needed to corroborate existing findings in other populations.
... UPF consumption is highest in Australia, North America, Europe, and Latin America, but is increasing rapidly in Asia, the Middle East, and Africa [19]. A systematic review concluded that high UPF intake has a positive association with the risk of all-cause mortality, and many non-communicable diseases such as cerebrovascular diseases, hypertension, metabolic syndrome, overweight, and obesity in adults [20]. ...
Article
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Childhood is a critical period for susceptibility to malnutrition. The consumption of ultraprocessed foods (UPFs) has been increasing among children. The objective of this study was to evaluate the relationship between UPF intake and overweight/obesity and malnutrition in children. 788 children aged 6 years were included in a population-based cross-sectional study in Tehran. A 168-item semiquantitative food frequency questionnaire was used to evaluate dietary intake. UPFs were detected using the NOVA classification system. Logistic regression analyses were used, and results were reported as odds ratios (ORs) and 95% confidence interval (CI) of obesity and malnutrition across the tertiles of UPFs adjusted for energy intake, socioeconomic status, and physical activity. The mean weight, height, BMI, and total energy intake of participants were 20.85 ± 2.35 kg, 113.75 ± 2.00 cm, 16.12 + 1.84 kg/m2, and 1014.74 ± 259.16 (kcal/d), respectively. There were no significant associations between UPF intake and obesity (OR = 0.97; 95% CI 0.31 to 3.01; P-trend = 0.98), wasting (OR = 0.94; 95% CI 0.30 to 2.87; P-trend = 0.87), overweight/obesity (OR = 0.86; 95% CI 0.59 to 1.25; P-trend = 0.45), underweight/wasting (OR = 0.69; 95% CI 0.40 to 1.17; P-trend = 0.17), marginal-stunting (OR = 1.16; 95% CI 0.71 to 1.89; P-trend = 0.53), or marginal-stunting/overweight/obesity (OR = 1.25; 95% CI 0.62 to 2.54; P-trend = 0.47). There was no evidence of an association between intake of UPFs and risk of overweight, obesity, and malnutrition in children.
... There is growing evidence that high consumption of UPFs is indicative of low diet quality and associated with a higher risk of coronary heart disease, cancer, cerebrovascular and metabolic diseases, hypertension, worse cardiometabolic risk profile, and a higher risk of all-cause mortality in adult and older populations [91][92][93]. Regarding the pregnancy period, a recent systematic review [27] indicated that high UPF consumption in pregnancy, lactation, and infancy had negative repercussions on health in general but no meta-analysis was performed. To our knowledge, this is the first study with meta-analysis to assess the effect of UPF-rich diet consumption, through unhealthy dietary patterns, Western foods and UPF intake, by pregnant women and perinatal outcomes, and is the most up-to-date and comprehensive systematic review on this topic. ...
Article
The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes.
... Inúmeras evidências, incluindo revisões sistemáticas de estudos de coorte e com meta-análises, mostram que o maior consumo de alimentos ultraprocessados está associado ao risco de doenças crônicas não transmissíveis, como obesidade, hipertensão, diabetes, dislipidemias, doenças cardiovasculares, depressão, cânceres -como o de mama -, distúrbios gastrointestinais, bem como mortalidade precoce por todas as causas 2,[5][6][7][8][9][10] . Nas duas primeiras edições da pesquisa, foram analisadas amostras representativas do conjunto de domicílios brasileiros situados nas principais regiões urbanas do Brasil (região metropolitana de Belém na região Norte; de Fortaleza, Recife e Salvador na região Nordeste; de Belo Horizonte, Rio de Janeiro e São Paulo na região Sudeste; de Curitiba e Porto Alegre na região Sul; e Distrito Federal e município de Goiânia, na região Centro-Oeste). ...
Article
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Objective: To evaluate the trend of household food acquisition according to the NOVA classification in Brazil between 1987-1988 and 2017-2018. Methods: We used household food acquisition data from five editions of the Pesquisas de Orçamentos Familiares (Household Budget Surveys), conducted by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics), in the years 1987-1988, 1995-1996, 2002-2003, 2008-2009, and 2017-2018. All reported foods were categorized according to the NOVA classification. The household availability of food groups and subgroups was expressed through their share (%) in total calories, for all Brazilian families, by household situation (urban or rural), for each of the five geographic regions of the country, by fifths of the household income per capita distribution (2002-2003, 2008-2009 and 2017-2018 surveys), and for the 11 main urban regions of the country (1987-1988, 1995-1996, 2002-2003, 2008-2009 and 2017-2018 surveys). Linear regression models were used to assess the trend of increasing or decreasing food purchases. Results: The diet of the Brazilian population is still composed predominantly of foods in natura or minimally processed and processed culinary ingredients. However, our findings point to trends of increasing share of ultra-processed foods in the diet. This increase of 0.4 percentage points per year between 2002 and 2009 slowed down to 0.2 percentage points between 2008 and 2018. The consumption of ultra-processed food was higher among households with higher income, in the South and Southeast regions, in urban areas, and in metropolitan regions. Conclusion: Our results indicate an increase in the share of ultra-processed foods in the diet of Brazilians. This is a worrisome scenario, since the consumption of such foods is associated with the development of diseases and the loss of nutritional quality of the diet.
... Many ready-to-eat or ready-to-heat foods and drinks are high in added sugars, sodium, saturated fats, and refined carbohydrates. Excessive consumption of these nutrients and ultra-processed foods increases the risk of obesity and related NCDs [13][14][15][16][17][18][19][20][21][22][23][24][25]. Indeed, a growing literature including both a large randomized controlled trial and over 45 longitudinal cohort studies linked ultra-processed food with increased risk of overweight/obesity, diet-related NCDs, and total and heart disease-linked mortality [16,26]. ...
Article
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Policies to require front-of-package labels (FOPLs) on packaged foods may help Indian consumers to better identify foods high in nutrients of concern, including sugar, saturated fat, and sodium, and discourage their consumption, which are outcomes that are critical for preventing rises in diet-related non-communicable disease. The objective was to test whether FOPLs helped Indian consumers identify “high-in” packaged foods and reduce intentions to purchase them. We conducted an in-person randomized experiment (n = 2869 adults between ages 18 and 60 years old) in six states of India in 2022. Participants were randomized to one of five FOPLs: a control label (barcode), warning label (octagon with “High in [nutrient]”), Health Star Rating (HSR), Guideline Daily Amount (GDA), or traffic light label. Participants then viewed a series of packaged foods high in sugar, saturated fat, or sodium with the assigned FOPL, and rated product perceptions and label reactions. Fewer than half of participants in the control group (39.1%) correctly identified all products high in nutrient(s) of concern. All FOPLs led to an increase in this outcome, with the biggest differences observed for the warning label (60.8%, p < 0.001), followed by the traffic light label (54.8%, p < 0.001), GDA (55.0%, p < 0.001), and HSR (45.0%, p < 0.01). While no FOPLs led to a reduction in intentions to purchase the packaged foods, the overall pattern of results suggested that warning labels are the most effective FOPL to help Indian consumers identify unhealthy foods.