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Abstract

The relationship between the global food system, and the worldwide rapid increase of obesity and related diseases, is not yet well understood. A reason is that the full impact of industrialized food processing on dietary patterns, including the environments of eating and drinking, remains overlooked and underestimated. Many forms of food processing are beneficial. But what is identified and defined here as ultra-processing, a type of process that had become increasingly dominant, at first in high-income countries, and now in middle-income countries, creates attractive, hyper-palatable, cheap, ready-to-consume food products that are characteristically energy-dense, fatty, sugary or salty, and generally obesogenic. In this study the scale of change in purchase and sales of ultra-processed products is examined and the context and implications are discussed. Data come from 79 high- and middle-income countries, with special attention to Canada and Brazil. Results show that ultra-processed products dominate the food supplies of high-income countries, and that their consumption is now rapidly increasing in middle-income countries. It is proposed here that the main driving force now shaping the global food system is transnational food manufacturing, retailing and fast-food service corporations whose businesses are based on very profitable, heavily promoted ultra-processed products, many in snack form.

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... These food items are frequently low priced, convenient, shelf-stable, easily consumed and highly palatable [12]. Recent global estimates demonstrate substantial growth in the types and quantities of ultra-processed foods procured [13,14] and consumed worldwide [15]. Indeed, at the beginning of 2021, we published a systematic review and meta-analysis that showed ultra-processed foods accounted for 17% to 56% (mean of 37%) of total daily energy intake across 28 countries [16]. ...
... The past several decades have seen an overrepresentation in the manufacturing, sales and intake of ultra-processed foods for many food systems globally, with future projections showing a continued upward trend [13,14]. The precautionary principle to address ultraprocessed food consumption (as well as production and distribution) in new official dietary guidelines developed by governmental and international health organisations is being called for [80] and increasingly adopted [81]. ...
... Potential bias: measurement validity domain.Nutrients 2022,14, 2568 ...
Article
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.
... Since the 1980s, numerous reports and papers across a wide range of scientific disciplines and foci have simply amplified their argument, showing that the current dietary transitions have serious impacts on ecosystems (UNEP et al., 2009), public health (Popkin, 2002(Popkin, , 2009Monteiro et al., 2013) and healthcare costs (WHO, 2015), climate change (Watts et al., 2015), biodiversity (Burlingame and Dernini, 2012;Lawrence et al., 2015) and land use (Smith, 2012;. As this literature expanded, consortia of scientists proposed that planetary boundaries -such as nitrogen, phosphorus, carbon, rates of biodiversity extinction -were in danger of exceeding safe limits (Rockström et al., 2009;Steffen et al., 2015). ...
... In terms of availability, shifts in the global supply system, especially with the rise of transnational food corporations (TFCs) in the past three to four decades have made energy-dense, nutrient-poor processed food products much more available. Technological advances in food processing, such as the extraction of vegetable oils and other processing techniques, have made the production of this type of food possible, profitable and less expensive for consumers (Popkin et al., 2011;Monteiro et al., 2013). ...
... Another consequence has been a certain level of destructuring of the traditional meal and an increase in snacking and eating out (Mestdag, 2005;Yates and Warde, 2015). While up to 50 years ago snacking was a rare activity among adults, now in countries such as the USA, Canada, Brazil, Mexico and China, up to one-quarter of all calories consumed come in snack form and, as incomes rise, so does the proportion of ultraprocessed foods that are used as snacks (Lang et al., 2009;Monteiro et al., 2013). ...
Chapter
Sustainable diets are those diets with low environmental impacts that contribute to food and nutrition security and to healthy lives for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable, are nutritionally adequate, safe, and healthy, and optimize natural and human resources. (FAO, 2010). This book takes a transdisciplinary approach and considers multisectoral actions, integrating health, agriculture and environmental sector issues to comprehensively explore the topic of sustainable diets. The team of international authors informs readers with arguments, challenges, perspectives, policies, actions and solutions on global topics that must be properly understood in order to be effectively addressed. They position issues of sustainable diets as central to the Earth’s future. Presenting the latest findings, they: • Explore the transition to sustainable diets within the context of sustainable food systems, addressing the right to food, and linking food security and nutrition to sustainability. • Convey the urgency of coordinated action, and consider how to engage multiple sectors in dialogue and joint research to tackle the pressing problems that have taken us to the edge, and beyond, of the planet’s limits to growth. • Review tools, methods and indicators for assessing sustainable diets. • Describe lessons learned from case studies on both traditional food systems and current dietary challenges. As an affiliated project of the One Planet Sustainable Food Systems Programme, this book provides a way forward for achieving global and local targets, including the Sustainable Development Goals and the United Nations Decade of Action on Nutrition commitments. This resource is essential reading for scientists, practitioners, and students in the fields of nutrition science, food science, environmental sciences, agricultural sciences, development studies, food studies, public health and food policy
... Temos que considerar, neste contexto, que estamos atualmente no meio de uma grande mudança em relação ao que as pessoas comem, na forma como comem e por quais razões comem o que comem. [1][2][3][4] Algumas dessas mudanças têm sido descritas como uma transição nutricional, que se refere a uma mudança de dietas ricas em carboidratos complexos e fibras para alimentos mais calóricos, mais gordura e açúcares. 3,[5][6][7][8][9] As mudanças resultam parcialmente da globalização e modernização dos alimentos e da alimentação, por exemplo, o acesso à novas tecnologias, a supermercados modernos e à comercialização dos alimentos. ...
... Especificamente, nos artigos científicos, as dietas alimentares modernas têm sido definidas por um elevado consumo de carne, açúcar, óleos e gorduras. 1,3,5,6,[8][9][10]29 Em contrapartida, as dietas tradicionais têm sido definidas por um elevado consumo de fibras e grãos. 3,6,[8][9][10] No entanto, comparando a alimentação atual em muitas sociedades ocidentais com a de cem anos atrás, verifica-se que existem diferenças não só no que as pessoas comem mas também na forma como elas comem, por exemplo, se comem em casa ou em outros locais. ...
... Especificamente, as dietas alimentares tradicionais caracterizam-se por um elevado consumo de alimentos não processados industrialmente 9,31 e de alimentos frescos, enquanto as dietas alimentares modernas se caracterizam por um elevado consumo de alimentos produzidos industrialmente em massa 26 e ultraprocessados. 1,8,9 Na sua classificação NOVA, Monteiro et al. 32 classificam os alimentos em quatro grupos: "alimentos não processados ou minimamente processados", "ingredientes culinários processados", "alimentos processados" e "alimentos ultraprocessados". Os alimentos ultraprocessados "não são alimentos modificados, mas formulações feitas na sua maioria ou inteiramente a partir de substâncias derivadas de alimentos e aditivos" (p.9). ...
Chapter
An introduction to dietary and health changes focusing on the traditional and the modern. ■ A discussion of what traditional and modern eating are. ■ Dimensions “what people eat” and “how people eat”. ■ Sub-dimensions of “what people eat”: ingredients, processing, preparation, temporal origin, spatial origin and variety. ■ Sub-dimensions of “how people eat”: temporal aspects, spatial, social aspects, meals, enjoyment, concerns. ■ Implications of the multidimensionality of traditional and modern eating for broader understanding of eating behavior and for future research
... Consumers are no longer limited to local produce but literally have the world at their fingertips. Processed and ultra-processed foods have emerged as an increasingly popular food choice in contemporary urban societies (16,18,35,36). Processed foods as described by NOVA food classification, are food items prepared by adding salt, sugar, oil, or other processed culinary ingredients to unprocessed or minimally processed foods employing preservation techniques like canning and non-alcoholic fermentation (37). ...
... Biscuits, carbonated beverages, canned fish, ready-toeat meals, powdered soups, instant noodles are some typical examples of ultra-processed foods (37). The burgeoning popularity of these ultra-processed foods is attributed to its easy accessibility and availability, cheap price, convenience, hyper-palatability, and ubiquitous marketing (35,38,39). Owing to these attractive features, ultra-processed foods have gradually begun displacing home-cooked meals and fresh fruits and vegetables in traditional diets (35)(36)(37). ...
... The burgeoning popularity of these ultra-processed foods is attributed to its easy accessibility and availability, cheap price, convenience, hyper-palatability, and ubiquitous marketing (35,38,39). Owing to these attractive features, ultra-processed foods have gradually begun displacing home-cooked meals and fresh fruits and vegetables in traditional diets (35)(36)(37). Moreover, the availability of ultra-processed foods has also been associated with waning household culinary practices and increased snacking episodes as reported in the literature (37,(40)(41)(42). ...
Article
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One of the leading risk factors for an escalating obesity burden in India is non-nutritious choices. Underpinned by the nutrition transition theory, this qualitative inquiry was designed to understand the urban middle-class Indian consumers’ views about processed foods and rapidly changing food choices. The study consisted of two phases, the first phase consisted of focus group discussions pertaining to the definition and conception of processed foods and the second phase consisted of interviews regarding the changing food environment. A convenience sample of Indian consumers aged 40–65 years were recruited from Mumbai and Kochi to participate in focus group discussions (FGD1 – nine participants and FGD2 – seven participants) and semi-structured face-to-face interviews (N = 22). Both discussions and interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the transcribed data. Features of processed foods mentioned were chemical and physical processing, prolonged shelf life and poor nutritional quality. Factors influencing food choices and consumption of processed foods reported by participants could be categorized into changes in the socio-cultural environment and changes in the food environment. Changes in the socio-cultural environment included globalization and urbanization, long work days and sedentary living, rise in income levels and decrease in household cooking. Changes in the food environment included increased availability and accessibility of processed foods, replacement of traditional Indian diet with Western food, food as indicators of status, food advertisements and convenience. These results are consistent with nutrition transition theory and provide useful direction for public health policies aimed at promoting healthy diets.
... Infants and children are consuming increasing amounts of foods with added sugars, high in salt, and high in saturated or trans fats (1,2). Commercially prepared foods are more likely to be high in energy, low in nutrients (energydense, nutrient-poor), and ultraprocessed (3,4). Globally, the consumption of sugary and savory snacks and refined foods has been increasing across all socioeconomic groups (5). ...
... 3 Not downgraded for inconsistency but note that there were differences between interventions and comparators across studies. 4 Not downgraded because study populations, exposures, and comparators were relevant to review question, although no studies were from low-income country populations. 5 Not downgraded because no evidence of imprecision (i.e., not wide CIs, small sample size, or low number of events). ...
... 3 Not downgraded because only 1 study. 4 Not downgraded because study populations, exposures, and comparators were relevant to review question, although no studies were from low-income country populations. 5 Not downgraded because no evidence of imprecision (i.e., not wide CIs, small sample size, or low number of events). ...
Article
This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage consumption in children on overweight and obesity. We searched PubMed (Medline), Cochrane CENTRAL and Embase for articles, irrespective of language or geography. Inclusion criteria were: 1) randomized controlled trials (RCTs); non-RCTs; cohort studies and pre/post studies with control; 2) participants ≤ 10.9 y at exposure; 3) studies reporting greater consumption of unhealthy foods/beverages vs. no or low consumption; 4) studies assessing anthropometric and/or body composition; and 5) publication date ≥ 1971. Unhealthy foods and beverages were defined using nutrient- and food-based approaches. Risk of bias was assessed using the ROBINS-I and RoB2 tools for non-randomized and randomized studies, respectively. Narrative synthesis was complemented by meta-analyses where appropriate. Certainty of evidence was assessed using GRADE. Of 26,542 identified citations, 60 studies from 71 articles were included. Most studies were observational (59/60), and no included studies were from low-income countries. The evidence base was low quality, as assessed by ROBINS-I and RoB2 tools. Evidence synthesis was limited by the different interventions and comparators across studies. Evidence indicated that consumption of sugar-sweetened beverages (SSB) and unhealthy foods in childhood may increase body mass index (BMI)/BMI z-score, % body fat or odds of overweight/obesity (low certainty of evidence). Artificially-sweetened beverages and 100% fruit juice consumption may make little/no difference to BMI, % body fat or overweight/obesity outcomes (low certainty of evidence). Meta-analyses of a subset of studies indicated a positive association between SSB intake and % body fat, but no association with change in BMI and BMI z-score. High-quality epidemiological studies that are designed to assess the effects of unhealthy food consumption during childhood on risk of overweight/obesity are needed to contribute to a more robust evidence base upon which to design policy recommendations. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO as CRD42020218109.
... These last ones are created with low-cost ingredients to be highly profitable, attractive and convenient (long shelf-life and ready to eat). The literature suggests that such foods, with their poor nutritional quality and high energy density, are able to alter hunger and satiety mechanisms by promoting excessive energy consumption [18,23]. ...
... Several mechanisms have been proposed to describe the association between intake of ultra-processed foods and weight-related outcomes. UPF are, in general, more energy-dense, high in refined carbohydrates and saturated and trans-fatty acids, low in fiber, and contain added sugars and sodium [18]. In addition, high consumption of ultraprocessed foods can reduce total energy expenditure because of the reduced thermic effect of the foods. ...
Article
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Purpose According to the NOVA classification, ultra-processed foods are products made through physical, biological and chemical processes and typically with multiple ingredients and additives, in which whole foods are mostly or entirely absent. From a nutritional point of view, they are typically energy-dense foods high in fat, sugar, and salt and low in fiber. The association between the consumption of ultra-processed food and obesity and adiposity measurements has been established in adults. However, the situation remains unclear in children and adolescents. Methods We carried out a systematic review, in which we summarize observational studies investigating the association between the consumption of ultra-processed food, as defined by NOVA classification, and obesity and adiposity parameters among children and adolescents. A literature search was performed using PUBMED and Web of Science databases for relevant articles published prior to May 2021. Results Ten studies, five longitudinal and five cross-sectional, mainly conducted in Brazil, were included in this review. Four longitudinal studies in children with a follow-up longer than 4 years found a positive association between the consumption of ultra-processed food and obesity and adiposity parameters, whereas cross-sectional studies failed to find an association. Conclusion These data suggest that a consistent intake of ultra-processed foods over time is needed to impact nutritional status and body composition of children and adolescents. Further well-designed prospective studies worldwide are needed to confirm these findings considering country-related differences in dietary habits and food production technologies.
... Euromonitor statistical data showed that the per capita retail sales of three UPFs, namely, frozen products, snacks, and soft drinks in some low-middle income African countries (Cameroon, Egypt, Morocco, and Nigeria) increased by 180, 115, and 273%, respectively. In contrast, an increase of 129, 46, and 48% was reported in upper-middle African countries such as Algeria and South Africa (36,45). This study concludes that the rise in the consumption of UPFs we see now is primarily influenced by the presence of industrial food manufacturing of UPFs, its retailing, and fast-food corporations (36). ...
... In contrast, an increase of 129, 46, and 48% was reported in upper-middle African countries such as Algeria and South Africa (36,45). This study concludes that the rise in the consumption of UPFs we see now is primarily influenced by the presence of industrial food manufacturing of UPFs, its retailing, and fast-food corporations (36). Most African countries, especially South Africa, have reported an increase in obesity in adults aged 18 years and above due to the consumption of UPFs (46)(47)(48). ...
Article
Full-text available
With increasing advocacy for plant food consumption, the sub-Saharan Africa landscape is home to diverse plant-based food commodities. The need to leverage the advantages of unprocessed/minimally processed foods (PFs) over ultra-processed foods (UPFs) is a system that requires exploitation. Most of the crops produced in the continent are either classified as traditionally or moderately PFs. However, the rise in industrialization and formalization of markets is impacting and marginalizing traditional food processing (FP). Current FP classification frameworks are briefly discussed. The level of processing of cereals, grains, fruits, vegetables, roots, and tuber crops in the continent requires intervention from nutritionists, food scientists, and scientific and governmental bodies to gain a holistic view and tackle the issue of food insecurity in Africa. This study reviews the levels of processing of African foods, challenges, and future directions.
... Since the 1980s, food systems have been shaped by dominant international economic policies designed to promote capital flow and trade. International and global trade agreements intensified since the 1990s, enabling transnational food manufacturing, retailing, "fast food" chains, and associated corporations to become colossal [7]. International free-trade agreements have been associated with increased consumption of sugar-sweetened beverages (SSBs) and processed food, as well as sugar and sweeteners used for the Taxes, Subsidies, and Policies production of these products. ...
... In 2016, 39% of adults aged 18 years and older had overweight, and 13% had obesity, and in some countries such as Mexico and the United States, their prevalence has reached >70%. This condition is a major risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, musculoskeletal disorders, and some cancers [7,[10][11][12]. ...
Chapter
This chapter describes some of the public health policy tools that have the potential to improve population diets. One possible policy response to the burden of obesity and diet‐related diseases is fiscal policies such as food taxes and subsidies. In addition to fiscal measures, other policies that have shown to improve the food environment include the promotion and protection of exclusive breastfeeding for children <6 months and continued breastfeeding during the first 2 years or more. Healthcare settings can also be used to promote healthy hydration practices and deter harmful behaviors, such as consuming sugar‐sweetened beverages. Primary care providers are strategically positioned to provide patient‐centered care, which includes screening and advising patients on improving lifestyle and dietary habits, as well as informing them of the risk they pose to their health.
... The increasing obesity prevalence in Brazil and worldwide has occurred in parallel with dramatic transformations in the globalizing food system. These changes are mainly characterized by the gradual weakening of traditional food patterns, based on fresh or minimally processed foods, with the concomitant increase in the consumption of ultraprocessed foods (4,5). Ultra-processed foods are industrial formulations typically ready for consumption made of numerous ingredients, often obtained from high-yield crops, such as sugars and syrups, refined starches, oils and fats, protein isolates, in addition to remains of intensive animal farming. ...
... Examples are cookies, candies, salty snacks, soft drinks, artificial juices, and several ready-to-eat meals (6). Food sales statistics suggest that sales of ultra-processed foods have been expanding intensively in many countries around the world since the 1990s, with particular intensity in middle-income countries (4). In Brazil, household food acquisition surveys showed that the dietary share of ultraprocessed foods increased from 14.3% in 2002/2003 to 19.4%, in 2017/2018 (7) and that it was cross-sectionally associated with the occurrence of obesity (8). ...
Article
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Objectives: To quantify the impact of temporal changes in the consumption of ultra-processed foods on obesity trends in Brazil between 2002 and 2009. Methods: We analyzed data from two Household Budget Surveys carried out in 2002/2003 (n = 182,333) and 2008/2009 (n = 190,159), which provided information on household food acquisition and individuals’ weight and height. We examined the association between ultra-processed foods consumption and obesity and quantified the fraction of increase in obesity prevalence attributable to the rise in the consumption of ultra-processed foods. Results: From 2002 to 2009, there was an increase in the obesity prevalence from 9.9% (95% CI 9.3; 10.4) to 13.2% (12.8; 13.7) while the contribution of ultra-processed foods to total energy consumption raised from 14.3% (13.4; 15.1) to 17.3% (16.5; 18.1). Ultra-processed foods consumption was positively associated with obesity prevalence. More than one quarter (28.6%) of the increase in obesity prevalence was attributable to the rise in the consumption of ultra-processed foods in the period. Conclusion: We found that the rise in the consumption of ultra-processed foods played a major role on the increase of obesity epidemic in Brazil.
... Beyond individual ingredients, one study examined longitudinal changes in the availability of ultra-processed foods, foods that are highly processed and manufactured from industrialised ingredients (12) . Findings indicated that between 1980 and 2012 per capita retail sales of ultra-processed foods increased by ∼10 % (13) . Overall, preliminary evidence indicates that the availability of fat, sugar and ultra-processed foods may have increased in the US food market in recent decades. ...
... Importantly, the palatability induced by the combination of ingredients in HPF is beyond what any single ingredient would produce alone (15,16) . Several prior studies have examined changes in other constructs in the literature, such as energy-dense foods and ultra-processed foods, both of which have increased over time (13,17) . However, neither energy density nor ultra-processing directly addresses hyper-palatability, which may be most directly related to overeating. ...
Article
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Objective To quantify the change in availability of hyper-palatable foods (HPF) in the US foods system over 30 years (1988 to 2018). Design Three datasets considered representative of the US food system were used in analyses to represent years 1988, 2001, and 2018. A standardized definition from Fazzino et al (2019) that specifies combinations of nutrients was used to identify HPF. Differences in the prevalence of HPF were characterized by Cochran’s Q and McNemar’s tests. Generalized linear mixed models with a fixed effect for time and random intercept for food item estimated change in the likelihood that a food was classified as hyper-palatable over time. Results The prevalence of HPF increased 20% from 1988 to 2018 (from 49% to 69%; p <.0001). The most prominent difference was in the availably of HPF high in fat and sodium, which evidenced a 17% higher prevalence in 2018 compared to 1988 (p <.0001). Compared to 1988, the same food items were >2 times more likely to be hyper-palatable in 2001, and the same food items were >4 times more likely to be classified as hyper-palatable in 2018 compared to 1988 (p values <.0001). Conclusions The availability of HPF in the US food system increased substantially over 30 years. Existing food products in the food system may have been reformulated over time to enhance their palatability.
... El hecho de ser alimentos ultraprocesados los convierte en productos altamente rentables e intensamente atractivos; sin embrago, son intrínsecamente poco saludables 5 . De hecho, son alimentos de alta densidad energética que contienen una alta cantidad de nutrientes como grasas saturadas, azucares libres, sodio y son de bajo contenido de nutrientes beneficiosos como fibra dietética, vitaminas, minerales y elementos bioactivos 6 . El aumento constante de consumo de los alimentos ultraprocesados coincidió con una creciente prevalencia de enfermedades crónicas no transmisibles como sobrepeso/obesidad, enfermedades cardio-vasculares, diabetes mellitus y diferentes tipos de cáncer [6][7][8] . ...
... De hecho, son alimentos de alta densidad energética que contienen una alta cantidad de nutrientes como grasas saturadas, azucares libres, sodio y son de bajo contenido de nutrientes beneficiosos como fibra dietética, vitaminas, minerales y elementos bioactivos 6 . El aumento constante de consumo de los alimentos ultraprocesados coincidió con una creciente prevalencia de enfermedades crónicas no transmisibles como sobrepeso/obesidad, enfermedades cardio-vasculares, diabetes mellitus y diferentes tipos de cáncer [6][7][8] . Además, el consumo excesivo de alimentos ultraprocesados se asocian a un mayor riesgo de diferentes tipos de cáncer y mortalidad por todas las causas 9 . ...
Article
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ntroduction: The constant consumption of ultra-processed foods represents a threat to the health of popula-tions, even for those who practice vegetarian regimen. Objective: The aim of this study was to describe the so-ciodemographic characteristics and intake of ultra-processedfoods in vegetarians and non-vegetarians. Methods: A cross-sectional online survey was applied. Atotal of 460 participants were considered, 87 vegetarians and373 non-vegetarians. Recruitment was carried out during themonth of July and September 2020, considering participantsaged 18 to 59 years, residents of the three regions of Peru.The Student’s t-test was used to contrast the means of thefrequency of consumption of ultra-processed foods and di-etary pattern, and the chi-square test was used to contrastproportions in the sociodemographic characteristics and in-take of ultra-processed foods according to dietary pattern. Asignificance level of 0.05 was considered. Results: Vegetarians tended to be women (60.9%), youngpeople aged 18 to 25 years (71.3%), residents of the coastalzone of Peru (83.9%), university students (85.1%) and witha monthly family income ranging from S/ 3,970 to S/12,660(49.2%). In general, vegetarians showed significantly lowerconsumption of snacks, cookies, sugary and carbonated bev-erages and sweets compared to non-vegetarians (p <0.001).Finally, it was observed that, compared to non-vegetarians,there was a higher percentage of vegetarians who reportednever having consumed ultra-processed foods, although con-sumption of snack foods was significantly higher in vegetari-ans than in non-vegetarians. Conclusion: Even vegetarians may have an unhealthy di-etary pattern characterized by consumption of ultra-processed foods. There is a need to implement interventionstrategies to improve the lifestyles of the study population
... These are based on what is now consistent and compelling evidence that the main driver of unhealthy diets and thus of related chronic diseases and disorders is not just foods or nutrients, individually or in combination. Rather, it is the displacement of freshly prepared dishes and meals, most notably since the 1980s, by ready-toconsume ultra-processed food and drink products that consist mostly or even solely of industrially manufactured ingredients and additives (Monteiro, 2009;Monteiro et al., 2013Monteiro et al., , 2017. ...
... In this period, the dietary energy share of ultra-processed products purchased from stores increased from 24 to 54 percent (Moubarac et al., 2014a). Such trends, which continue, are documented in other countries (Baker & Friel, 2016;Juul & Hemmingsson, 2015;Monteiro et al., 2011Monteiro et al., , 2013Moodie et al., 2013;Pan American Health Organization, 2015). Canadians are now the second largest buyers of ultra-processed foods and drinks in the world (after the U.S.), averaging at least 230 kilograms per person per year (Pan American Health Organization, 2015). ...
Article
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Diet-related diseases and disorders in Canada are a national public health emergency, now and as projected. One main reason is that the national food supply has become increasingly dominated by ultra-processed food and drink products, mostly snacks, that displace dietary patterns based on fresh meals. Policies and practices that will enhance the good health and well-being of Canadians of all ages, regions, classes, and social and ethnic groups, and that will benefit society, the economy, and the environment forever, are immediate and imperative priorities. Current programs, including the 2019 Canada’s Food Guide, are moving in the right direction, but are too slow and have notable limitations. Compelling and consistent evidence from studies conducted in Canada and by independent research teams all over the world shows that the main issue with food, nutrition, and health is not nutrients, as has been assumed, but the nature, purpose, and degree of food processing. This is already recognized by UN agencies and an increasing number of national governments. This review examines the evidence on the impact of diets high in ultra-processed food on human and planetary health. It also comments on recent Canadian food guidance. It then introduces the NOVA classification, which takes food processing into account, and analyzes the recent Canadian diet in terms of food processing. Finally, this review proposes healthy eating and policy recommendations that strengthen the 2019 Food Guide, so as to reduce the burden of diet-related disease and enhance the health and well-being of the Canadian people.
... Furthermore, there is increasing concern that excess consumption of industrially processed foods is driving the increase in the prevalence of diet-related chronic diseases [15]. Such foods that, for example, include packaged instant soups and noodles, and pre-prepared meat, fish, and vegetables, are often made from cheap ingredients and additives, which are lower in nutritional quality and higher in energy density [16]. While most young and ...
... Globally, the availability of UPF is high. Trends in the purchase and sales of UPF demonstrate the greatest consumption in high-income countries, but they are increasing in lower-and middle-income countries [16]. Interestingly, Australian data show that the lowest household income quintile consumes less UPF [63]. ...
Article
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Women of reproductive age have a high proportion of overweight/obesity and an overall poor nutritional intake and diet quality. Nutritional modelling is a method to forecast potential changes in nutrition composition that may offer feasible and realistic changes to dietary intake. This study uses simulation modelling to estimate feasible population improvements in dietary profile by reducing ultra-processed food (UPF) consumption in Australian women of reproductive age. The simulation used weighted data from the most recent 2011–2012 National Nutrition and Physical Activity Survey. A total of 2749 women aged 19–50 years was included, and 5740 foods were examined. The highest daily energy, saturated fat, and added sugar and sodium came from UPF. Reducing UPF by 50% decreased energy intake by 22%, and saturated fat, added sugar, sodium, and alcohol by 10–39%. Reducing UPF by 50% and increasing unprocessed or minimally processed foods by 25% led to a lower estimated reduction in energy and greater estimated reductions in saturated fat and sodium. Replacement of 50% UPF with 75% of unprocessed or minimally processed foods led to smaller estimated reductions in energy and nutrients. Our results provide insight as to the potential impact of population reductions in UPF, but also increasing intake of unprocessed or minimally processed foods, which may be the most feasible strategy for improved nutritional intake.
... All consumed food items and beverages from the previous 24 h were categorized into 10 food groups following the Minimum Dietary Diversity for Women (MDD-W) approach, which is useful to reflect the micronutrient adequacy of diets and is recommended for use in LMICs (30). In addition, foods and beverages were assigned to one of four categories of the NOVA classification based on their level of processing (31). However, our study only focused on whether the foods and beverages consumed fell into the fourth NOVA category of ultra-processed foods. ...
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Background Malnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents. Methods Twelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected ( n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets. Results On average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score. Conclusion While the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.
... Ultra-processed foods include carbonated soft drinks; sweet or savory packaged snacks; chocolate and candies (confectionery); ice cream; mass-produced packaged bread and buns; margarine and other spreads; cookies (biscuits), pastries, cakes, and cake mixes; breakfast "cereals"; preprepared pies and pasta and pizza dishes; poultry and fish "nuggets" and "sticks, " sausages, burgers, hot dogs, and other reconstituted meat products; powdered and packaged "instant" soups, noodles, and desserts; and many other products (1). These types of food products have become dominant in the food system (2), being easily found everywhere, often with attractive claims and aggressive marketing strategies, and placed on prominent shelves in several food retailers (3). ...
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The availability of ultra-processed foods in a municipality tends to be related to different types of food retailers and their location in the territory, besides social, economic, and demographic factors. The aim of this study was to evaluate the availability of ultra-processed foods according to different types of food retailers and sociodemographic factors. This is a cross-sectional observational study carried out with audit data from food retailers in the municipality of Jundiaí, SP. Using a validated instrument, data on the availability of 18 types of ultra-processed foods were used to create a score of ultra-processed foods, ranging from 0 to 100 points, and five subscores referring to the ultra-processed food subgroups. Descriptive statistics and means comparison tests were performed to verify differences in the ultra-processed food availability score, according to the food retail type, household income, number of household members, and percentage of people of the color population in the census tract in which food retailers were located. Geo-referenced maps were used to characterize the score of ultra-processed in the territory, according to sociodemographic variables. A total of 649 food retailers were analyzed, most of which were classified as neighborhood markets (25.4%). The supermarkets were the category with the highest ultra-processed food availability score. Among the subgroups of ultra-processed foods analyzed, candies, soft drinks, and snacks were available in 60% of the food retailers. Higher ultra-processed food availability score was observed in regions with lower income, higher percentage of people of color population, and higher number of members per household. The findings show that the greater availability of ultra-processed foods is related to supermarkets and markets and regions of greater social vulnerability, which can put this population at nutritional risk.
... Low-and middle-income countries (LMIC) are facing micronutrient and protein/energy deficiencies but simultaneously are experiencing overweight or obesity in their populations, which are conditions that alone or in combination increase the risk of non-communicable diseases (NCDs) [1]. Changes in the global food system, triggered by the continues increment of food processed by industries, have exacerbated the increase in overweight globally [2]. In high-income countries (HIC), the consumption of ultra-processed products (UPPs) (e.g., foods attractive for their flavor and relative low price, but rich in salt, sugar, saturated fats, and refined cereals flours) provides more than 60% of the total daily energy intake [3,4], while in LMIC, per capita sales of these products have increased over 30% in the last 20 years [5][6][7]. ...
Article
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Ultraprocessed products (UPPs), associated with obesity and non-communicable diseases (NCDs), are becoming predominant on the global market and a target for market-driven fortification initiatives. The aim of this article is to describe the implications of adding micronutrients to UPPs with excessive amounts of critical nutrients associated with NCDs and provide recommendations for legislation and policies. UPPs with added micronutrients such as breakfast cereals, sugar-sweetened beverages, powder beverages, fruit juices, sauces, and bouillon cubes, among others, are commonly available and heavily promoted in Latin American countries. Misleading advertising of UPPs with added micronutrients and with excessive content of sugar, fat, and salt might increase the consumption of such products, giving them a “health halo effect” that leads consumers to overestimate their nutritional quality and healthfulness. Although international collections of standards such as the Codex Alimentarius provide some guidelines on this matter, countries need to implement national legislations, through a food systems approach, to regulate the marketing and labeling of UPPs. Lastly, there is still the need to foster research to close knowledge gaps and help countries to guide the process of food fortification strategies from a regulatory standpoint.
... 5 Despite representing a worldwide public health problem, most individuals do not realize how high this consumption is, 6,7 even with trends of household availability of sodium-rich products, such as ultraprocessed foods, on the rise. 8 The higher the contribution to total energy of ultraprocessed foods, the higher the sodium intake and the risk of developing chronic noncommunicable diseases, such as hypertension. [9][10][11] Moreover, table salt is a major dietary source in several countries, 5 for example, in Brazil, where in addition to salt-based condiments used for seasoning, it accounts for approximately 70% of all sources. ...
Article
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This study aimed to develop and validate an instrument to assess Brazilian adults' knowledge, perceptions, and behaviors (KPB) toward salt and sodium. Based on a PAHO/WHO questionnaire, a new instrument was developed and evaluated by 11 experts, generating item and scale-level content validity indexes (I-CVI and S-CVI, respectively). Face validity was verified through a focus group with eight participants, followed by an operational test with 36 interviewees. Exploratory factor analysis (EFA) was used to determine the construct validity, and Cronbach's α coefficient was calculated to analyze instrument's reliability, using data collected via telephone from a probabilistic sample of 422 adults. The generated solutions were analyzed from theoretical and statistical significance perspectives, which supported the determination of the best model. Remaining items were scored, with higher scores related to healthier practices. A descriptive analysis was performed considering the data from the 422-adult sample. I-CVIs (0.73-1), S-CVIs (0.93; 0.97) and the interviewees' analysis indicated that items are representative and clear, in addition to being suitable for application to the target audience. Tests confirmed sample adequacy to perform the EFA (KMO = 0.82; Bartlett's sphericity test, p < .001). The final validated model, with 16 items, sufficiently explained the variance and presented good reliability (Cronbach's α = 0.81; 95% CI 0.79 - 0.84). Women, older individuals, and with higher education had significantly higher scores, regardless of chronic diseases diagnosis (p < .001). This instrument is ready to be applied and easily reproduced, contributing to the assessment of KPB toward salt and sodium in Brazil.
... Around the world, human diets have shifted towards increased consumption of energy-dense foods (Monteiro et al., 2013). In particular, sugar-sweetened beverage (SSB) consumption has increased worldwide, and is proliferating most rapidly in developing countries (Basu et al., 2013). ...
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Globally, the factors influencing sugar-sweetened beverage (SSB) consumption have been extensively studied in many countries. However, there is no research investigating these factors at the population level. This study analyzed the major factors influencing taxed SSB consumption in Thailand. The Thai SSB tax applies to energy drinks (ED), carbonated drinks (CD) and non-100% fruit juice drinks (FD), and came into effect in 2017. This study used data from the second wave of the 'Longitudinal Monitoring Survey of Sugar-Sweetened Beverage Consumption' survey conducted in Thailand in 2019. A total of 4,736 Thai residents aged 15 years or older from four geographic regions and Bangkok in Thailand participated in the study. Data on self-reported frequency and quantity of consumption of taxed SSB were collected using semi-quantitative food frequency questionnaire. The data also include sociodemographic characteristics, lifestyle behaviors (physical activity, smoking, and alcohol drinking), current health condition, and knowledge of sugar recommendations. Binary and multinomial logistic regression and generalized linear model analyses were conducted. CD was the most consumed taxed SSB (34.2%) among the sample, followed by FD and ED, respectively. The findings suggest that certain sociodemographic characteristics (male, residing in Bangkok or Central region, lower educational attainment), physical inactivity, and smoking were associated with a higher level of SSB consumption. Consumption was lower for every year increase in age. We also observed a statistically-significant association between lack of knowledge of recommended limit on sugar intake and higher level of CD consumption. In order to further reduce SSB consumption in Thailand, more comprehensive, multifaceted policies and strategies are needed to complement the existing SSB taxation policy in Thailand, with a particular focus on addressing particular sociodemographic groups and other health-related behaviors.
... A pragmatic decision was made to limit the search to post-2000. The food supply has changed significantly in the last 20 years with an increasing availability of processed foods [20]. It was felt that examining research post-2000 would capture dietary interventions made within a modern food supply and hence reflect the most current understanding of the relationship between dietary intake and depression. ...
Article
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This systematic literature review examined whole food or whole diet interventions to treat depression. The inclusion criteria encompassed adults, depression, a recognized depression scale and a whole food or diet intervention. APA PsychINFO, CINAHL, the Cochrance Central Register of Controlled Trails, MEDLINE and Scopus were searched for original research addressing diet as a treatment for depression in adult populations. The quality of the study was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Seven studies; with 49,156 participants; met the eligibility criteria. All these studies found positive outcomes with depression levels decreasing after dietary intervention. The calculated effect size varied from small (Cohen’s d = 0.32) to very large (Cohen’s d = 1.82). The inconsistent nature of the studies limited the synthesis of the data. Recommendations are provided to enhance future study design and measurement outcomes. Overall, the findings show a positive result for diets that promote an increased intake of fresh produce, wholegrains, low-fat dairy and lean protein sources, while also decreasing the intake of processed and high-fat foods. No funding was provided for this review. The protocol for this review is registered with PROSPERO (CRD42020210426).
... Esto infiere que los hábitos de alimentación en este tipo de población son similares; sin embargo, pudieran existir otros factores (ambientales o genéticos) que intervienen los resultados de este indicador. En este sentido, Monteiro et al. 18 señalaron que el ultraprocesamiento de alimentos, se ha convertido en un proceso dominante en la industria en países con ingresos altos y medios. Este tipo de procesamiento tiene como objetivo diseñar y desarrollar productos con mayor atractivo sensorial, con hiper-palatabilidad, de bajo costo y listos para consumir, los cuales en su formulación contienen altas cantidades de energía, grasas saturadas y trans, azúcares añadidos y sodio, por lo cual son considerados obsesogénicos. ...
Chapter
Sin lugar a dudas los factores dietéticos tienen una relación importante en el desarrollo y prevención de la diabetes mellitus, por esta razón en el presente estudio se aborda la resencia de prediabetes en una población trabajadora aparentemente sana. La prediabetes tiene como característica principal un aumento de glucosa en sangre -Glucosa en ayuno 100 a 125 mg/dL y Hemoglobina glicosilada (HbA1c) 5.7 a 6.4%- como la define la Federación Nacional de Diabetes (2020).
... 33 Unfortunately, traditional foods are being replaced by the convenience of ultraprocessed foods, such as confectionery, in Brazil 34 and worldwide. 35 These foods have high energy density and glycaemic load, low fibre and micronutrients, and higher concentrations of unhealthy fats, sugars and sodium. 36 Thus, their frequent consumption is harmful to health. ...
Article
Objective: To investigate the association between tooth loss severity and core and non-core food consumption in the older Brazilian population. Methods: We analysed data from 20 756 people aged 60 years or older who participated in the 2019 Brazilian National Health Survey. The average consumption days a week of core (8-item) and non-core (4-item) foods were the outcomes, measured using a Food Frequency Questionnaire. Tooth loss severity was the main exposure, using a four-category ordinal variable: mild (1-12 teeth missing), moderate (13-22), severe (23-31) and edentulous (all 32). Sociodemographic, tobacco smoking, use of dental prosthesis, difficulty in chewing and systemic conditions were among the covariates. Linear regression models estimated the association between tooth loss and food consumption. Results: Almost two-thirds of participants had moderate or worse levels of tooth loss. Older adults with more severe tooth loss reported an overall lower consumption of core and higher non-core foods than those with mild tooth loss. Worse tooth loss severity was associated with lower consumption of vegetables and/or legumes and fruits, and higher consumption of beans, artificial fruit juices and confectionery. Conclusions: Older Brazilian adults with more severe tooth loss are consuming lower core and higher non-core foods. Our findings reinforce the importance of the common risk factor approach to tackle the adverse effects of tooth loss on diet.
... There has been increased attention given to the health impacts of highly processed foods that are high in salt, added sugar, saturated and trans fats, and energy density, and low in fiber, protein, and micronutrients, and that also contribute to, and are associated with, overweight, obesity, and non-communicable diseases Monteiro et al. 2013;Baker and Friel 2016;Baker et al. 2020;Hall, n.d.). Sub-optimal dietary outcomes have stimulated governmental nutrition policies to strive to reduce the intake of salt, added sugar, and unhealthy fats. ...
Chapter
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Because AFSs are diverse, dynamic, and evolve continuously, they require massive continuous investment to enable ongoing discovery and adaptation merely to prevent backsliding.
... There has been increased attention given to the health impacts of highly processed foods that are high in salt, added sugar, saturated and trans fats, and energy density, and low in fiber, protein, and micronutrients, and that also contribute to, and are associated with, overweight, obesity, and non-communicable diseases Monteiro et al. 2013;Baker and Friel 2016;Hall, n.d.). Sub-optimal dietary outcomes have stimulated governmental nutrition policies to strive to reduce the intake of salt, added sugar, and unhealthy fats. ...
... The past three decades have witnessed the most rapid economic development in China. The population continued to grow, but more importantly, this continuous population growth with rising incomes caused a shift in the diet consumed (Colen and Swinnen, 2016;Monteiro et al., 2013). Cash crops are crucial raw materials for luxury goods such as processed foods and alcoholic beverages. ...
Article
Variations in phenology are regarded as a dynamic bio-indicator of global climate change. Rising incomes and the shift toward a diverse diet have been increasing the cash crop demand. However, the response of cash crop phenology to climate change and adaptive management practice remains largely unknown. In this study, using phenology records from 1991 to 2010, we separate the effects of climatic factors and management on phenological changes in the cash crops of sorghum, peanut, and canola based on the statistical and machine learning models. Our results show: (1) The sowing, emergence, three-leaf, and milk ripening date of sorghum showed a significantly (p < 0.05) advanced trend. The sowing, emergence, and five-leaf for canola likewise exhibited a significantly advanced trend (0.55 to 0.91 days a⁻¹). The phenophases of the peanut were generally delayed (0.12 to 0.86 days a⁻¹). (2) For sorghum, canola, and peanut, there is a delayed effect of increasing sunshine hours on heading/anthesis dates. The sowing date for sorghum and peanut delayed with the increased temperature. The three-leaf and milk ripening date of sorghum were sensitive to the wind speed. (3) Sunshine hours contributed to the extension of the whole growth period for sorghum, peanut, and canola, by 68.1, 60.7, and 40.0 %, respectively. The wind speed and temperature had comparable contributions to the maturity date, the former even dominating the heading date of sorghum. (4) Adaptive management practice partially offsets the effect of climate change and supports the length of the whole growth period for sorghum and peanut. Climate change exerts a positive effect on the vegetative growth period for three crops. Our results identified the main climatic factors regulating cash crop phenology. Wind speed must be incorporated in the process-based model to better account for the phenological variations associated with climate change.
... These ultra-processed foods are typically low in dietary fibre, more energy dense and contain higher levels of sugar, salt and saturated fat than unprocessed foods (Monteiro et al., 2011;Moubarac et al., 2013). Although research into ultra-processed foods is in its infancy, preliminary experimental data have shown that they have appetitive properties which drive increases in consumption (Hall et al., 2019). ...
Thesis
The average adult in the UK consumes 200-300 calories beyond their Guideline Daily Amount. For working adults, more than one-third of calories are consumed in the workplace, making this an important environment for intervention. This thesis makes a contribution to the academic literature, by improving our understanding of how and when offering lower-energy alternatives (‘swaps’) is effective, and to public health by refining an intervention which could be delivered in workplace canteens. Two scoping reviews were conducted (studies 1 & 2) and pointed towards the potential effectiveness of pre-ordering lunch and offering healthier swaps as strategies that may help to improve the healthfulness of food and drink choices. When offering lower energy swaps for snacks and non-alcoholic drinks, studies 3 (n=449) and 4 (n=3,481) recruited samples of UK adults in employment to test the effect of different messages on the acceptance of swaps in an experimental online canteen. The results indicated that messages focusing on the lower-energy content of swaps offered may be an effective and acceptable approach. When highlighting the energy content of swaps offered, increasing the interpretability of this information, by providing physical activity calorie equivalent information (PACE) (i.e., the number of minutes walking required to expend the energy contained) further increased the acceptance of snack and drink swaps offered. In study 5, an online version of a real-world canteen was developed and the intervention (prompts to swaps accompanied by a PACE message) was due to be tested in a real-world trial with the healthcare organisation Bupa. However, due to Covid-19, it was tested qualitatively with employees (n=30) of this organisation across the full lunch menu to provide insights about the factors perceived to influence swap acceptance and the acceptability of the intervention. Swap acceptance was facilitated by the provision of PACE information, and swap similarity in terms of taste, texture, and expected satiety as well as the perception that alternatives provided meaningful energy savings. Overall, the intervention was viewed as an acceptable approach to help reduce energy intake in the workplace. Following refinements to the intervention, Study 6 tested the effect of offering lower-energy swaps with and without PACE messages on the energy of hypothetical lunches pre-ordered with a representative online sample of working adults (n=2,150). Offering swaps with and without a PACE message was found to significantly reduce average energy ordered at lunch compared to when no swaps were offered, the PACE message was more acceptable, and there was no evidence of significant interactions between intervention efficacy and participant characteristics. Offering lower-energy swaps in the workplace when employees pre-order is an acceptable and promising intervention to reduce the energy of foods and drinks ordered. Future work should replicate this research in real-world settings.
... Partially hydrogenated oils (PHO), produced by hydrogenation of vegetable oils in the presence of a metal catalyst at high temperatures under vacuum, are the major sources of i-TFA (7). PHO are widely used by the food industry because of their high adaptability to different applications, as they possess neutral taste, are solid at room temperature and resistant to repeated frying (1,8), and have low cost and high palatability (9). ...
Article
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Consumption of industrially produced trans-fat acids (TFA) is a public health concern. Therefore, it is important that information on TFA in packaged foods be clearly informed to consumers. This study aimed to assess the evolution of TFA information presented in packaged foods sold in Brazil in 2010 and 2013, before and after the introduction of stricter regulatory requirements for TFA-free claims on food labels. A repeated cross-sectional study was performed through food label censuses of all packaged foods available for sale in two stores from the same supermarket chain, totaling 2,327 foods products in 2010 and 3,176 in 2013. TFA-free claims and information indicating TFA in the ingredients list and nutrition facts label were analyzed by descriptive statistics and Pearson’s chi-square test. There was a 14% decrease in the use of ingredients containing or potentially containing industrially produced TFA (i-TFA), according to analysis of the ingredients list. However, when analyzing foods by groups, it was found that this decrease was significant only for group A (bakery goods, bread, cereals, and related products; from 59 to 35%, p < 0.001). By contrast, food group F (gravies, sauces, ready-made seasonings, broths, soups, and ready-to-eat dishes) showed a 5% increase in i-TFA. The use of specific terms for i-TFA decreased between 2010 and 2013, but there was an increase in the use of alternative terms, such as vegetable fat and margarine, which do not allow consumers to reliably identify whether a food product is a possible source of i-TFA. There was an 18% decrease in the use of TFA-free claims in products containing or potentially containing i-TFA. However, almost one-third of foods sold in 2013 were false negatives, that is, foods reported to contain 0 g of TFA in the nutrition facts label or with TFA-free claims but displaying specific or alternative terms for i-TFA in the ingredients list. The results indicate that adoption of stricter requirements for TFA-free claims on food labels in Brazil helped reduce the prevalence of such claims but was not sufficient to decrease i-TFA in industrialized foods sold in supermarkets.
... Moreover, today's industrialized food system allows people only restricted access to fresh and natural foods by narrowing their range of food environment [8,9]. It consequently makes people become increasingly dependent on ultraprocessed foods, convenience foods and delivery foods, which are usually energy-dense and nutrient-poor [10][11][12]. Furthermore, under the profound effect of mass media, people are easily exposed to stimulating food advertisements and untrustworthy food information [13,14]. ...
Article
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Due to the COVID-19 pandemic and industrialized food systems, people’s eating behavior has become seriously restricted. Especially, university students have started to overly depend on processed foods and carnivorous diets, and it places a huge burden on society by inducing the deterioration of health and environmental sustainability. Therefore, this study was undertaken to examine the effects of university students’ perceived food literacy on ecological eating behavior towards sustainability. A total of 395 university students in South Korea participated in this research. First, students’ food literacy components, which are reading labels and budgeting, healthy snack styles, healthy food stockpiling and resilience and resistance, exert positive influences on ecological eating behavior; second, the other two components, which are food preparation skills and social and conscious eating, have no positive impact on ecological eating behavior. Finally, the influences of food literacy on ecological behavior are significantly moderated by gender differences. This suggests that strengthening university students’ food literacy through education is necessary to promote ecological eating behaviors and advance the development of sustainable society.
... It is also important to work with the impacts caused by the gradual imposition of processed and ultra-processed foods provided by the globalized agri-food system and that is causing public health problems such as malnutrition and obesity (Monteiro et al., 2013). In this sense, data on obesity place Hidalgo as one of the states with the highest incidence, with 490.75 cases per 100 thousand inhabitants (Anuario de Morbilidad, 2014). ...
Article
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Esta investigación tuvo como objetivo caracterizar el sistema agroalimentario localizado que aún persiste en tres municipios habitados por población náhuatl en la Huasteca Hidalguense en México, caracterizada por su pobreza, marginación y vulnerabilidad ante el cambio climático. Las herramientas metodológicas fueron una encuesta a productores (n= 68) y consumidores (n= 68) y una revisión documental. Los datos obtenidos fueron analizados con estadística descriptiva. Los resultados indican que en la Huasteca Hidalguense existe un sistema agroalimentario localizado en condiciones críticas, en cuyo funcionar es fundamental la participación de pequeños productores con escasos recursos y afectados en su quehacer productivo por condiciones de sequía en los últimos cinco años. Se considera que la recuperación y el fortalecimiento del sistema agroalimentario localizado de la región fortalecerá la seguridad alimentaria y nutricional de la población.
... The same observations were previously reported by other groups [38][39][40][41] underlying the inadequacy of energy intake compared to recommendations in pregnancy, especially in the last two trimesters. A possible reason of these results is that the FFQ methodology employed in the present and in mentioned previous studies do not include a few novel foods, new ultra-processed food or ethnical cooking items that are widely consumed in the studied populations [42,43], thus possibly contributing to the increase in the real energy intake. Moreover, generally, OW patients tend to under-estimate their general food consumption. ...
Article
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Background: Nutritional quality during pregnancy is crucial for mother and child health and their short/long-term outcomes. The aim of this study is to evaluate the adherence to nutritional recommendations in Italy during the three pregnancy trimesters in Normal Weight (NW) and Over Weight (OW) women. Methods: Data from a multicenter randomized controlled trial included 176 women (NW = 133; OW = 43) with healthy singleton pregnancies enrolled within 13 + 6 weeks of gestation. Dietary intake was assessed every trimester by a Food Frequency Questionnaire. Results: OW and NW had similar gestational weight gain. However, as Institute of Medicine (IOM) recommend lower gestational weight gain (GWG) for OW, they exceeded the suggested range. In both groups, caloric intake during the three trimesters never met recommendations. Protein intake in first and second trimester was higher than recommendations, as was sugars percentage. Dietary fiber intake was lower in OW. Polyunsaturated fatty acids, calcium, iron and folic acid requirements were never satisfied, while sodium intake exceeded recommendations. Conclusions: NW and OW women in Italy do not adhere to nutritional recommendations during pregnancy, with lower caloric intake, protein and sugars excess and inadequacies in micronutrients intake. Pregnant women in Italy should be provided with an adequate counseling and educational intervention as well as supplementation when indicated.
... Moreover, phosphate salts added as additives are inorganic phosphate with an almost 100% bioavailability ( Fig. 1), indicating that independently of the amount present in the UPF, the phosphate will almost completely be absorbed in the intestine [14]. In the last decades, consumption of UPF has increased [74]. UPF consumption represents 20 to almost 60% of the total energy intake consumed depending on the different population groups studied [16,63,68,69,78,95]. ...
Article
Full-text available
Phosphate is essential in living organisms and its blood levels are regulated by a complex network involving the kidneys, intestine, parathyroid glands, and the skeleton. The crosstalk between these organs is executed primarily by three hormones, calcitriol, parathyroid hormone, and fibroblast growth factor 23. Largely due to a higher intake of ultraprocessed foods, dietary phosphate intake has increased in the last decades. The average intake is now about twice the recommended dietary allowance. Studies investigating the side effect of chronic high dietary phosphate intake suffer from incomplete dietary phosphate assessment and, therefore, often make data interpretation difficult. Renal excretion is quickly adapted to acute and chronic phosphate intake. However, at the high ends of dietary intake, renal adaptation, even in pre-existing normal kidney function, apparently is not perfect. Experimental intervention studies suggest that chronic excess of dietary phosphate can result in sustained higher blood phosphate leading to hyperphosphatemia. Evidence exists that the price of the homeostatic response (phosphaturia in response to phosphate loading/hyperphosphatemia) is an increased risk for declining kidney function, partly due by intraluminal/tubular calcium phosphate particles that provoke renal inflammation. High dietary phosphate intake and hyperphosphatemia are progression factors for declining kidney function and are associated with higher cardiovascular disease and mortality risk. This is best established for pre-existing chronic kidney disease, but epidemiological and experimental data strongly suggest that this holds true for subjects with normal renal function as well. Here, we review the latest advances in phosphate intake and kidney function decline.
... Poor diets are responsible for one in five deaths globally, more than any other risk factor (2). While poor diets vary, they are crudely characterized by low intake of whole grains, fruits, nuts, and seeds, and vegetables and, in some contexts, as having excess intake of sugars (3), saturated fats, calories, and highly processed foods of non-nutritive substances (4,5). Dietary challenges have compounded with the homogenization of food supplies over the past eight decades (6)(7)(8). ...
Article
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Globally, we are failing to meet numerous nutritional, health, and environmental targets linked to food. Defining food composition in its full chemical and quantitative diversity is central to data-driven decision making for supporting nutrition and sustainable diets. “Foodomics”—the application of omics-technology to characterize and quantify biomolecules to improve wellbeing—has the potential to comprehensively elucidate what is in food, how this composition varies across the food system, and how diet composition as an ensemble of foods guides outcomes for nutrition, health, and sustainability. Here, we outline: (i) challenges of evaluating food composition; (ii) state-of-the-art omics technology and innovations for the analysis of food; and (iii) application of foodomics as a complementary data-driven approach to revolutionize nutrition and sustainable diets. Featuring efforts of the Periodic Table of Food Initiative, a participatory effort to create a globally shared foodomics platform, we conclude with recommendations to accelerate foodomics in ways that strengthen the capacity of scientists and benefit all people.
... Sugar addition contradicts the guidelines for feeding children younger than 2 [31,32], and could be avoided by offering fruits and drinks unsweetened, not offering UPF, and with strategies as using fruits and dry fruits to sweeten culinary preparations to children. Excessive consumption of UPF with high carbohydrate content during childhood may lead to obesity [35], a risk factor for obesity in adulthood. The percentage of calories found in this food group is larger than the percentage found in a population-based study, developed in Southern Brazil. ...
Article
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Objective To investigate the contribution of ultra-processed food to the nutritional dietary profile of school feeding in public child day-care centers. Methods Cross-sectional study carried out from June-November/2013. Samples from six daily meals were collected in twenty non-consecutive days. A total of 117 school meals (123 food items) were offered to children from 12-36 months of age. The served portions were determined by direct weighting. Physicochemical analyses were performed to establish the nutritional composition. School meals were classified according to the processing degree: (A) unprocessed/minimally processed/culinary preparations, (B) processed food, or (C) ultra-processed food. The contribution of each group to the quantity of energy, macronutrients and sodium was calculated. Student’s t test was applied for comparison between groups. Results Ultra-processed meals contributed to 45.8% of energy, 33.9% of lipids, 42.8% of proteins, 48.9% of carbohydrates, and 20.9% of sodium. All lunches and 90% of dinners were classified as unprocessed/minimally processed/culinary preparations. 39.0% of the meals were ultra-processed (mainly breakfast and snacks). Ultra-processed meals had a greater quantity of energy (p=0.026) and carbohydrates (p<0.001) per serving, while unprocessed/minimally processed/culinary preparations offered more sodium per serving (p<0.001). Conclusion Although most meals were classified as unprocessed/minimally processed/culinary preparations, ultra-processed food, which should be avoided at this stage of life, are offered daily, contributing with higher energy and carbohydrates offer per serving. The municipality need to improve the quality of the meals offered to children in these child day-care centers, observing the new Resolution nº 6/2020 that came into effect in 2021.
... Considering that higher socioeconomic status is associated with more psychosocial resources, including access to health-promoting services and resources that facilitate nutrition knowledge and cooking skills (Hagger et al., 2013;Monteiro et al., 2013), households with lower socioeconomic status may experience more disruptions in food access and changes in eating patterns during a global pandemic. Additionally, in a retrospective cohort study by Little et al. (2021) on the impact of socioeconomic status on clinical outcomes of COVID-19 (n = 3528), patients with COVID-19 who resided in high poverty areas were significantly younger, more likely to be female or a racial minority, or had a higher prevalence of comorbidities compared to individuals who resided in low poverty areas (Little et al., 2021). ...
Article
In the United States, the Coronavirus Disease 2019 (COVID‐19) pandemic necessitated nationwide closures of kindergarten through twelfth grade (K‐12) schools. Stay‐at‐home orders and social distancing mandates were also implemented to mitigate the spread of COVID‐19. The purpose of this systematic review was to synthesize the existing literature on how COVID‐19 impacted K‐12 students' eating patterns, physical activity, and sleep in the United States. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, a literature search was conducted between October and December 2021. Inclusion criteria were studies focused on COVID‐19 and eating patterns, physical activity, and sleep in students enrolled in K‐12 schools since March 2020. International studies were excluded. Mixed findings were observed for eating patterns whereby the consumption of unhealthful savory and sweet items and healthful snacks (e.g., fruit and vegetables) increased. Reductions in physical activity and disrupted sleep routines were also observed. Heterogeneity in methodological procedures may limit the generalizability of these findings. In the United States, preliminary data suggest that select health‐promoting behaviors were negatively impacted by the COVID‐19 pandemic. Given that prolonged unhealthful eating patterns, physical inactivity, and poor sleep contribute to chronic disease risk, initiatives that increase health‐promoting behaviors are warranted. Some health‐promoting behaviors were negatively impacted by COVID‐19. Unhealthful savory and sweet items and healthful snacks increased. Reductions in physical activity and disrupted sleep routines were observed. Some health‐promoting behaviors were negatively impacted by COVID‐19. Unhealthful savory and sweet items and healthful snacks increased. Reductions in physical activity and disrupted sleep routines were observed.
... Poor diets are responsible for one in five deaths globally, more than any other risk factor (2). While poor diets vary, they are crudely characterized by low intake of whole grains, fruits, nuts, and seeds, and vegetables and, in some contexts, as having excess intake of sugars (3), saturated fats, calories, and highly processed foods of non-nutritive substances (4,5). Dietary challenges have compounded with the homogenization of food supplies over the past eight decades (6)(7)(8). ...
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Globally, we are failing to meet numerous nutritional, health, and environmental targets linked to food. Defining food composition in its full chemical and quantitative diversity is central to data-driven decision making for supporting nutrition and sustainable diets. ‘Foodomics,’ or the application of omics-technology to improve wellbeing, has the potential to comprehensively elucidate what is in food, how this composition varies with environmental, management, and processing factors across the food system, and importantly, how diet composition as an ensemble of foods guides outcomes for nutrition, health, and sustainability. Here, we outline: (1) challenges of evaluating food composition; (2) state-of-the-art omics technology and innovations for the analysis of food; and (3) application of foodomics to revolutionize nutrition and sustainable diets. Featuring efforts of the Periodic Table of Food Initiative, a participatory effort to create a globally shared foodomics platform, we conclude with recommendations to accelerate the field in ways that strengthen the capacity of scientists globally and benefit all people, particularly those most vulnerable to malnutrition and diet-driven illness.
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In many non-Asian countries, soy is consumed via soy-based meat and dairy alternatives, in addition to the traditional Asian soyfoods, such as tofu and miso. Meat alternatives are typically made using concentrated sources of soy protein, such as soy protein isolate (SPI) and soy protein concentrate (SPC). Therefore, these products are classified as ultra-processed foods (UPFs, Group 4) according to NOVA (not an acronym), an increasingly widely used food classification system that classifies all foods into one of four groups according to the processing they undergo. Furthermore, most soymilks, even those made from whole soybeans, are also classified as UPFs because of the addition of sugars and emulsifiers. Increasingly, recommendations are being made to restrict the consumption of UPFs because their intake is associated with a variety of adverse health outcomes. Critics of UPFs argue these foods are unhealthful for a wide assortment of reasons. Explanations for the proposed adverse effects of UPFs include their high energy density, high glycemic index (GI), hyper-palatability, and low satiety potential. Claims have also been made that UPFs are not sustainably produced. However, this perspective argues that none of the criticisms of UPFs apply to soy-based meat and dairy alternatives when compared to their animal-based counterparts, beef and cow's milk, which are classified as unprocessed or minimally processed foods (group 1). Classifying soy-based meat and dairy alternatives as UPFs may hinder their public acceptance, which could detrimentally affect personal and planetary health. In conclusion, the NOVA classification system is simplistic and does not adequately evaluate the nutritional attributes of meat and dairy alternatives based on soy.
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Going to university means that many students assume, for the first time, responsibilities associated with living outside the family group, such as controlling eating habits. A survey was conducted among 161 university students in order to find out their perceptions regarding their type of diet, their knowledge of nutrition issues, their consumption of ultra-processed foods, and to evaluate the Nutri-Score labeling system as an aid in choosing healthier products. This is a cross-sectional observational study. Participants who have the perception of following a healthy diet show a more adequate BMI, regularly practice sports and read labels (nutritional information, expiration date, and ingredients). In general, the university students surveyed do not read the labels (64%) and find it difficult to identify the degree of wholesomeness of what they consume. Furthermore, they buy products based on the external information on the packaging (72%). The consumption of ultra-processed products, such as alcohol and soft drinks, is higher in those who live outside their family homes. The Nutri-Score labeling system is perceived as an aid for better product choice (89%).
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The fundamental biological drivers of dietary intake are no different in humans than other species, from insects in laboratory studies to wild primates in natural ecologies. In this chapter, the authors show how research, initially on insects and subsequently many other species (from single cellular slime molds to apes in the wild), has suggested a new ecologically inspired approach for understanding the roles of biology, environment, and their interactions in driving the obesity epidemic, and potentially identifying solutions. They explain the theoretical foundations for the approach, illustrate its application to addressing relevant questions in some non‐human species, and show how it has been applied in studies of humans. Recent research suggests that the protein leverage hypothesis might provide a new approach for integrating with existing public health frameworks to understand how human biology interacts with transitioning food environments to generate epidemics of obesity and associated disease.
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Background Our aim was to investigate the association between ultra-processed food (UPF) consumption and the incidence of elevated symptoms of common mental disorders (CMD) in two Brazilian birth cohorts. Methods We analyzed data from the 1993 (n = 3130) and 1982 (n = 3165) Pelotas Birth Cohorts. In the 1993 cohort, the 18y wave provided the first wave data and the 22y wave the second wave data. In the 1982 cohort, the first and the second waves data came from the 22y and the 30y waves, respectively. The self-reporting questionnaire (SRQ-20) was used to assess CMD symptoms and determine the incidence of elevated symptoms of CMD over time. UPF consumption was assessed using food frequency questionnaires, and it was expressed as % of the total energy and % of g/d intake and coded into quartiles according to sex. Poisson and Cox regression models were used to estimate the association between UPF consumption and incidence of elevated symptoms of CMD. Results There were no associations between first wave quartiles of UPF consumption and change during the second wave in the number of symptoms of CMD in both cohorts and both cohorts in the same model (quartiles based on % of total energy:Q2: HR = 1.15, 95%CI: 0.93–1.42; Q3 = 0.91, 0.73–1.14; Q4 = 0.97, 0.77–1.21. Quartiles based on % of g/d: Q2 = 1.03, 0.83–1.27; Q3 = 1.05, 0.85–1.31; Q4 = 0.97, 0.78–1.21). Limitations Recall bias and only two time-points in each cohort study. Conclusions The consumption of ultra-processed food was not associated with the incidence of elevated CMD symptoms over time in both birth cohorts.
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Food system transformations occur in a complex political, economic, social, and territorial landscape. The study provides a historical construction of global food regime changes and the adaptiveness, transformability, and resilience of the local food system in Lebanon, a Middle Eastern context. Lebanon offers a unique opportunity to understand the influence of global food regimes and geopolitics on agriculture, the local food system, and capital accumulation. After the 1975–1990 Lebanese Civil War, Lebanon experienced food retail transformation and international penetration through foreign investments. These alterations have several implications for society and the local food system: farming households' influence on agricultural policies and the political commitment to support the farming community decreased. The paper concludes that Lebanon's local food system transformation is a manifestation of geopolitical events and global food regime changes. This may have important implications and pave the way for a new food system that is based on the revitalization of agriculture and new forms of geoeconomic partnerships with regional actors.
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Overindulgence, excessive consumption, and a pattern of compulsive use of natural rewards, such as certain foods or drugs of abuse, may result in the development of obesity or substance use disorder, respectively. Natural rewards and drugs of abuse can trigger similar changes in the neurobiological substrates that drive food- and drug-seeking behaviors. This review examines the impact natural rewards and drugs of abuse have on perineuronal nets (PNNs). PNNs are specialized extracellular matrix structures that ensheathe certain neurons during development over the critical period to provide synaptic stabilization and a protective microenvironment for the cells they surround. This review also analyzes how natural rewards and drugs of abuse impact the density and maturation of PNNs within reward-associated circuitry of the brain, which may contribute to maladaptive food- and drug-seeking behaviors. Finally, we evaluate the relatively few studies that have degraded PNNs to perturb reward-seeking behaviors. Taken together, this review sheds light on the complex way PNNs are regulated by natural rewards and drugs and highlights a need for future studies to delineate the molecular mechanisms that underlie the modification and maintenance of PNNs following exposure to rewarding stimuli.
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The aim of this study was to conduct a literature scope review of the association between the consumption of ultra-processed foods and health outcomes. The search was carried out in the PubMed, Web of Science and LILACS databases. Studies that assessed the association between the consumption of ultra-processed foods, identified on the NOVA classification, and health outcomes were eligible. The review process resulted in the selection of 63 studies, which were analyzed in terms of quality using a tool from the National Institutes of Health. The outcomes found included obesity, metabolic risk markers, diabetes, cardiovascular diseases, cancer, asthma, depression, frailty, gastrointestinal diseases and mortality indicators. The evidence was particularly consistent for obesity (or indicators related to it) in adults, whose association with the consumption of ultra-processed foods was demonstrated, with dose-response effect, in cross-sectional studies with representative samples from five countries, in four large cohort studies and in a randomized clinical trial. Large cohort studies have also found a significant association between the consumption of ultra-processed foods and the risk of cardiovascular diseases, diabetes and cancer - even after adjusting for obesity. Two cohort studies have shown an association of ultra-processed foods consumption with depression and four cohort studies with all-cause mortality. This review summarized the studies' results that described the association between the consumption of ultra-processed foods and various non-communicable diseases and their risk factors, which has important implications for public health.
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Food insecurity is a well-known risk factor for a number of health conditions, including stunting, overweight, and poor mental health. However, less is known about the pathways through which food insecurity shapes health at the individual and household levels and even less about how food insecurity overlaps with poor water quality and access to impact physical and mental health. In this chapter, we describe the individual and joint effects of food and water insecurity on health and argue that limitations in the water and food environments interact synergistically as a syndemic contributing to co-occurring overweight and cardiometabolic disease alongside persistent infectious disease and undernutrition. Such research is needed to understand the social and biological pathways linking the experiences of food and water insecurity to the dual burden of disease in low- and middle-income country settings like the Galapagos.
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In this landmark e-book of Frontiers of Nutrition, the authors from several Latin American nations provide findings that seed a plant-based research agenda for Latin America. Cairo et al. provide findings clearly showing how obesity and overweight have reached the rural areas of Brazil. The emergence of processed and ultra-processed foods in diet patterns across the lifespan in Latin America is shown in pre-schoolers in Chile by Araya et al. and reviewed for the entire region by Matos et al.. Despite these strong trends, there remains a paucity of research infrastructure in Latin America for culturally tailored dietary intervention trials to reverse the nutrition transition away from cultural diets based on minimally processed whole plant foods and fewer animal products. The supplement continues the build of this emergent research infrastructure for dietary intervention. Sanchez Urbano et al. provide evidence of the feasibility and acceptability of dietary intervention advice in the Latin American context. Loureiro et al. provide insights from diet patterns in Brazilian adults, and Contreras-Guillén et al. is innovating dietary recall methods for Argentina. Figueroa et al. tackle the question of whether a plant-based Mediterranean diet can be adapted for the Latin American region. Taken together, the supplement articles herein are a stride forward in the path to reverse the nutrition transition that is creating a sizable noncommunicable disease burden in Latin America.
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Dietary interventions with probiotics have been widely reported to be effective in regulating obesity, and the intestinal microbiota is considered to be an important environmental factor. However, few reports focus on the interactions of microbiota-metabolites-phenotypic variables in ob/ob mice, and they have not been characterized in great detail. In this study, we investigated the effects of Bacillus amyloliquefaciens SC06 on obesity, the intestinal microbiota and the bile acid metabolism of ob/ob mice using biochemical testing, histochemical staining, high-throughput sequencing of the 16S rRNA gene, LC-MS/MS analysis and qRT-PCR. The results showed that SC06 ameliorated the fat mass percentage, hepatic steatosis and liver lipid metabolism disorders and reshaped the gut microbiota and metabolites in male ob/ob mice, specifically deceasing f_S24-7, p_TM7, s_Alistipes massiliensis, f_Rikenellaceae, f_Prevotellaceae, f_Lactobacillaceae, g_Alistipes, g_Flexispira, g_Lactobacillus, g_Odoribacter, g_AF12 and g_Prevotella and increasing f_Bacteroidaceae, g_Bacteroides and f_Desulfovibrionaceae. Meanwhile, SC06 treatment groups had lower ibuprofen and higher glycodeoxycholic acid and 7-dehydrocholesterol. Correlation analysis further clarified the relationships between compositional changes in the microbiota and alterations in the metabolites and phenotypes of ob/ob mice. Moreover, SC06 downregulated bile acid synthesis, export and re-absorption in the liver and increased ileum re-absorption into the blood in ob/ob mice, which may be mediated by the FXR-SHP/FGF15 signaling pathway. These results suggest that Bacillus amyloliquefaciens SC06 can ameliorate obesity in male ob/ob mice by reshaping the intestinal microbial composition, changing metabolites and regulating bile acid metabolism via the FXR signaling pathway.
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An in-depth understanding of people's experiences, beliefs and thoughts about cooking and homemade meals is essential for the design of a more effective discourse to encourage cooking from scratch. In this context, the objective of the present work was to explore the social representations of homemade meals and cooking. An online survey was conducted with 974 Uruguayan adults, recruited using an advertisement on Facebook. Participants were asked to write down the first words that came to their mind when thinking of homemade meals and cooking. Responses were coded into categories using inductive coding. The structure of the social representations was explored using the frequency of mention and rank of appearance of the categories. Results showed that the social representations of homemade meals were largely consensual among participants and mainly related to pleasure, health, and wellbeing. However, the social representations of cooking did not have a clear structure, which raised diverse associations related to homemade foods, positive emotions but also to lack of convenience in terms of time and effort. Results suggest public campaigns aimed at encouraging people to cook from scratch should position cooking as enjoyable task and diminish perception of lack of time and effort association.
Article
Objectives: The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CVD) incidence and mortality, and the dose-response relationship. Methods: Published literature was retrieved through a structured search of 10 electronic databases: MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO and Embase, without language or year of publication restrictions. In addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes: The PRISMA Statement. Results: Twenty-one prospective cohort studies were included in the systematic review. The CVDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CVD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; CI 1.01 to 1.19; p = 0.02). There was no association with Ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; CI 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CVD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; CI 1.08 to 1.26; p < 0.0001). There was no association with Ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CVD. Conclusion: According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CVD. This systematic review and meta-analysis protocol was registered on the PROSPERO (number: CRD42019100914).
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A relação entre o consumo de produtos ultraprocessados e o aumento da obesidade e do risco de doenças crônicas não transmissíveis (DCNT) impulsionou organismos internacionais a mobilizarem os governos para regular a redução dos teores de açúcares, gorduras e sódio nesses produtos. O artigo analisa a compreensão de diferentes sujeitos estratégicos sobre os riscos à saúde associados aos produtos ultraprocessados, e a intervenção pública adotada para modificar a sua composição, em atendimento à Política Nacional de Alimentação e Nutrição (PNAN). Trata-se de uma investigação empírica qualitativa em que foram entrevistados representantes de 12 instituições. Adotou-se o referencial teórico da Hermenêutica da Profundidade em conjunto com a Análise de Discurso. Este estudo se concentrou no tema genérico “Acordo e Regulação” e no enunciado matriz “Regulação Consentida”. Considerando um cenário de circulação global dos produtos ultraprocessados, não disciplinados por normas internacionais, a medida de intervenção pública foi a de instituir Acordos com algumas corporações de alimentos, em contraposição ao regulamento compulsório. Tal medida foi criticada por parte dos sujeitos do Setor Público e da Sociedade Civil, pois a relevância do tema para a saúde pública requer regras claras para redução dos nutrientes-chave e com sanções. Em posição contrária, os sujeitos do Setor Regulado avaliam essa medida como sensata e de compreensão do governo. Embora haja divergências entre os sujeitos, constata-se que os Acordos, em contraposição à regulação, desrespeitam as disposições da PNAN 2012 e representam um retrocesso face às suas características particulares, cujos resultados interferirão lentamente na melhoria nutricional dos produtos ultraprocessados.
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The years 2019-2021 witnessed a pandemic that forced humans to confine to their homes. COVID has already taken millions of lives worldwide and there is a need to review the existing medical intervention. When there is an outbreak of a disease, our body's defense mechanism works as a shield to prevent the body from invading pathogens. This ability of humans has evolved over a long period. Though the COVID-19 pandemic is threatening the world, even in the absence of any targeted medicine or vaccine, 433 million people recovered, which speaks volumes about the immune system's capability to counter hitherto unknown invaders. The proposed plasma therapy is also dependent on the antibodies produced by the immune system of a recovered patient. Vaccines created against SARS-CoV2 also trigger the natural immune system to make the necessary antibodies before the active virus attacks. Thus, all available and future roads point towards the capability of our immune system only. The COVID waves made scientists and researchers understand that not every person exposed to the SARS CoV-2 virus gets infected, and not all COVID-positive patients develop respiratory issues [1]. The conventional medicinal system has also contributed in a great way to curb the situation. However, an accepted and recommended approach to complementary therapies as a holistic tool has not found its way. Antibiotics target pathogens mostly with no consideration of repercussions on host cells [2]. In this paper, we have tried to address the current situation and the role of yoga, meditation, and breathing techniques to help face the crisis and prepare our immune system for possible further outbreaks. We also look at diet and other factors that impair our immunity and make us more vulnerable to virus attacks.
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Conforme se fortalece, no Brasil, a agenda de promoção da alimentação adequada e saudável, associações nacionais das indústrias de alimentos têm inflexionado sua atividade política corporativa (CPA). Destacando a Associação Brasileira da Indústria de Alimentos (ABIA), a Associação Brasileira de Laticínios e a União da Indústria de Cana-de-Açúcar, e tratando do período entre 2014 e 2020, este artigo analisa tal inflexão em suas dimensões representativas, comunicacionais e institucionais. Fundamentado metodologicamente no modelo de identificação da CPA, o trabalho tem como fontes registros da observação participante no Instituto Pensar Agropecuária (IPA) e no Legislativo, anotações de entrevistas com dirigentes e técnicos de associações empresariais e políticos, além de diversos documentos e websites das entidades, do Estado e da sociedade civil. Os resultados demonstram que, na dimensão representativa, as associações das indústrias de alimentos reformularam seu lobbying no Legislativo, para isso criando uma comissão no IPA; na dimensão comunicacional, houve aumento da proeminência de uma narrativa de apropriação da agenda da alimentação adequada e saudável, estratégia discursiva que passou a ladear outras duas narrativas, uma de contraposição à agenda, outra de deslocamento das responsabilidades corporativas para decisões individuais; finalmente, na dimensão institucional, ocorreram notáveis transformações na ABIA, além da criação de outras associações e redes. A conclusão indica que a CPA das principais associações de indústrias de alimentos no país está se alterando de modo acentuado para responder às críticas aos determinantes comerciais da saúde.
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Throughout human existence, diet and nutritional status have undergone a sequence of major shifts among broad patterns of food use. Large shifts in the composition of diet, reflected in changes in stature and body composition and in disease patterns, have occurred. The nature and pace of these nutritional changes vary considerably over time and space, with a noticeable acceleration of change now occurring in many countries. A marked worldwide shift is evident toward a diet high in fat and processed foods and low in fiber, with corresponding increases in degenerative diseases. Such a shift is not inexorable; however, knowledge and appropriate policies will be needed if currently developing societies are to bypass the more detrimental aspects of the nutrition patterns that characterize many industrialized societies.
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Major changes have been occurring almost unnoticed in staple value chains in Asia. The Quiet Revolution in Staple Food Value Chains documents and explains the transformation of value chains moving rice and potatoes between the farm gate and the consumer in Bangladesh, the People's Republic of China, and India. The changes noted are the rapid rise of supermarkets, modern cold storage facilities, large rice mills, and commercialized small farmers using input-intensive, mechanized technologies. These changes affect food security in ways that are highly relevant for policymakers across Asia—the rise of supermarkets provides cheaper staples, more direct relations in the chains combined with branding have increased traceability, and the rise of cold storage has brought higher incomes for potato farmers and all-season access for potato consumers. The book also joins two debates that have long been separate and parallel—food industry and agribusiness development and market competitiveness—with the food security and poverty alleviation agenda. About the International Food Policy Research Institute The International Food Policy Research Institute (IFPRI) was established in 1975 to identify and analyze alternative national and international strategies and policies for meeting food needs of the developing world on a sustainable basis, with particular emphasis on low-income countries and on the poorer groups in those countries. IFPRI's research program reflects worldwide collaboration with governments and private and public institutions interested in increasing food production and improving the equity of its distribution. Research results are disseminated to policymakers, opinion formers, administrators, policy analysts, researchers, and others concerned with national and international food and agricultural policy. IFPRI is a member of the Consultative
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Production and consumption of industrially processed food and drink products have risen in parallel with the global increase in overweight and obesity and related chronic non-communicable diseases. The objective of this study was to analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight (overweight plus obesity) and obesity in Brazil. The study was based on data from the 2008-2009 Household Budget Survey involving a probabilistic sample of 55,970 Brazilian households. The units of study were household aggregates (strata), geographically and socioeconomically homogeneous. Multiple linear regression models were used to assess the relationship between the availability of processed and ultra-processed products and the average of Body Mass Index (BMI) and the percentage of individuals with excess weight and obesity in the strata, controlling for potential confounders (socio-demographic characteristics, percentage of expenditure on eating out of home, and dietary energy other than that provided by processed and ultra-processed products). Predictive values for prevalence of excess weight and obesity were estimated according to quartiles of the household availability of dietary energy from processed and ultra-processed products. The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% (lower quartile) to 39.4% (upper quartile). Adjusted linear regression coefficients indicated that household availability of ultra-processed products was positively associated with both the average BMI and the prevalence of excess weight and obesity, whereas processed products were not associated with these outcomes. In addition, people in the upper quartile of household consumption of ultra-processed products, compared with those in the lower quartile, were 37% more likely to be obese. Greater household availability of ultra-processed food products in Brazil is positively and independently associated with higher prevalence of excess weight and obesity in all age groups in this cross-sectional study.
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Purpose: A classification of foods based on the nature, extent, and purpose of industrial food processing was used to assess changes in household food expenditures and dietary energy availability between 1938 and 2011 in Canada. Methods: Food acquisitions from six household food budget surveys (1938/1939 , 1953, 1969, 1984, 2001, and 2011) were classified into unprocessed or minimally processed foods, processed culinary ingredients, and ready-to-consume processed or ultra-processed products. Contributions of each group to household food expenditures, and to dietary energy availability (kcal per capita) were calculated. Results: During the period studied, household expenditures and dietary energy availability fell for both unprocessed or minimally processed foods and culinary ingredients, and rose for ready-to-consume products. The caloric share of foods fell from 34.3% to 25.6% and from 37% to 12.7% for culinary ingredients. The share of ready-to-consume products rose from 28.7% to 61.7%, and the increase was especially noteworthy for those that were ultra-processed. Conclusions: The most important factor that has driven changes in Canadian dietary patterns between 1938 and 2011 is the replacement of unprocessed or minimally processed foods and culinary ingredients used in the preparation of dishes and meals; these have been displaced by ready-to-consume ultra-processed products. Nutrition research and practice should incorporate information about food processing into dietary assessments.
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Objective: To establish temporal trends in household food and drink consumption in Brazil, taking into account the extent and purpose of its industrial processing. Methods: Data was obtained from Household Budget Surveys conducted in Brazil in 1987-1988, 1995-1996, 2002-2003 and 2008-2009. In all surveys, probabilistic samples of households in the metropolitan areas were studied and, for the last two surveys, the scope was national. The units of analysis were food purchases records of clusters of households. The purchased food items were divided according to the extent and purpose of their industrial processing into: 'in natura' or minimally processed foods, processed culinary ingredients and ready-to-consume, processed and ultra-processed food and drink products. The quantity of each item was converted into energy. For each survey, the daily availability of calories per capita and the caloric share of the food groups were estimated. For the national surveys, estimates were calculated by income quintiles. Temporal trends were assessed using linear regression models and difference of means tests. Results: The caloric share of ready-to-consume products significantly increased between 2002-2003 and 2008-2009 (from 23.0% to 27.8% of total calories), mainly because of the increase in the consumption of ultra-processed products (20.8% to 25.4%). In the same period, there was a significant reduction in the caloric share of foods and culinary ingredients. The increase in the ultra-processed products caloric share occurred across all income quintiles. There was an uniform increase in the caloric share of ready-to-consume products in the metropolitan areas, mostly in place of ultra-processed products, accompanied by a decrease in the share of 'in natura' or minimally processed foods and culinary ingredients. Conclusions: The share of ultra-processed products significantly increased in the Brazilian diet, as seen in the metropolitan areas since the 1980s, and confirmed at a national level in the 2000s.
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Levels of overweight and obesity across low- and-middle income countries (LMIC) have approached levels found in higher-income countries. This is particularly true in the Middle East and North Africa and in Latin America and the Caribbean. Using nationally representative samples of women aged 19-49, n = 815,609, this paper documents the annualized rate of increase of overweight from the first survey in early 1990 to the last survey in the present millennium. Overweight increases ranged from 0.31 percent per year to 0.92 percent per year for Latin America and the Caribbean and for the Middle East and North Africa, respectively. For a sample of eight countries, using quantile regression, we further demonstrate that mean body mass index at the ninety-fifth percentile has increased significantly across all regions, representing predicted weight increases of 5-10 kilograms. Furthermore we highlight a major new concern in LMICs, documenting waist circumference increases of 2-4 cm at the same BMI (.e.g. 25) over an 18 year period. In sum, this paper indicates growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level.
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A revolution in food systems—food supply chains upstream from farms, to the food industry in the midstream segments of processing and wholesale and in the downstream segment of retail, then on to consumers—has been under way in the United States for more than a century and in developing countries for more than three decades. The transformation includes extensive consolidation, very rapid institutional and organizational change, and progressive modernization of the procurement system. In this article we examine the economics of these system-wide changes. We argue that the steps of conceptualizing and empirically researching this transformation—its patterns and trends, determinants, and impacts on farms and processing small and micro enterprises—are still in their infancy because of (a) remaining limitations on data suitable for formal modeling and hypothesis testing and (b) the sheer complexity of food system–related decisions that need to be modeled and understood. With the rapid accumulation of high-qual...
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In an article that forms part of the PLoS Medicine series on Big Food, David Stuckler and colleagues report that unhealthy packaged foods are being consumed rapidly in low- and middle-income countries, consistent with rapid expansion of multinational food companies into emerging markets and fueling obesity and chronic disease epidemics.
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Trade liberalization remains at the forefront of debates around globalization, particularly around the impact on agriculture and food. These debates, which often focus on how poorer countries can 'trade their way' out of poverty, pay limited attention to dietary health, especially in the light of the WHO's Global Strategy for Diet, Physical Activity and Health (2004), which warned that future health burdens will be increasingly determined by diet-related chronic diseases. This article examines the diet transition as the absent factor within debates on liberalizing trade and commerce. We describe the evolution of trade agreements, noting those relevant to food. We review the association between trade liberalization and changes in the global dietary and disease profile. We illustrate some of the complex linkages between trade liberalization and the 'diet transition', illustrated by factors such as foreign direct investment, supermarketization and cultural change. Finally, we offer three scenarios for change, suggesting the need for more effective 'food governance' and engagement by public health advocates in policy making in the food and agriculture arena.
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We examine how the transformation of food value chains (FVCs) influence the triple malnutrition burden (undernourishment, micronutrient deficiencies and over-nutrition) in developing countries. We propose a FVC typology (modern, traditional, modern-to-traditional, and traditional-to-modern) that takes into account the participants, the target market, and the products offered. Next, we propose selected hypotheses on the relationship between each FVC category and elements of the triple malnutrition burden. The primary finding is that the transformation of FVCs creates challenges and opportunities for nutrition in developing countries. For example, Modern FVCs may increase over-nutrition problems and alleviate micronutrient deficiencies for urban people with relatively high incomes. However, they have little nutritional impacts among rural residents and urban poor people, who primarily depend on traditional FVCs to access adequate quantities of calories and micronutrients. In addition, modern food manufacturers are leveraging traditional distribution networks (modern-to-traditional FVCs), substantially increasing access to low-priced processed/packaged foods in rural areas and low-income urban neighbors with mixed impacts on the triple burden of malnutrition. Further research should focus on the influence of FVC transformation on reduction of micronutrient deficiencies, on modeling demand substitution effects across food categories and the attendant policy implications for malnutrition.
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This issue of Current Biology addresses the biology of food. Scientific and public interest in food covers many different perspectives, but since there is no discipline of food, food research tends to be carried out separately in such areas as ecology, physiology, and the neurosciences. The integration promised by Current Biology's multiple reviews is therefore particularly valuable.
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Background/objectives: Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil. Subjects/methods: Data from the first of two non-consecutive food diaries from 34,003 individuals (aged ≥ 10 years) in the first Brazillian nationally representative dietary survey (2008-2009) were used. Meals were defined as the largest (kcal) eating event reported during select times of the day (Breakfast, 0600-1000 hours; Lunch, 1200-1500 hours; Dinner, 1800-2100 hours); all other eating occasions were considered snacks. We estimate daily energy intake, percentage of persons consuming snacks, number of daily snacks and per capita and per consumer energy from snacks (kcal/day, kcal/snack and % of daily energy from snacks). Results: In all, 74% of Brazilians (≥ 10 years) snacked, reporting an average 1.6 snacks/day. Also, 23% of the sample were heavy snackers (≥ 3 snacks/day). Snacking accounted for 21% of daily energy intake in the full sample but 35.5% among heavy snackers. Compared with non-snackers (1548 kcal/day), light (1-2 snacks/day) and heavy snackers consumed more daily energy (1929 and 2334 kcal/day, respectively). Taking into account time of day, the largest percentage of persons reported afternoon/early evening snacking (1501-1759 hours, 47.7%). Sweetened coffee and tea, sweets and desserts, fruit, sugar-sweetened beverages, and high-calorie salgados (fried/baked dough with meat/cheese/vegetable) were the top five most commonly consumed snacks. Differences were observed by age groups. Trends in commercial sales were observed, especially for sugar-sweetened beverages. Conclusions: Many commonly consumed snack foods in Brazil are classified, in the US, as being high in solid fats and added sugars. The public health impact of snacking in Brazil requires further exploration.