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Exploring the consumption of ultra-processed foods and its association with food addiction in overweight children
Abstract
Abstract
The present study explored the consumption of ultra-processed foods and its association with food addiction in overweight children. The prevalence of food addiction was investigated using the Yale Food Addiction Scale for Children in overweight 9-11 year-old children (BMI/age ≥1 Z score) of both sexes from two schools (n = 139). Food intake was estimated by a food frequency questionnaire and the food items were classified into 4 categories: minimally processed, culinary ingredients, processed foods and ultra-processed foods (UPF), based on their degree of processing. Among the children, 95% showed at least one of the seven symptoms of food addiction and 24% presented with a diagnosis of food addiction. In analysis of covariance adjusted for age and sex, a tendency of higher consumption of added sugar (refined sugar, honey, corn syrup) and UPF was found among those diagnosed with food addiction. Multiple logistic regression adjusted for sugar, sodium and fat ingestion showed that consumption of cookies/biscuits (OR = 4.19, p = 0.015) and sausages (OR = 11.77, p = 0.029) were independently associated with food addiction. The identification of foods that may be associated with addictive behavior is very important for correctly treating and preventing childhood obesity, which continues to be one of the greatest health problems in the world.
... Thus, the extent of food processing has been used to characterize the quality of food consumed in some studies. The majority of these studies were crosssectionally designed, analysing children older than 2 years, demonstrating a significant presence of food with a high degree of processing in the diet of the studied populations (Cornwell et al., 2018; C. S. Costa et al., 2019;Filgueiras et al., 2019;Rauber et al., 2015;Spaniol et al., 2020). Some Brazilian researchers have performed an analysis of complementary feeding, considering the extent of food processing (Fonseca et al., 2019;Giesta et al., 2019;Passanha et al., 2021;Ribas et al., 2021;Santos et al., 2018). ...
... Therefore, although studies have also found data supporting the hypothesis that the extent of processing in food is negatively associated with nutritional status and health outcomes in childhood (Cornwell et al., 2018;C. S. Costa et al., 2019;Filgueiras et al., 2019;Fonseca, Ribeiro, Andreoli, 2019;Rauber et al., 2015;Spaniol et al., 2020), food processing in complementary feeding has not been extensively studied. ...
... Buckley et al., 2019;C. S. Costa et al., 2019;Filgueiras et al., 2019;Hoffman et al., 2020;Mais et al., 2017;Moubarac et al., 2017;Neri et al., 2019;Onita et al., 2021;Ribeiro & de Araújo Pinto, 2021). ...
Infant feeding practices impact children's nutritional and health status, influencing growth and development. This study aimed to analyse the evolution of infant feeding practices from 9 to 24 months of age, considering infant and young child feeding (IYCF) indicators and food processing. The infant feeding practices in children from the Brazilian site of the MAL-ED study were evaluated at 9 (n = 193), 15 (n = 182) and 24 months (n = 164) using 24-h dietary recalls. IYCF indicators were evaluated, and the extent of food processing was evaluated, using the NOVA classification. Breastfeeding declined significantly over time, from 77.6% at 9 months to 45.1% at 24 months. Although dietary diversity did not significantly change during the study period (80.5% at 24 months), the minimum acceptable diet significantly increased from 67.9% to 76.1% at 24 months (p < 0.0005). All the studied children consumed sweetened beverages from 9 months. Unhealthy food consumption and zero vegetable or fruit consumption significantly increased over time (p < 0.0005). Unprocessed food consumption decreased from 9 to 24 months of age (p < 0.0005), while ultra-processed food consumption increased (p < 0.0005) during the study period. Logistic regressions showed that, at 9 months, breastfed children presented a lower risk for ultra-processed food consumption (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.13-0.77); and children reaching the minimum acceptable diet presented more risk for ultra-processed food consumption (OR = 2.31; 95% CI = 1.01-5.27). In conclusion, data showed a reduction in the quality of infant feeding practices over the first 2 years of life, with a decrease in breastfeeding and an increase in the consumption of unhealthy and ultra-processed foods.
... However, the meta-analysis assessing associations of ultra-processed food consumption with mental disorders was limited only to depression and by the number of studies available for inclusion at the time of publication (n = 2). Several additional studies have since been published assessing the link between ultra-processed food consumption and depression as well as other mental disorders [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The need for an updated review is further exacerbated by the fact that ultra-processed foods have become increasingly ubiquitous for many food systems globally [13], thus understanding any relationship with mental disorders is critical for understanding the health implications of this trend. ...
... Eleven studies modelled ultra-processed food consumption as the exposure variable and mental disorder parameters as the outcome [17][18][19]21,[23][24][25][26]30,48,50], with the remaining six modelling associations in the opposite direction [20,22,[27][28][29]31]. ...
... Of the 11 studies that treated ultra-processed food consumption as the exposure variable, 8 coded ultra-processed food intake categorically (dichotomous [21,25,26], tertiles [18,24] and quartiles [19,48,50], with the lowest category being the reference group and referring to lowest consumption). The remaining three studies coded ultra-processed food consumption continuously [17,23,30]. ...
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.
... Following assessment against the inclusion criteria, 15 articles were included in this review ( Figure 1). The majority of included studies used a cross-sectional design (n = 12 studies [28][29][30][31][32][33][34][35][36][37][38][39]); with the remaining being a RCT (n = 1 [40]) and two prospective cohort studies (n = 1 study, with 3, 6 and 12-month follow-up of dietary and FA outcomes [41]; and n = 1 study, with a cross-sectional analysis of data collected [42]) In descending order, studies were carried out in Turkey (n = 4), Australia (n = 3), Canada (n = 2), USA (n = 2), Brazil (n = 1), Greece (n = 1), Iran (n = 1), and Israel (n = 1), Table 2. ...
... Following assessment against the inclusion criteria, 15 articles were included in this review ( Figure 1). The majority of included studies used a cross-sectional design (n = 12 studies [28][29][30][31][32][33][34][35][36][37][38][39]); with the remaining being a RCT (n = 1 [40]) and two prospective cohort studies (n = 1 study, with 3, 6 and 12month follow-up of dietary and FA outcomes [41]; and n = 1 study, with a cross-sectional analysis of data collected [42]) In descending order, studies were carried out in Turkey (n = 4), Australia (n = 3), Canada (n = 2), USA (n = 2), Brazil (n = 1), Greece (n = 1), Iran (n = 1), and Israel (n = 1), Table 2. ...
... A total of 128,441 participants (n = 1395 male and 127,046 female) were included across the studies, and study sample sizes ranged from 18 to 123,688 (median, 181). Eleven of the 15 studies included both male and female participants [28][29][30][31][32][33][35][36][37][38][39], and four studies included female participants exclusively [34,[40][41][42]. Twelve of the included studies were carried out exclusively in adults ranging in age from 18 to 91 years (mean, 36.2 ± 7.3; n = 11 studies reported mean age), and three studies exclusively in children/adolescents ranging in age from 9 to 18 years (mean, 13.0 ± 2.3) [30,32,38]. ...
(1) Background: Research suggests that certain foods may have addictive effects; however, no reviews have systematically appraised studies in this area. The aims of this review were to determine the nutrients, foods and dietary patterns associated with addictive eating. (2) Methods: Published studies up to November 2020 were identified through searches of 6 electronic databases. Eligible studies included those in in children and adults that reported dietary intakes of individuals with ‘food addiction’. (3) Results: Fifteen studies (n = 12 in adults and n = 3 in children/adolescents with Yale Food Addiction Scale defined ‘food addiction’) were included. Foods commonly associated with addictive eating were those high in a combination of fat and refined carbohydrates. Generally, intakes of energy, carbohydrates and fats were significantly higher in individuals with addictive eating compared to those without. (4) Conclusions: Due to the heterogeneity in study methodologies and outcomes across included studies, it is difficult to conclude if any specific foods, nutrients or dietary patterns facilitate an addictive process. Further research is needed to elucidate potential associations. However, present addictive eating treatment approaches could incorporate individualised dietary advice targeting foods high in fat and refined carbohydrates.
... After assessment against the inclusion criteria, 27 articles were included in this Review (figure). Most included studies used a cross-sectional design (n=23); 40-62 the other studies were intervention (n=2) 63 [40][41][42][43][44][45][46][47][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] of the 27 studies included both male and female participants with an average of 56·2% female participants per study (range 15·1-91·0%). One other study 48 included female participants only. ...
... 18 studies were done in students in secondary school or university students, or both. 40 51,58 or university students (n=4; mean age <19 years) 44,45,56,57 were included because the overall mean age of the sample fell within the age range of the inclusion criteria. Fewer studies recruited adolescents from the general community (n=2), 50,58 primary schools (n=1; mean age 10 years), 51 adolescents seeking weight loss (n=3), 55,63,64 adolescents admitted to hospital with a DSM-diagnosed psychiatric disorder (n=1) 43 or eating disorder (n=1), 49 or adolescents presenting for bariatric surgery (n=1). ...
... 60 For all studies, with the exception of one, 41 the participants' weight status was reported (n=12 using self-report measures). Weight status was reported as mean body-mass index (BMI; kg/m²; n=15), [43][44][45]48,49,52,54,55,57,58,60,[62][63][64][65] BMI z-score (n=4), 40,51,53,66 BMI percentile (n=3), 46,50,61 or a frequency of distribution across BMI categories (n=15), 40,42,43,[45][46][47][48]51,53,54,[56][57][58][59]61 or a combination. Six studies only included adolescents classified as having overweight or obesity. ...
The intersection between eating behaviours and mental health has garnered substantial attention in recent years. For this Review, we systematically reviewed the available research to find out the prevalence of food addiction as measured by the Yale Food Addiction Scale, and to investigate its association with mental health-related outcomes in adolescents. Eight databases were searched using keywords from Jan 1, 2009, to Aug 5, 2020, to identify studies reporting a Yale Food Addiction Scale diagnosis or symptom score, or both. In total, 27 studies were included. The prevalence of a food addiction diagnosis ranged from 2·6% to 49·9% in non-clinical and clinical populations, and prevalence was higher in women and adolescents with a higher weight status. Food addiction was associated with disordered eating, depressive and anxiety symptoms, and a poorer quality of life and self-esteem. These associations have important implications for the assessment and management of eating behaviours and mental health in adolescents. Transdiagnostic prevention and management intervention strategies could be explored.
... Thus, acknowledging that the term "food addiction" is too broad and that not all foods are addictive, Schulte et al. (2015) proposed redefining the phenomenon as "Highly Processed Food Addiction" (HPFA). HPFA circumscribes the phenomenon of diminished eating control to a specific set of foods (Aguirre et al., 2022;Gearhardt & Hebebrand, 2021;Polk et al., 2017;Schulte et al., 2015); and, as noted earlier, HPFA emphasizes the role that overconsumption of highly processed foods plays in increasing overweight and obesity prevalence rates worldwide (Filgueiras et al., 2019). Although a complex multiplicity of causal factors contributes to obesity, there is little debate over the existence of a phenotype that identifies a subpopulation that experiences strong food cravings and diminished control, and repeated failed attempts to gain control, over their food intake (Gearhardt & Hebebrand, 2021). ...
... Although a complex multiplicity of causal factors contributes to obesity, there is little debate over the existence of a phenotype that identifies a subpopulation that experiences strong food cravings and diminished control, and repeated failed attempts to gain control, over their food intake (Gearhardt & Hebebrand, 2021). It is also accepted that individuals expressing the phenotype are likely to binge eat highly processed foods and are also likely to be overweight or obese (Filgueiras et al., 2019). Based on the incentive-salience theory of drug addiction (Berridge & Robinson, 2016;Robinson et al., 2013;Robinson & Berridge, 2003), Berridge et al. (2010) posited that consuming highly palatable foods sensitize dopaminergic systems and increases the salience of cues associated with those foods. ...
... The use of three food categories was selected to ensure parsimony in the model (i.e., to keep the model as simple as possible, so long as the calibration showed satisfactory/plausible results; see Sections 2.3.7 and 3.1 for calibration methods and results) [46]. One of the categories represents the outcome of interest (vegetables), while the other two represent all other foods, divided into those known to be unhealthy if consumed in excess (e.g., sugar-sweetened beverages, ultra-processed foods high in fat, sugar, and/or salt, etc.) [47][48][49], and all other foods (e.g., natural grains, cereals, legumes, etc.). The types of foods sold in each store, their price, perceived quality, and the estimated time it takes to consume them, as well as the variety of food items and services offered at each store type, were factors that were found to matter for store selection among participants of the FRESH-Austin Study, per survey-based (see Table 1) and additional qualitative data. ...
... This change is proportional to the portions of unhealthy foods (high in fat, sugar, and/or salt) that the agent consumed during the given week, minus the number of vegetable-based portions consumed during the same week. This feedback loop is implemented to simulate the fact that diets high in fat, sugar and salt appear to increase appetite and lead to progressive overeating, a phenomenon that has been described as the Salted or Unhealthy Food Addiction Hypothesis [47,48]. ...
Modifying the food environment of cities is a promising strategy for improving dietary behaviors, but using traditional empirical methods to test the effectiveness of these strategies remains challenging. We developed an agent-based model to simulate the food environment of Austin, Texas, USA, and to test the impact of different food access policies on vegetable consumption among low-income, predominantly Latino residents. The model was developed and calibrated using empirical data from the FRESH-Austin Study, a natural experiment. We simulated five policy scenarios: (1) business as usual; (2)-(4) expanding geographic and/or economic healthy food access via the Fresh for Less program (i.e., through farm stands, mobile markets, and healthy corner stores); and (5) expanding economic access to vegetables in supermarkets and small grocers. The model predicted that increasing geographic and/or economic access to healthy corner stores will not meaningfully improve vegetable intake, whilst implementing high discounts (>85%) on the cost of vegetables, or jointly increasing geographic and economic access to mobile markets or farm stands, will increase vegetable intake among low-income groups. Implementing discounts at supermarkets and small grocers is also predicted to be an effective policy for increasing vegetable consumption. This work highlights the utility of agent-based modeling for informing food access policies.
... Emerging evidence now highlights the importance of food processing in mental health and eating behaviors with epidemiological data showing an association between UPF intake and the advent of depression in longitudinal studies ( [31,32], see [33] for a meta-analysis), or food addiction traits [34][35][36], and eating disorders [37] in cross-sectional studies. Also, children with high neophobia more frequently consumed UPF rich in sugar and had a lower adherence to traditional dietary patterns [38]. ...
... An increased ratio of quinolinic/kynurenic and KYN/Trp have been linked to mental illness, including poor stress coping abilities in depression and cognitive impairment [117,118]. Such mental difficulties are highly present in individuals with eating disorders and obesity [106,119], which are also characterized by consuming a notable amount of UPF [24,[35][36][37]. ...
Ultra-processed foods and drinks (UPF) are formulation of ingredients, mostly of exclusive industrial use, that result from a series of industrial processes. They usually have a low nutrient but high energy density, with a high content of saturated and trans fats, and added sugars. In addition, they have characteristic organoleptic properties, and usually contain sophisticated additives, including artificial sweeteners, to intensify their sensory qualities and imitate the appearance of minimally processed foods. In addition, recent research has warned about the presence of chemicals (e.g., bisphenol) and neo-formed contaminants in these products. UPF production and consumption growth have been spectacular in the last decades, being specially consumed in children and adolescents. UPF features have been associated with a range of adverse health effects such as overeating, the promotion of inflammatory and oxidative stress processes, gut dysbiosis, and metabolic dysfunction including problems in glucose regulation. The evidence that these UPF-related adverse health effects may have on the neural network implicated in eating behavior are discussed, including the potential impact on serotonergic and dopaminergic neurotransmission, brain integrity and function. We end this review by placing UPF in the context of current food environments, by suggesting that an increased exposure to these products through different channels, such as marketing, may contribute to the automatic recruitment of the brain regions associated with food consumption and choice, with a detrimental effect on inhibitory-related prefrontal cortices. While further research is essential, preliminary evidence point to UPF consumption as a potential detrimental factor for brain health and eating behavior.
... However, only 9% of children reach this recommendation, since the average consumption among boys is 3 portions/day and 2.7 portions/day among girls (PUBLIC HEALTH ENGLAND, 2017). The acceptance for foods with high fat and sugar contents is predominant among children (FILGUEIRAS et al., 2019;MORAN et al., 2019). These products have high palatability, in addition to attractive sensory features, which can lead to food dependence (ONAOLAPO; ONAOLAPO, 2018). ...
... It was found that 55.1% of daily energy consumption comes from ultra-processed products, among children and adolescents. In Brazil, the average consumption of added sugar by children is around 11% (FILGUEIRAS et al., 2019), exceeding the average recommendation of 5% by the World Health ...
The research aim was to develop cooking workshops using five health foods least accepted by elementary school children and assess their sensory acceptability and physicochemical composition. Three hundred and thirty two elementary school children aged between 7 and 10 years participated in the research. Food acceptability was evaluated in order to verify the nutritious foods less accepted by children, for use in preparations prepared in cooking workshops. Five products were prepared in cooking workshops: eggplant cookie, chard muffin, cress bread, radish pancake and chayote esfiha. All preparations showed high Acceptability Indexes (> 85%). Higher lipid, calorie and fiber contents and lower ash and moisture contents were found in eggplant cookie. Lower contents of carbohydrate and calories were found in radish pancake, while higher contents of protein and ash were observed in chayote esfiha and chard muffin, respectively. The products with the highest carbohydrate contents were eggplant cookie and cress bread, while chard muffin had the lowest fiber content. It is concluded that cooking workshop is an effective educational strategy to improve the acceptability of vegetables with low acceptability for elementary school children.
... FA can be diagnosed in individuals with different nutritional statuses, but the risks associated with and changes in the control of food consumption are greater in overweight individuals (4) . Preliminary investigations in overweight and obese children revealed eating behaviours consistent with FA (5,6) . ...
... Ultra-processed foods were identified according to the NOVA system (8) and are represented by items such as sweet and savoury cookies, snacks, instant noodles, sweets, sausages, soft drinks and beverages, and sugary dairy products. The complete description of the quantification, food classification, and application of this questionnaire has been described in a previous study (6) . ...
The present study evaluated the association of food addiction (FA), the change of the BMI/AgeZ-score, and the consumption of ultra-processed foods in overweight students undergoing a 16-month, multicomponent intervention in the school environment. FA was investigated using the Yale Food Addiction Scale for Children and the dietary assessment was estimated using the Semi-quantitative Food Frequency Questionnaire in overweight 9- to 11-year-old students (BMI/ageZscore≥1) of both sexes at their baseline and after the intervention (n=120). Among the schoolchildren, 33.4% had FA in at least one of the two assessments. The analysis of mixed-effects models to assess the effect of the intervention and the change of the BMI/AgeZ-score between evaluations showed that the occurrence of FA influenced the maintenance of weight (time#FA, β=0.30, 95%CI=0.05 to 0.54), p=0.016. Weight loss was observed only in individuals who did not present FA (BMI/Age Z-score= −0.3). When evaluating the effect of the intervention and the dietary variables, we verified a reduction in the consumption of sugary milk-based drinks (−17 kcal, p=0.04) only in non-FA students at the end of the study. FA has been identified as an underlying factor with therapeutic relevance, and an enhanced understanding of FA can open new paths for the prevention and management of obesity.
... This was then substantiated by a second study with a large sample of participants [52]. In adolescents from the general population, UPF consumption has also been associated with sBED conditions, including food addiction [159][160][161], but in addition to internalizing problems [162], depressive symptoms [163], and anxietyinduced disturbances [164]. However, despite these associations, the potential effect of the consumption of UPFs on the brain systems implicated in BED and sBED remains to be understood. ...
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
... Overall, the current findings showed that UPF consumption is associated with the volume of brain regions implicated in reward processes and conflict monitoring. The addictive potential of UPF is under current debate (Lustig, 2020;Schulte et al., 2015), with previous studies having reported an association between direct estimation of UPF consumption with food addiction traits (Filgueiras et al., 2019;Pursey et al., 2017). The present study lacks the appropriate reward-based indices to substantiate the association between the UPF-associated brain volumes and these specific behaviors. ...
Background:
The consumption of ultra-processed foods and drinks (UPF) has been associated with depression and inflammation and preclinical studies showed that some UPF components disrupt the amygdala-hippocampal complex. We combine diet, clinical and brain imaging data to investigate the relationship between the UPF consumption, depressive symptoms, and brain volumes in humans, considering interactions with obesity, and the mediation effect of inflammation biomarkers.
Methods:
One-hundred fifty-two adults underwent diet, depressive symptoms, anatomic magnetic resonance imaging assessments and laboratory tests. Relationships between the % of UPF consumption (in grams) of the total diet, depressive symptoms, and gray matter brain volumes were explored using several adjusted regression models, and in interaction with the presence of obesity. Whether inflammatory biomarkers (i.e., white blood cell count, lipopolysaccharide-binding protein, c-reactive protein) mediate the previous associations was investigated using R mediation package.
Results:
High UPF consumption was associated with higher depressive symptoms in all participants (β = 0.178, CI = 0.008-0.261) and in those with obesity (β = 0.214, CI = -0.004-0.333). Higher consumption was also associated with lower volumes in the posterior cingulate cortex and the left amygdala, which in the participants with obesity also encompassed the left ventral putamen and the dorsal frontal cortex. White blood count levels mediated the association between UPF consumption and depressive symptoms (p = 0.022).
Limitations:
The present study precludes any causal conclusions.
Conclusions:
UPF consumption is associated with depressive symptoms and lower volumes within the mesocorticolimbic brain network implicated in reward processes and conflict monitoring. Associations were partially dependent on obesity and white blood cell count.
... Beginning during early childhood, consumption of ultra-processed infant foods of homogenous flavours and textures may inhibit development of taste preferences associated with healthy eating habits throughout life (Foterek et al., 2015;García et al., 2013). The potentially addictive nature of UPFs, hypothesised to be driven by product design characteristics such as palatability (Schulte et al., 2015), may also play a role in encouraging excessive consumption of UPFs notably in adults and children who experience food addiction (Filgueiras et al., 2019;Pursey et al., 2015). ...
Using group model building we developed a series of causal loop diagrams identifying the environmental impacts of ultra-processed food (UPF) systems, and underlying system drivers, which was subsequently validated against the peer-reviewed literature. The final conceptual model displays the commercial, biological and social drivers of the UPF system, and the impacts on environmental subsystems including climate, land, water and waste. It displays complex interactions between various environmental impacts, demonstrating how changes to one component of the system could have flow-on effects on other components. Trade-offs and uncertainties are discussed. The model has a wide range of applications including informing the design of quantitative analyses, identifying research gaps and potential policy trade-offs resulting from a reduction of ultra-processed food production and consumption.
... It has been found that the majority of hotels in Malaysia that serve basic facilities to meet the needs of Muslim tourists are between 3 and a few 4-star hotels, while the majority of 4 to 5-star hotels are owned by outside operators such as Hilton, Starwood and InterContinental Hotels Group, for example. These international brands have refused to opt for local custom compliant because the implementation of the concept needs to be properly planned, as it involves high costs due to the large space needed for gender segregation between men and women, for example [14,13,15] and some outside operators have even regretted that the concept will have an impact on overall food and food [16]. These were supported by the initial revenue loss faced by De Palma hotel in the region of 20% after rebranding to a fully local custom compliant hotel, but fortunately the hotel has now earned more than its original sales [17,18]. ...
... Studies have shown that excess sugar consumption leads to overweight, obesity, diabetes, cardiovascular problems, and dental caries (Angarita-DíazMdel, Fong, Bedoya-Correa, & Cabrera-Arango, 2022;Pietrantoni & Mayrovitz, 2022;Veit et al., 2022). Several studies on humans and rats reported that consuming high amounts of sugar-rich beverages and foods leads to cravings and addiction (Avena et al., 2008;Campana et al., 2019;Filgueiras et al., 2019). However, reducing sugar intake has proven to be difficult for consumers, as excess consumption has been shown to affect the brain reward system. ...
Trehalulose (1-O-α-D-glucopyranosyl-D-fructose) is a naturally occurring disaccharide composed of fructose and glucose. It is a sucrose isomer with a unique α-1,1 glycosidic bond that is more stable than the 1,2 glycosidic bond found in sucrose, giving it a lower glycemic index (GI). Trehalulose sugar production is often complicated, and the literature on the production is scarce. However, trehalulose is gaining popularity after a recent study revealed the abundance of this sugar in stingless bee honey (13 to 44 g per 100 g). The current short review discusses the chemical and physiological properties of trehalulose and its potential health benefits based on a bibliometric approach. Furthermore, it evaluates the antidiabetic potential of trehalulose as an emerging alternative sweetener.
... Both UPFs and take-away food are commonly high in energy density, sugars, salt, trans fats, additives, and chemical contaminants but low in protein, micronutrients, and fibers [29,30] and are confirmed to increase the risk of NCDs among youths [31,32]. Additional evidence demonstrated that 15% of youths showed addictive-like responses to UPFs, defined as food addiction [33,34], sharing similar functional and structural changes in neurological systems with drug abuse [35]. In this context, policies or strategies implemented by governments, such as warning labels on packages and additional taxes, do not have the intended effect of decreasing unhealthy food purchasing, because most parents either ignore them or fail to understand their significance [36]. ...
Diet has been recognized as a vital risk factor for non-communicable diseases (NCDs), climate changes, and increasing population, which has been reflected by a rapidly growing body of the literature related to healthy eating. To reveal a panorama of the topics related to healthy eating, this study aimed to characterize and visualize the knowledge structure, hotspots, and trends in this field over the past two decades through bibliometric analyses. Publications related to healthy eating between 1 January 2002 and 31 December 2021 were retrieved and extracted from the Web of Science database. The characteristics of articles including publication years, journals, authors, institutions, countries/regions, references, and keywords were assessed. The analyses on co-authorship, co-occurrence, and co-citation were performed and network visualization maps were constructed by VOSviewer. Major subdomains identified by bibliometrics were further discussed and analyzed. A total of 12,442 articles on healthy eating were identified. Over the past two decades, the annual global publications increased from 71 to 1764, showing a nearly 25-fold growth. The journal Nutrients published the most articles and The American Journal of Clinical Nutrition possessed the highest citations. The United States, Harvard University, and Hu, Frank B. were identified as the most productive and influential country, institution, and author, respectively. The co-occurrence cluster analysis of the top 100 keywords formed four clusters: (1) the food insecurity environment for youths highlighting the necessity and significance of implementing healthy eating in early life; (2) sustainable advantages of the Mediterranean diet; (3) the importance of an overall healthy lifestyle optimization leveraged by eHealth; (4) the challenges during the course of healthy eating against obesity, which are prominent in reflecting the knowledge structure, hotspots, and trends. Moreover, COVID-19, orthorexia nervosa, sustainability, microbiota, food insecurity, and e-health are identified keywords that represented the latest high-frequency keywords and indicated the emerging frontiers of healthy eating. This study indicates that the number of publications on healthy eating will increase in the future and that healthy dietary patterns and clinical applications of healthy eating will be the next hotspots in this research field.
... Since the development of the Yale Food Addiction Scale (YFAS) psychometric scale to measure FA, several studies have been conducted on this theme worldwide (Davis, 2017;Praxedes et al., 2022;Pursey et al., 2014). The scale has been translated and validated into Brazilian Portuguese (Nunes-Neto et al., 2018) and Spanish (Granero et al., 2014;Granero et al., 2018), including with semantic adaptations for the Chilean (Marín, 2014) and Mexican populations (Valdés-Moreno et al., 2016), and some studies using this scale have thus reported on the prevalence of FA in Latin American countries (Falc on et al., 2021;Filgueiras et al., 2019;Lopez-Lopez et al., 2021;Obreg on et al., 2015). ...
Objective
Food addiction (FA) has been extensively investigated worldwide; however, the prevalence of FA in the Latin American population has yet to be established and past work has largely neglected the specificities of this region, that includes the most significant economic disparities in the world. Thus, the objective of this study was to assess the prevalence of FA measured by the Yale Food Addiction Scale in Latin America.
Method
The search was performed on MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL, and the gray literature. FA prevalence data were collected, and random effects meta‐analyses were performed to calculate the overall weighted prevalence, the prevalence by country, and by clinical and non‐clinical samples.
Results
A total of 10,082 occurrences were identified through database searches, and 23 studies were included (Mexico = 9; Brazil = 7; Chile = 4; Argentina = 1; Peru = 1; Uruguay = 1). The prevalence of FA found in clinical samples was 38% (95% CI: 16%–63%; I ² = 98.67%; 8 studies), while in non‐clinical samples, it was 15% (95% CI: 10%–21%; I ² = 98.51%; 15 studies).
Discussion
The average prevalence of FA in the Latin American countries included here was in accordance with that reported in other regions worldwide. It is noteworthy that the studies were conducted only in six countries, which are among those with the highest income in the region and do not represent the situation in native populations or those with lower purchasing power. This gap in the data also reflects the effects of economic disparities on the availability of empirical data in the region.
Public Significance
The prevalence of food addiction in Latin America was similar to that reported in other regions. It was higher among individuals with overweight, whether or not undergoing bariatric surgery, than in non‐clinical samples. These findings contribute to aggregate information about this condition that has drawn the attention of clinicians and researchers.
... We believe this may as well be related to the mechanism of addiction. Except for a few patients with congenital obesity [such as leptin de ciency (48)], obesity was believed strongly related to uncontrolled diet (49), and quite a number of common chemicals in food, such as sucrose, sodium chloride, fat and caffeine, are addictive (50)(51)(52). ...
Background
Lacking physical activity (PA) is an important risk factor for depression, the continuous decline of PA inevitably leads to the prolongation of sedentary behavior (SB) among adults, and limited evidence suggests that SB is also an independent risk factor associated with depression.
Objective
This study is to investigate the association between long-term sedentary behavior (LTSB) and depression in a representative sample of the American adult population using data from the National Health and Nutrition Examination Survey (NHANES).
Materials and Methods
Data from NHANES 2017–2018 were aggregated, including demographic information, degree of depression, PA, duration of sedentary behavior, body index, etc. PA was assessed by the Global Physical Activity Questionnaire (GPAQ). Depression was screened by a Patient Health Questionnaire (PHQ-9) in which includes several questions (Have little interest in doing things; Feeling down, depressed, or hopeless; Trouble sleeping or sleeping too much; etc.). Logistic regression was carried out to analyze associations between LTSB and depression.
Results
A total of 4728 adults (mean age 51.00 ± 17.49 years, 2310 males and 2418 females) were recruited in this study. The SB duration < 360 /d was negatively correlated with moderate to severe depression (r=-0.146, P = 0.029), while SB duration ≥ 720 min/d was a positive correlation with depression (r = 0.472, P = 0.001), significant correlations were not observed in other SB duration. LTSB had a significant effect on depression (OR = 1.484, 95% Cl: 1.176–1.817, P = 0.001), especially in moderate to severe depression (OR = 1.697, 95% Cl: 1.229–1.342, P = 0.001). The effects remained significant after adjusting for independent variables (OR = 1.429, 95% Cl: 1.122–1.820, P = 0.004), and this association was stronger in the occurrence of moderate to severe depression (OR = 1.586, 95% Cl: 1.139–2.210, P = 0.006). Furthermore, the detection rate of depression in females (710/2418, 29.36%) was higher than that in males (484/2310, 20.95%), and the difference was statistically significant (P < 0.001).
Conclusions
LTSB is a risk factor for depression, especially in moderate to severe depression. Middle-aged females who are not married tend to be the most likely to suffer from depression.
... Although several cross-sectional studies revealed a close correlation between FA and body mass index z-score (BMIZ) (16,17), the potential causal relationship between FA and weight status has not been identified. Moreover, studies concerning FA were rare in children and adolescents, particularly longitudinal studies (18). ...
Objective
Food addiction (FA) is associated with a higher body mass index z -score (BMIZ) in children and adolescents; however, whether these two aspects evolve interdependently remains unknown. This study aimed to address this question using a cross-lagged study.
Methods
Weight status, including BMIZ, fat content (FC), and visceral fat level (VFL), was determined in 880 children and adolescents (mean age = 14.02 years [range = 8.83–17.52 years]) at two-time points with an interval of 6 months. FA was characterized using the Chinese version of the dimensional Yale Food Addiction Scale for Children 2.0. Furthermore, FC and VFL were measured using direct segmental multi-frequency bioelectrical impedance analysis at each time point.
Results
Higher FA was associated with increased BMIZ, FC, and VFL ( P < 0.05). FA at T0 could predict increased FC at T1 ( P < 0.05). The characteristics of females, primary students, and living in urban areas may aggravate the adverse effect of FA on weight status over time and age, particularly the increased VFL in participants aged > 14 years.
Conclusion
Children and adolescents with a high FA level were at risk for weight gain attributed to increased FC, and the adverse effect could be aggravated with time and age. Novel FA-targeting interventions may help mitigate the risk of getting obesity.
... Como consecuencia, la población ha venido incluyendo en sus dietas el consumo de PCUP, en los que se reconocen ingredientes y características organolépticas que los hacen más apetitosos y se asocian con comportamiento adictivos (36,37), razón por la cual el consumo de estos productos ha crecido exponencialmente en los últimos años (38), lo que potencia sus efectos nocivos para la salud (4,6,36,37,39-41). ...
El patrón alimentario promovido y dominante en la actualidad, se caracteriza por una fuerte industrialización y presencia de productos comestibles ultraprocesados cuyo perfil nutricional afecta la salud, y además, genera implicaciones social, cultural, económica y ambientalmente negativas, asociadas a las formas de producción, procesamiento, distribución y consumo de estos productos, propiciando un distanciamiento entre el ser humano y el alimento, deteriorando la cultura alimentaria e invisibilizando la alimentación como hecho social. En este documento se reflexiona sobre la importancia de migrar hacia un patrón alimentario basado en alimentos reales y se esboza la alimentación real como propuesta parael análisis de los asuntos alimentarios y nutricionales. La alimentación real es una concepción vanguardista con poca teorización, podría identificarse como un patrón de alimentación que supera la visión limitada del nutricionismo, a su vez, representa unbajo impacto ambiental, es pertinente desde el punto de vista sociocultural y promueve la adopción de estilos de vida saludables
... Palatability Addictiveness High Yale Food Addiction Scale scores are associated with higher intakes of energy-dense, nutrient poor processed foods in adults [98]* and higher intakes of UPFs among children [99]*. The addictive nature of the foods is likely due to palatability, and is also associated with level of processing [100]*. ...
Building on an extensive review of the literature and expert elicitation using group model building, we developed a series of causal loop diagrams identifying the environmental impacts of ultra-processed food (UPF) systems, and underlying system drivers. The final conceptual model displays the commercial, biological and social drivers of the UPF system, and the impacts on environmental sub-systems including climate, land, water and waste. It displays complex interactions between various environmental impacts, demonstrating how changes to one component of the system could have flow-on effects on other components. Trade-offs and uncertainties are discussed. The model has a wide range of applications including guiding policy interventions to promote healthy and sustainable diets, identifying policy trade-offs and informing the design of quantitative analyses.
... UPFs [32,[84][85][86][87] and are more likely to exhibit compulsive patterns of consumption with these foods [11], which likely interferes with adherence to the sustained caloric restriction required for weight loss. FA has been associated with poorer outcomes in behavioral weight loss treatments for both adults and youths, including lower attendance, higher attrition, lower weight loss, and higher weight regain [88,89]. ...
... For younger ages (children and adolescents), UPPs have been associated with unfavorable health outcomes [21][22][23]. These include excess body fat, abdominal obesity [24][25][26][27], high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol [28,29], and food addiction [30]. Additionally, there is an association between lower (vs. ...
Background:
Ultraprocessed products (UPPs) have been associated with unfavorable health outcomes; however, until now, they have not been associated with the coexistence of undernutrition and overnutrition, known as the double burden of malnutrition (DBM) at the individual level.
Methods:
Cross-sectional analyses were performed on data collected from children and adolescents participating in the 2006 and 2016 Mexican National Health and Nutrition Surveys. The food and beverages reported in the food frequency questionnaire (SFFQ) were classified as UPPs as defined by the NOVA classification system. Associations of UPPs with anemia, excess weight, and the DBM were estimated with logistic regression models. A pseudo-panel was generated using the cohorts of children born from 1997 to 2001 to estimate the effect of the UPPs on anemia, excess weight, and the DBM.
Results:
The consumption of UPPs (% energy) was higher in 2016 (children 30.1% and adolescents 28.3%) than in 2006 (children 27.3% and adolescents 23.0%) in both age-groups. The higher contribution of UPPs was positively associated with excess weight and the DBM in children's lower tertile of socioeconomic status (SES) and the DBM in higher tertile of SES in adolescents. The pseudo-panel analysis shows the positive association between UPPs and DBM in lower SES.
Conclusions:
These results provide evidence of the association between the consumption of UPPs and the DBM and excess weight in children and adolescents.
... Prospective studies indicated that consumption of UPF among children is associated with added sugar content in the diets and even influences anthropometric and glucose profiles (Costa et al., 2019;Neri et al., 2019). Besides, the development of unhealthy feeding habits through the potentially addictive behaviour of UPF is likely to have long-term health effects (Filgueiras et al., 2019;Gearhardt & Schulte, 2021). In children, consumption of UPF was associated with cardiometabolic risk and asthma (Elizabeth et al., 2020). ...
The quality of complementary feeding can have both short- and long-term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non-quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra-processed food (UPFs). Up to one-in-five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient-dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes.
... 20 Several epidemiological investigations in children have indicated that the consumption of industrially processed food is associated with a higher risk of abdominal obesity, adverse changes in glucose and lipid profiles, and food addiction. [21][22][23] Such findings have also been observed in similar studies on sugar-sweetened beverages. 24 Sucrose and high-fructose corn syrup (HFCS) are common sweeteners in industrially processed food and sugar-sweetened beverages, which contain 50% and 55% of fructose respectively. ...
Background and objectives:
Childhood obesity is rapidly rising in China and effective diet interventions are needed. Here, we determine whether the Chinese government-recommended diet (GRD) or a modified diet of further restriction of sugar and ultra-processed food but without energy restriction, minimally processed diet (MPD) is effective on weight loss in children and adolescents with obesity/overweight.
Methods and study design:
This open-label, randomized study included 60 children and adolescents between 5-18 years old with overweight/obesity. Participants were randomized 1:1 to the GRD or MPD and self-managed at home for 12 weeks. Both groups received general recommendations in physical activities. The changes were evaluated in body weight, fasting glucose and insulin, lipid metabolism and serum uric acid between baseline and week 12.
Results:
The results indicated great reductions by time for BMI, BMI z-score, fat mass percentage and fat mass index in both groups. An obvious decrease by time for weight was found in the MPD group (p<0.001) as well as fasting glucose (p=0.005), fasting insulin (p=0.001), total cholesterol (p=0.007) and serum uric acid (p=0.006). As for the amount of visceral fat, greater reduction by time was observed in MPD group compared with GRD group.
Conclusions:
A 12-week self-intervention combining the Chinese government-recommended diet with physical activities was effective on weight loss in children and adolescents with overweight/obesity. The minimally processed diet was more effective on decreasing visceral fat mass and may be beneficial to improving insulin resistance. Further studies are required to assess long-term outcomes of the general public.
... While some studies in the literature found that food addiction affected obesity in children (12,13,23,24,26,27,29,(32)(33)(34), some studies reported that there was no significant effect (11,(14)(15)(16)35,36). This meta-analysis study revealed that food addiction had an important role on obesity. ...
Aim:This study aimed to analyse the effect of food addiction in children on obesity.Materials and Methods:A comprehensive literature review was conducted between January 2013 and July 2019 (Google Scholar, Pubmed, Embase/Elsevier, PsycINFO, EBSCOhost, Science Direct, BioMed Central). The word combinations “child”, “adolescent”, “obesity”, “food addiction”, “eating behaviour” and “food addiction scale for children” were used in the search process. The selected articles were examined in detail by two independent reviewers, and the methodological quality of the studies to be included in this study were evaluated using the Joanna Briggs Institute Meta-Analysis Statistical Appraisal and Review Tool (JBI-MAStARI Critical Appraisal Tool). General effect size, tests of heterogeneity, publication bias, and sensitivity analyses were performed with the random-effects model. The Comprehensive Meta-Analysis 3 software package was used for data analysis.Results:As a result of the test of heterogeneity, those studies falling within the food addiction in children sub-dimension were determined to show heterogeneous characteristics (Q=74,109, I2=83.80, p
... Currently diabetes affects almost half a billion people with a worrying trend in the next future [2]. Additionally, globalization easily offers availability, attraction and addiction [13,14] to highly palatable, cheap and low quality junk food, with a preannounced epidemic of obesity [15] and a massive increase of type-2 diabetes mellitus (T2DM) prevalence 1,16,17, with enormous impacts on economics. ...
Background and aims
The increasing prevalence of diabetes mellitus is causing a massive growth of peripheral artery disease incidences, a disabling complication of diabetic atherosclerosis, which leads often to the amputation of the affected limb. Critical limb ischemia is the terminal disease stage, which requires a prompt intervention to relieve pain and save limbs. However, patients undergoing revascularization often suffer from cardiovascular, cerebrovascular and major adverse limb events with poor outcomes. Furthermore, the same procedure performed in apparently similar patients has various outcomes and lack of an outcome predictive support causes a high lower limb arterial revascularization rate with disastrous effects for patients. We collected the main risk factors of major adverse limb events in a more readable and immediate format of the topic, to propose an overview of parameters to manage effectively peripheral artery disease patients and to propose basics of a new predictive tool to prevent from disabling vascular complications of the disease.
Methods
Most recent and updated literature about the prevalence of major adverse limb events in peripheral artery disease was reviewed to identify possible main predictors.
Results
In this article, we summarized major risk factors of limb revascularization failure and disabling vascular complications collecting those parameters principally responsible for major adverse limb events, which provides physio-pathological explanation of their role in peripheral artery disease.
Conclusion
We evaluated and listed a panel of possible predictors of MALE (Major Adverse Limb Event) in order to contribute to the development of a predictive score, based on a summary of the main risk factors reported in scientific articles, which could improve the management of peripheral artery disease by preventing vascular accidents.
... Reardon et al. (2014) found that highly-processed foods comprised between 13 and 22% of total food expenditure in rural households in four low-and middle-income Asian countries compared to 17.7% and 36.7% in urban households (Reardon et al., 2014). A small study in overweight Brazilian children showed a tendency of higher consumption of added sugar as well as UPF products among those children diagnosed with food addiction (Filgueiras et al., 2019). ...
Food systems that deliver healthy diets without exceeding the planet’s resources are essential to achieve the worlds’ ambitious development goals. Healthy diets need to be safe, accessible, and affordable for all, including for disadvantaged and nutritionally vulnerable groups such as of smallholder producers, traders, and consumers in low- and middle-income countries. Globally, food systems are experiencing rapid and drastic changes and are failing to fulfil these multiple duties simultaneously. The international community therefore calls for rigorous food systems transformations and policy solutions to support the achievement of healthy diets for all. Most strategies, however, are essentially supply- and market-oriented. Incorporation of a healthy diet perspective in food system transformation is essential to enable food systems to deliver not only on supplying nutritious foods but also on ensuring that consumers have access can afford and desire healthy, sustainable, and culturally acceptable diets. This paper argues that this should be guided by information on diets, dietary trends, consumer motives, and food environment characteristics. Transformational approaches and policies should also take into account the stage of food system development requiring different strategies to ensure healthier diets for consumers. We review current knowledge on drivers of consumer choices at the individual and food environment level with special emphasis on low- and middle income countries, discuss the converging and conflicting objectives that exist among multiple food-system actors, and argue that failure to strengthen synergies and resolve trade-offs may lead to missed opportunities and benefits, or negative unintended consequences in food system outcomes. The paper proposes a menu of promising consumer- and food-environment- oriented policy options to include in the food systems transformation agenda in order to shift LMIC consumer demand towards healthier diets in low- and middle income countries.
... Traditional nutritious foods, which tend to be high in complex carbohydrates and vegetables, are being replaced by foods high in fat and calories [18]. Currently, ultra-processed food products contribute a large part of the calories in the children's diet [19][20][21]. The consumption of processed foods with a high content of fats and refined sugars is gaining prominence to the detriment of those that constitute the pillars of a healthy diet, such as fruit, vegetables, legumes, cereals, or fish [22]. ...
Early acquisition of healthy lifestyle habits is crucial for good adult health. For this reason, the primary stage of education is a critical period to implement educational policies in this regard. The aim of this review is to compile the published evidence regarding school interventions at the primary stage aimed at preventing obesity, and which integrate as part of their action plan two features: an improvement in knowledge or nutrition habits and the promotion of physical activity (PA), and the use of new information and communications technologies (ICT) to do this. The method used for this review is the searching of different databases for publications that include these criteria. The results show beneficial effects of such interventions in improved eating habits and increased PA. The effect on BMI is limited, and the use of ICT can be of help at a motivational level for the maintenance and fulfilment of the health objectives. However, studies of this type in elementary school are very limited, so it would be necessary to continue researching on this line. In conclusion, this review demonstrates the suitability of carrying out mixed interventions (improved nutrition and PA) together with the use of new technologies to improve health and prevent obesity at an early age.
... Previous studies have identified that soft drinks and sweetened fruit juices are among the UPF contributing most to total energy intake (14)(15)(16)18,38,47,58) , which is expected due to their hyper-palatability, non-perishable nature, branding and aggressive marketing by transnational and giant corporations makes them extremely appealing. (12) Their flavours, colours, emulsifiers and other additives makes them inherently unhealthy, but also potentially addictive and likely to displace intake of other healthier fluids (12,(59)(60)(61) . Hence, the observed reduction for drinking plenty of water as UPF consumption increases is expected as the consumption of water may be replaced by ultra-processed beverages, such as soft drinks and fruit drinks. ...
Objective
To examine how socio-demographic characteristics and diet quality vary with consumption of ultra-processed foods (UPFs) in a cross-sectional nationally representative survey of Australian adults.
Design
Using a 24-hour recall, this cross-sectional analysis of dietary and socio-demographic data classified food items using the NOVA system, estimated the percentage of total energy contributed by UPFs and assessed diet quality using the Dietary Guideline Index (DGI – 2013 total and components). Linear regression models examined associations between socio-demographic characteristics and diet quality with percentage of energy from UPFs.
Setting
Australian Health Survey 2011-13
Participants
Australian Adults aged ≥ 19 years (n=8,209)
Results
Consumption of UPFs was higher among younger adults (19-30 years), adults born in Australia, those experiencing greatest area level disadvantage, lower levels of education, and the second lowest household income quintile. No significant association was found for sex or rurality. A higher percentage of energy from UPFs was inversely associated with diet quality and with lower DGI scores related to the variety of nutritious foods, fruits, vegetables, total cereals, meat and poultry, fish, eggs, nuts and seeds, legumes/beans, water and limits on discretionary foods, saturated fat and added sugar.
Conclusions
This research adds to the evidence on dietary inequalities across Australia and how UPFs are detrimental to diet quality. The findings can be used to inform interventions to reduce UPF consumption and improve diet quality.
... 5 Moreover, ultraprocessed foods tend to be habitually consumed and less satiating, which may lead to overconsumption. 5,8,9 Growing evidence has suggested positive associations between ultraprocessed food consumption and the risk of chronic disease and mortality. [10][11][12][13][14] The energy contribution from ultra-processed products in North American and European countries is considerable. ...
Background
Food environments have changed rapidly, and the global interest in ultra-processed foods has increased. Ultra-processed foods are typically energy dense, high in sugars and fat, and low in fiber, protein, minerals, and vitamins.
Objective
This study aimed to estimate the energy contribution of ultra-processed foods in the diet of Korean adults and to examine the association between ultra-processed food consumption and dietary intake and diet quality.
Design
This study is a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey (2016–2018).
Participants/settings
A total of 16,657 adults aged ≥19 years who completed a 1-day 24-hour recall.
Main outcome measures
Absolute and relative intake of energy and nutrients were measured and dietary quality was assessed using the Korean Healthy Eating Index (KHEI).
Statistical analysis
Multiple regression models adjusted for sociodemographic variables were used to examine the association between quintiles of ultra-processed foods dietary energy contribution and dietary intake and quality.
Results
Mean reported daily energy intake was 2,031 kcal, with 25.1% of calories coming from ultra-processed foods. Mean energy contribution from ultra-processed foods ranged from 3.6% kcal (Q1) to 52.4% kcal (Q5). Energy contribution of ultra-processed foods was positively associated with reported intake of daily energy, total sugars, and total and saturated fat and inversely associated with reported intake of carbohydrates, fiber, minerals, and vitamins. Both sodium and potassium were negatively associated with percentage of energy from ultra-processed foods. However, the sodium-to-potassium ratio was high regardless of quintile of energy contribution from ultra-processed foods, and the ratio was positively associated with percentage of total energy from ultra-processed foods. Although the KHEI score was inversely associated with percentage of daily energy from ultra-processed foods, all levels of ultra-processed food consumption were associated with poor diet quality.
Conclusions
The ultra-processed foods consumption of Korean adults accounted for one fourth of daily energy intake, and a higher dietary energy contribution from ultra-processed foods was associated with poorer dietary intakes and a lower dietary quality. Further studies are needed to understand factors influencing selection and consumption of ultra-processed foods and to identify effective strategies to promote healthy food choices.
... Un estudio en el cual también se aplicó la Escala YFAS-C en niños a partir de los 8 años de edad y adolescentes, identificó adicción a los alimentos en una proporción pequeña de participantes 12 y otro estudio identificó adicción a los alimentos en participantes con OB, también en una proporción pequeña 13 , sin embargo, otro estudio realizado en Brasil en niños con SP, con edad comprendida entre los 9 y 11 años, identificó al menos un síntoma en la mayoría de los participantes y la cuarta parte presentó adicción a los alimentos 14 , por otra parte como se señaló en el presente estudio se aplicó la escala YFAS-C a cuidadores de niños preescolares y a pesar de que una quinta parte de los preescolares presentó SP-OB no se identificó adicción a los alimentos, lo anterior, requiere seguirse estudiando, al menos en la población preescolar, dado que idealmente es el cuidador principal quien identificaría de forma temprana si se esta presentando adicción a los alimentos, lo anterior podría estar relacionado a una incapacidad del cuidador de percibir esta conducta de riesgo. El concepto de adicción a los alimentos es un tema muy debatido en la literatura científica, un estudio documentó que las madres participantes no creían en este concepto, dado que podrían sentirse ofendidas por el término, bajo la premisa de que implica una conexión entre la OB y la adicción, término que es similar a la adicción a las drogas o alcoholismo que son trastornos estigmatizados [15][16] . ...
Objetivos:
1) Identificar y contrastar los síntomas de adicción a los alimentos en preescolares con y sin sobrepeso-obesidad (SP-OB), 2) Identificar y contrastar la frecuencia e intensidad de los antojos por alimentos en preescolares con y sin SP-OB, 3) Identificar factores que determinan el índice de masa corporal (IMC) del preescolar.
Materiales y Métodos:
Estudio descriptivo correlacional, participaron 201 cuidadores. Se aplicó la Escala Adicción a los Alimentos de Yale para Niños (YFAS-C) y Cuestionario Características de Antojos por los Alimentos. Se midió peso y talla del preescolar.
Resultados:
El coeficiente de fiabilidad Kuder-Richardson de YFAS-C, fue 0.635. El 91% de los cuidadores fueron madres. La media de síntomas de adicción a los alimentos en preescolares con SP-OB fue=0.3488 (n = 43) y sin SP-OB ẋ = 0.3987 (n = 158), U = 3351.00, p ˃ 0.05. Anticipación de refuerzo positivo fue la característica de antojo con la media más alta (ẋ= 9.05, DE = 4.21) y la más baja emociones (ẋ = 2.40, DE = 0.878), no se encontraron diferencias significativas. No se encontró relación entre los síntomas de adicción a los alimentos y el IMC del preescolar. Los antojos contribuyeron al IMC del preescolar, varianza explicada 12.2%.
Conclusiones:
La escala YFAS-C es la única diseñada para evaluar los síntomas de adicción a los alimentos en niños, sin embargo, en el presente estudio no se identificaron síntomas. Se recomienda continuar explorando este concepto, en este grupo de edad.
This study aimed to investigate the relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food consumption among undergraduate students. Specific and validated scales were used in order to evaluate chronotype, addiction-like eating behavior and mindful eating (N = 605). Dietary intake was determined by food frequency questionnaire and percentage energy from ultra-processed food was calculated. Self-reported weights and heights were obtained from the participants. Mean scores of scales, social jetlag, energy intake, ultra-processed food intake and BMI were compared by chronotypes. Associations between chronotype, addiction-like eating behavior, mindful eating, ultra-processed food consumption and BMI were determined by Pearson's test. The relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food intake were assessed by linear regression models and adjusted for sex, BMI, energy intake, season, smoking and alcohol consumption. Evening-type participants had higher scores of social jetlag (2.01 ± 0.09), appetitive drive (26.02 ± 0.63), low dietary control (20.50 ± 0.41), addiction-like eating behavior (46.52 ± 0.85), lower scores of recognition (21.91 ± 0.43) and higher percentage energy from ultra-processed food (32.24 ± 1.26%). Chronotype score showed negative associations with addiction like eating behavior (β=-0.247, p < 0.001) and ultra-processed food consumption (β=-0.247, p < 0.001), and a positive association with recognition (β = 0.124, p < 0.001). Results suggest that chronotype is inversely associated with addiction-like eating behavior and ultra-processed food consumption, and positively associated with mindful eating among undergraduate students.
The study objectives were to determine whether consumption of ultra-processed foods (UPF) and eating patterns are associated with food addiction (FA) in a Brazilian sample. This is a cross-sectional study. The Brazilian Food and Nutrition Surveillance System tool assessed food consumption markers and dietary patterns. The modified Yale Food Addiction Scale 2.0 was used to determine FA. 5946 participants were included with a mean age of 24 ± 6 years, and 4371 (73.5%) were female. After statistical adjustments for confounders, individuals with FA had lower consumption of fresh fruits (PR: 0.88; 95%CI: [0.79; 0.97]), vegetables (PR: 0.87; 95%CI: [0.79; 0.97]), and beans (PR: 0.85; 95%CI: [0.77; 0.95]). They also had higher consumption of UPF: hamburgers/sausages (PR: 1.15; 95%CI: [1.04; 1.27]), instant noodles, packaged snacks, and/or salty cookies (PR: 1.27; 95%CI: [1.13; 1.42]), and sandwich cookies, sweets, and/or treats (PR: 1.26; 95%CI: [1.14; 1.40]). Positive associations between FA and having meals in front of the screen (PR: 1.48; 95%CI: [1.28; 1.71]) and having a late-night snack (PR: 1.24; 95%CI: [1.11; 1.39]) remained. The negative association between FA and skipping breakfast (PR: 0.76; 95%CI: [0.68; 0.85]) also remained. These eating patterns may contribute to FA, which could be potential targets for clinical intervention.
Atualmente, os padrões alimentares dominados por alimentos ultraprocessados têm gradualmente substituído as dietas tradicionais, levando a impactos negativos sobre a saúde, a segurança alimentar e o meio ambiente. As transformações nesses padrões alimentares podem sofrer maior ou menor resistência na medida em que a cultura alimentar esteja preservada e os ambientes alimentares favoreçam escolhas alimentares saudáveis e desincentivem as não saudáveis. A superação desses desafios depende da prioridade para a questão da alimentação saudável nas políticas setoriais e intersetoriais que fortaleçam e preservem a cultura alimentar local, promovendo saúde, sustentabilidade, resiliência e inclusão a partir dos sistemas alimentares.
Currently, dietary patterns dominated by ultra-processed foods have gradually replaced traditional diets, causing negative impacts on health, food and nutritional security and on the environment. The transformation in the diets can be more or less resistantaccording to how preserved the food culture is and how food environments promote healthy dietary choices and disincentive unhealthy behaviors. Overcoming these challenges depends on the priority given tohealthy diets in sectoral and intersectoral policies to strengthen and preserve the local food culture and promote health, sustainability, resilience and inclusiveness through the food systems.
Traditional Med diets consumed around the Mediterranean basin reflect the local environment and so may vary quite widely in food content. This chapter discusses the importance of minimising consumption of foods typical of a Western diet. The Western diet includes substantial amounts of meat and other animal products, refined grains and HFSS foods. Most of the packaged foods that typify the Western diet are highly calorific and of low nutritional value. The higher fibre content and lower level of free sugars in the Med diet compared to the Western diet result in different effects on the microbiome. The food industry is responding to the demand for pre prepared vegan/vegetarian foods with a massive expansion of new lines. Current evidence suggests that to ensure nutritional adequacy, it is easier for consumers to transition to flexitarian diets such as the Med diet than to vegetarian/vegan diets.
Objective
Childhood trauma has been associated with substance use disorders (SUDs), but less research has investigated its association with food addiction (i.e., compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). Existing research on childhood trauma and food addiction has focused primarily on women from restricted samples. Further, emotion dysregulation difficulties are implicated in both childhood trauma and food addiction, but research has not explored whether it may play a mediating role.
Method
Thus, the current study utilizes a sample of 310 participants recruited from Amazon Mechanical Turk (mean age = 41.3 years old, 47.4% men, 78.7% white) to investigate the mediating role of emotion dysregulation in the association between childhood trauma and food addiction. We also conducted exploratory analyses to investigate for gender differences in these associations. Gender-stratified correlational matrixes were conducted to investigate association between childhood trauma, food addiction, and emotional dysregulation. Moderated mediation models and multilevel regressions were also conducted to identify the role of gender in the association between childhood trauma, food addiction, and emotion dysregulation.
Results
Emotion dysregulation was found to partially mediate the associations between food addiction and childhood trauma and gender was found to moderate associations between childhood trauma and emotion dysregulation, as well as childhood trauma and food addiction. Both moderating pathways were significantly stronger for men compared to women.
Discussion
Results suggests that emotion dysregulation may be one important mediator in the association between childhood trauma and food addiction, particularly for men. The identification of other potential mechanisms contributing to the association between childhood trauma and food addiction and the use of longitudinal measurement strategies will be important in future research.
Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.
Background
The prevalence of excess weight and obesity in children has increased significantly worldwide. The concept of food addiction (FA) has been associated with eating-related problems and obesity. Studies on this topic have primarily examined adult samples and little is known about addictive-like eating among Mexican children and adolescents.
Methods
We conducted this study to examinate the prevalence of FA in a group of 291 overweight and obese children and adolescents using YFAS scale for children (YFAS-C) in Mexico.
Results
According to the YFAS-C approximately 14.4% of participants met for FA diagnosis. Forty-two (14.4%) received a FA diagnosis: 14 children and 28 adolescents. The number of FA symptoms in participants who received an FA diagnosis (M = 4.35, SD = 1.07) compared to participants with no FA diagnosis (M = 1.70, SD = 1.53) was significantly higher ( p ≤ 0.001). There were no statistically significant gender differences and the proportion of subjects with an FA diagnosis did not differ by age between children and adolescents. FA is a focus of interest in attempting to explain certain behaviors that may contribute to the development of obesity and explain the failure of the weight loose programs in children.
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of “dopamine homeostasis” to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
Consumers are concerned with the amount of sucrose added to foods and its effects on human health. One way to reduce this concern is through the consumption of sucrose substitutes, such as isomaltulose. Isomaltulose is an alternative sugar that should be regarded by the food industry as much healthier than sucrose, due to its beneficial properties; these include, low glycemic index and slow hydrolysis, prebiotic potential, and low cariogenic potential. In this work, a bibliometric analysis associated with a review of literature was conducted as a rigorous method for exploring and analyzing large volumes of scientific data, to understand the global scenario and identify the trends regarding isomaltulose. Important facts from its history and origin were discussed, as well the main research and countries that have contributed to its growing interest in the food industry. Over the years, from the discovery of new beneficial properties, more studies have been conducted, demonstrating that the interest in isomaltulose has been increasing. Finally, we concluded that isomaltulose is a promising sucrose substitute that could change the scenario of the sugar-rich foods market; and its use for the development of new products is highly encouraged.
O mundo está cada vez mais gordo: o problema da adiposidade, hoje, preocupa mais que a fome e contribui à proliferação de uma série de doenças crônicas não transmissíveis, resultando em milhões de óbitos todos os anos. Frente a essa problemática, a Lei 20.606 promulgada no Chile foi pioneira em tornar obrigatória a inserção de um símbolo de “alerta” (similar a um sinal de trânsito “pare”) que indica quando certo nutriente (açúcar, sódio, gordura ou valor energético) possui teor prejudicial à saúde. Parte-se da ideia de que pequenas alterações no ambiente são capazes de provocar mudanças no comportamento, conforme a teoria de nudge formulada por Thaler e Sustein. Com efeito, o objetivo desse trabalho é identificar estratégias que, quando aplicadas à rotulagem nutricional, influenciam a tomada de escolhas alimentares mais saudáveis, além de instigar a formulação de produtos mais benéficos à saúde. Para tanto, a partir do paradigma chileno, realiza-se uma análise comparativa entre as normas atuais sobre rotulagem nutricional, no Brasil e no Chile, considerando a recente aprovação da Resolução RDC nº 429 de 2020, que substitui a RDC nº 360/2003 e introduz a rotulagem nutricional frontal no Brasil. Como resultado dessa investigação, restou evidenciado que o rótulo nutricional frontal de “advertência”, nos moldes da legislação chilena, influi efetivamente na realização de escolhas conscientes e seguras, além de promover a sustentabilidade a partir da reformulação de produtos. A nova resolução da ANVISA, em que pese tenha aprimorado a tabela nutricional (tornando-a mais chamativa, legível, facilmente comparável e próxima à lista de ingredientes), ainda necessita avançar em relação ao sistema de rotulagem nutricional frontal escolhido para a efetiva promoção dos direitos humanos do consumidor à saúde e à alimentação.
Palavras-Chave: Rotulagem Nutricional. Alimentos Ultraprocessados. Direito à Informação. Segurança Alimentar. Sustentabilidade.
URI: http://www.repositorio.jesuita.org.br/handle/UNISINOS/11067.
Background
Ultra-processed foods (UPF) are associated with poor diet quality and chronic diseases. UPF falls into one of the four groups classified according to the extent and purpose of processing: Group 1 includes unprocessed and minimally processed foods (MPF); group 2 refers to processed culinary ingredients (PCI); group 3, processed foods (PF); and group 4, UPF.
Objective
The aim of this study was to evaluate the relative validity of a semi-quantitative food frequency questionnaire (SFFQ) compared to two 24-hour dietary recalls to estimate dietary intake per NOVA food group in Mexican children and adolescents.
Design
This study is a secondary analysis of dietary data from a subsample of children and adolescents who participated in the 2012 Mexican National Health and Nutrition Survey
Participants/setting
The study participants were 217 children (5 to 11 years) and 165 adolescents (12 to 19 years) with complete information for the SFFQ and two 24 hour-dietary recalls (24DRs).
Main outcome measures
Daily averages of energy intake and % of energy intake for each NOVA category were calculated using the SFFQ and two 24DRs.
Statistical analysis
To assess relative validity, the SFFQ was compared with two 24DRs to estimate dietary intake per NOVA food group. Mean differences, Spearman correlations and intra-class correlations coefficients (ICC) and Bland–Altman plots for continuous variables and weighted kappa for ordinal variables were calculated.
Results
For percentage of energy intake, ICC in children and adolescents were moderate for MPF (ICC=0.47, ICC=0.56, respectively) and UPF (ICC=0.53, ICC=0.57, respectively). Bland–Altman plots indicated reasonably consistent agreement for UPF and MPF groups in children and adolescents. Classification by quintiles was acceptable in all groups.
Conclusions
Data from this study indicated reasonable relative validity of the SFFQ to rank the percentage of energy intake from MPF and UPF in Mexican children and adolescents.
Ultra-processed foods defined by NOVA system, a classification of foods based on their degree and purpose of industrial food processing, are formulations of ingredients, mostly of exclusive industrial use, that result from a series of industrial processes. NOVA has been recognized as a valid tool for nutrition and public health research, policy and action. This article outlines the NOVA system, with focus on ultra-processed food group, and how its consumption is affecting diet quality and the increasing development of obesity, diabetes type-2, cardiovascular disease, cancer, and many other chronic diseases all over the world.
Purpose of Review
The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities.
Recent Findings
In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods.
Summary
UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health — though further mechanistic studies are needed.
Purpose:
This study was carried out to determine the effect of an obesity prevention program on children's eating behaviors, food addiction, physical activity, and obesity prevalence.
Design and methods:
A pretest-posttest quasi-experimental design was used in the study. The study was conducted with a total of 128 students, including 55 in the intervention and 73 in the control groups. The obesity prevention program was implemented in the intervention group, and a routine curriculum training program was followed in the control group. The study data were collected before the intervention and in the third, sixth, and fifteenth months after the completion of the intervention. The data were evaluated using the chi-square test, McNeamer test, Cochrane Q test, multivariate analysis of variance in repeated measures, the Bonferroni adjusted paired t-test, power analysis, effect size, and regression analysis.
Results:
At the end of the study, it was determined that the body mass index values and food addiction rates of the students in the intervention group were lower than those of the students in the control group (p < .05). There was a significant difference between the mean scores of the students in the intervention and control groups obtained from the eating behavior questionnaire and the physical activity questionnaire in terms of time, group, and group * time interaction (p < .05). Also, the intervention program was found to have a large effect size (0.39) and a strong effect (0.85) on body mass index.
Conclusion:
The obesity prevention intervention program was found to be effective in increasing children's positive eating behaviors and mean physical activity score and decreasing food addiction rates and body mass index values.
Practice implications:
We recommend that the intervention program implemented in this study should be used widely in the curriculum of the Ministry of Education. This program shows that the school nurse is effective in preventing obesity in children. For this reason, there should be a school nurse in schools for implementing health-promoting education programs.
Objetivou-se avaliar a evolução da prevalência de anemia em crianças quilombolas de Alagoas, Brasil. Trata-se de uma análise descritiva comparando resultados de dois inquéritos domiciliares (2008; n = 950 e 2018; n = 426), envolvendo amostra das crianças de 6 a 59 meses. A anemia foi diagnosticada com hemoglobina < 110g/L (HemoCue). As prevalências entre os dois inquéritos foram descritas percentualmente e pela razão de prevalência (RP) e intervalo de 95% de confiança (IC95%), calculados por regressão de Poisson. As prevalências de anemia em 2008 e 2018 foram, respectivamente, 53% (IC95%: 49,8-56,1) e 38% (IC95%: 33,4-42,6), configurando um declínio de 28,3% (RP = 0,72; IC95%: 0,63-0,82). Crianças de 6 a 24 meses foram mais acometidas do que aquelas de 25 a 59 meses, tanto em 2008 (72% vs. 44%) como em 2018 (54,8% vs. 28,3%). Houve redução de prevalência em ambas as faixas etárias (23,9% e 35,7%, respectivamente). Essa redução mais pronunciada nas crianças mais velhas fez que as mais jovens passassem a ter quase o dobro da prevalência vista nas de maior idade (RP = 1,94; IC95%: 1,53-2,46). Conclui-se que houve declínio expressivo da prevalência de anemia durante o período avaliado, persistindo, porém, como relevante problema de saúde pública, sobretudo entre as crianças de 6 a 24 meses. As crianças avaliadas sobrevivem em grande vulnerabilidade social, evidenciando-se que, para promover a saúde dessa população, não são suficientes ações no âmbito da saúde pública. Gestores e profissionais de saúde devem estar atentos aos dados aqui apresentados, visando à implementação de medidas para enfrentamento das iniquidades sociais e de saúde que contribuem para maior vulnerabilidade desse grupo étnico-racial.
In this work we analyze the current interpretations based on the studies of Nutrigenomic and Microbiomics, according to which, at the base of many pathological and dysmetabolic manifestations, there would be or variations of single nucleotide polymorphisms (Snps), in the Nutrigenomic vision, or changes of the normal gut microbiota, in the Microbiomic conception. In particular, we analyze critically, the singular pathogenic coincidence, which for the same pathologies calls into question or Snps mutations or the presence of specific modifications of the Microbiota. Other possible causes of observed diseases are thus neglected. On the basis of the literature examined, we present a different interpretation of pathogenic causes.
Objective
To assess the prospective associations between consumption of ultra-processed food and risk of cancer.
Design
Population based cohort study.
Setting and participants
104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification.
Main outcome measures
Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors.
Results
Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis).
Conclusions
In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations.
Study registration
Clinicaltrials.gov NCT03335644.
Purpose of review:
This review investigates how exposure to palatable food and its associated cues alters appetite regulation and feeding behaviour to drive overeating and weight gain.
Recent findings:
Both supraphysiological and physiological feeding systems are affected by exposure to palatable foods and its associated cues. Preclinical research, largely using rodents, has demonstrated that palatable food modulates feeding-related neural systems and food-seeking behaviour by recruiting the mesolimbic reward pathway. This is supported by studies in adolescents which have shown that mesolimbic activity in response to palatable food cues and consumption predicts future weight gain. Additionally, stress exposure, environmental factors and individual susceptibility have been shown to modulate the effects of highly palatable foods on behaviour. Further preclinical research using free-choice diets modelling the modern obesogenic environment is needed to identify how palatable foods drive overeating. Moreover, future clinical research would benefit from more appropriate quantification of palatability, making use of rating systems and surveys.
Ultra-processed foods are ready-to-heat and ready-to-eat products created to replace traditional homemade meals and dishes due to convenience and accessibility. Because of their low-fiber and high-fat and sugar composition, these foodstuffs could induce a negative impact on health. They are partially responsible for obesity and chronic non-transmissible diseases; additionally, they could impact in the prevalence of autoimmune diseases such as type 1 diabetes and celiac disease. The rationale is that the nutritional composition of ultra-processed foodstuffs can induce gut dysbiosis, promoting a pro-inflammatory response and consequently, a “leaky gut”. These factors have been associated with increased risk of autoimmunity in genetically predisposed children. In addition, food emulsifiers, commonly used in ultra-processed products could modify the gut microbiota and intestinal permeability, which could increase the risk of autoimmunity. In contrast, unprocessed and minimally processed food-based diets have shown the capacity to promote gut microbiota eubiosis, anti-inflammatory response, and epithelial integrity, through bacterial butyrate production. Thus, to decrease the susceptibility to autoimmunity, genetically predisposed children should avoid ultra-processed food products and encourage the consumption of fresh and minimally processed foods.
Purpose:
The Food Cravings Questionnaires are among the most often used measures for assessing the frequency and intensity of food craving experiences. However, there is a lack of studies that have examined specific cut-off scores that may indicate pathologically elevated levels of food cravings.
Methods:
Receiver-Operating-Characteristic analysis was used to determine sensitivity and specificity of scores on the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) for discriminating between individuals with (n = 43) and without (n = 389) "food addiction" as assessed with the Yale Food Addiction Scale 2.0.
Results:
A cut-off score of 50 on the FCQ-T-r discriminated between individuals with and without "food addiction" with high sensitivity (85%) and specificity (93%).
Conclusions:
FCQ-T-r scores of 50 and higher may indicate clinically relevant levels of trait food craving.
Level of evidence:
Level V, descriptive study.
Purpose of review:
The aim of this narrative review was to summarize and critique recent evidence evaluating the association between ultra-processed food intake and obesity.
Recent findings:
Four of five studies found that higher purchases or consumption of ultra-processed food was associated with overweight/obesity. Additional studies reported relationships between ultra-processed food intake and higher fasting glucose, metabolic syndrome, increases in total and LDL cholesterol, and risk of hypertension. It remains unclear whether associations can be attributed to processing itself or the nutrient content of ultra-processed foods. Only three of nine studies used a prospective design, and the potential for residual confounding was high. Recent research provides fairly consistent support for the association of ultra-processed food intake with obesity and related cardiometabolic outcomes. There is a clear need for further studies, particularly those using longitudinal designs and with sufficient control for confounding, to potentially confirm these findings in different populations and to determine whether ultra-processed food consumption is associated with obesity independent of nutrient content.
Background
Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity.
Methods/study design
The study was conducted by the Center for Recovery and Nutritional Education (CREN) in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438) consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] –for-age Z score, n = 138) received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353) participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n = 125) were invited to attend the routine outpatient care at CREN.
Discussion
This study is the first to assess the effectiveness of a multi-component and environmental school-based intervention for the recovery of low-income, overweight/obese children and adolescents. If positive, the results demonstrate the feasibility for the recovery of excess of weight in populations of similar conditions and age.
Trial registration
Brazilian Registry of Clinical Trials - ReBEC Primary Id Number RBR-9t2jr8. Registration Date: Nov. 30, 2016. Retrospectively registered.
Protocol version: 3.
Existing research suggests that there is an overlap between binge eating disorder (BED) and the construct of 'food addiction' (FA). The objective of this study was to determine the overlapping features of BED and FA through a comparison of the individual scales of commonly used tools including the Binge Eating Scale (BES) and the Yale Food Addiction Scale (YFAS) in a sample of Australian adults. Adults (>18 years of age) were invited to complete an anonymous online survey on FA. Binge eating was assessed through the BES and addictive eating behaviours were assessed through the YFAS (n = 1344). The prevalence and severity of both FA and binge eating increased across weight categories. The overall correlation between the total score from the BES and FA symptoms was r = 0.76, p < 0.001; for females it was r = 0.77, p < 0.001, and for males it was r = 0.65, p < 0.001. Total BES score and the BES emotion factor were most often associated with FA symptoms, as was demonstrated to produce stronger correlations with FA symptoms. In contrast, the BES behaviour factor was less strongly associated to FA with the majority of correlations <0.6. This study demonstrates the overlap between BED and FA, and highlights the possible unique differences between the forms of disordered eating.
Objective
To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-processed foods and prevalence of obesity.
Design
Ecological, cross-sectional study.
Setting
Europe.
Subjects
Estimates of ultra-processed foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time.
Results
Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unprocessed or minimally processed foods, 20·3 % for processed culinary ingredients, 19·6 % for processed foods and 26·4 % for ultra-processed foods. The average household availability of ultra-processed foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-processed foods resulted in an increase of 0·25 percentage points in obesity prevalence.
Conclusions
The study contributes to a growing literature showing that the consumption of ultra-processed foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unprocessed or minimally processed foods and make ultra-processed foods less available and affordable.
Purpose of Review
Behavioural and neurobiological similarities have been identified between the consumption of certain foods and addiction-related disorders. However, few studies have investigated what components of food may promote an addictive-like response in humans. This review evaluates recent research concerning the nutritional aspects of addictive-like eating.
Recent Findings
Based on the current evidence base, highly processed, hyper-palatable foods with combinations of fat and sugar appear most likely to facilitate an addictive-like response. Total fat content and glycaemic index also appear to be important factors in the addictive potential of foods. Despite public interest and evidence from animal studies, few studies have reported an association between sugar and addictive-like eating.
Summary
Due to the paucity of studies, it is difficult to conclusively identify a specific food or ingredient as capable of triggering an addictive-like response in humans. Future studies using validated dietary assessment tools are essential and may inform the development of novel strategies to treat maladaptive eating behaviours.
(Those listed here were responsible for the technical coordination and formulation of these official national dietary guidelines issued by the Brazilian federal Ministry of Health. The abstract is taken from the preamble by the General Coordination of Food and Nutrition, Ministry of Health, Brasília)
The World Health Organization (WHO) recommends, in its Global Strategy on Diet, Physical Activity and Health, that governments formulate and periodically revise national guidelines on food and nutrition. Revised and updated versions should take into account changes in population dietary patterns and states of health and disease, and also progress of scientific knowledge. These Guidelines are aimed at supporting food and
nutrition education actions and national food and nutrition programmes and policies in Brazil.
Creation of dietary guidelines is part of a set of several national intersectoral actions that aim to improve the standards of diet and nutrition of the population and contribute toward promoting health. WHO therefore
proposes that governments provide information and guidance to facilitate healthier food choices and habits, taking into account national and local food cultures, written for everybody and presented clearly and
attractively
The Dietary Guidelines for the Brazilian Population are part of the general strategy to promote adequate and healthy eating, which in turn is part of the Brazilian national policy for food and nutrition. Adequate and healthy diet is a basic human right. This right implies ensuring permanent and regular access, in a socially fair manner, to food and ways of eating that satisfy the social and biological requirements of everybody. It also takes into account special dietary needs, and the needs to be culturally appropriate, and allow for differences in gender,
race, and ethnicity. Adequate and healthy diet should be accessible both physically and financially, and harmonious in quantity and quality, meeting the needs of variety, balance, moderation, and pleasure. Furthermore, it should derive from sustainable practices of production and distribution.
Thus, these Dietary Guidelines for the Brazilian Population are designed to support and encourage healthy eating practices personally and collectively and also to support policies, programmes, and actions whose purpose is to encourage, protect, and promote the good health and the food and nutrition security of the whole Brazilian population
Preliminary findings suggest that Attention Deficit Hyperactivity Disorder (ADHD) may be associated with disordered eating behaviour, but whether there is sufficient evidence to suggest an association between ADHD and specific types of disordered eating behaviour is unclear. Furthermore, it is uncertain whether specific features associated with ADHD are differentially associated with disordered eating behaviour. A systematic review of seventy-five studies was conducted to evaluate the potential association between ADHD symptomatology and disordered eating behaviour and to provide an estimate of the strength of evidence for any association. Overall, a moderate strength of evidence exists for a positive association between ADHD and disordered eating and with specific types of disordered-eating behaviour, in particular, overeating behaviour. There is consistent evidence that impulsivity symptoms of ADHD are positively associated with overeating and bulimia nervosa and more limited evidence for an association between hyperactivity symptoms and restrictive eating in males but not females. Further research is required to assess the potential direction of the relationship between ADHD and disordered eating, the underlying mechanisms and the role of specific ADHD symptoms in the development and/or maintenance of disordered eating behaviour. We propose a framework that could be used to guide the design of future studies.
Background:
Ultraprocessed food consumption has increased in the past decade. Evidence suggests a positive association between ultraprocessed food consumption and the incidence of overweight and obesity. However, few prospective studies to our knowledge have investigated this potential relation in adults.
Objective:
We evaluated the association between ultraprocessed food consumption and the risk of overweight and obesity in a prospective Spanish cohort, the SUN (University of Navarra Follow-Up) study.
Design:
We included 8451 middle-aged Spanish university graduates who were initially not overweight or obese and followed up for a median of 8.9 y. The consumption of ultraprocessed foods (defined as food and drink products ready to eat, drink, or heat and made predominantly or entirely from processed items extracted or refined from whole foods or synthesized in the laboratory) was assessed with the use of a validated semiquantitative 136-item food-frequency questionnaire. Cox proportional hazards models were used to estimate adjusted HRs and 95% CIs for incident overweight and obesity.
Results:
A total of 1939 incident cases of overweight and obesity were identified during follow-up. After adjustment for potential confounders, participants in the highest quartile of ultraprocessed food consumption were at a higher risk of developing overweight or obesity (adjusted HR: 1.26; 95% CI: 1.10, 1.45; P-trend = 0.001) than those in the lowest quartile of consumption.
Conclusions:
Ultraprocessed food consumption was associated with a higher risk of overweight and obesity in a prospective cohort of Spanish middle-aged adult university graduates. Further longitudinal studies are needed to confirm our results. This trial was registered at clinicaltrials.gov as NCT02669602.
Purpose of review:
We explore how a global shift in the food system caused by global economic growth, increase in available food per capita and in food processing is a driver of the obesity epidemic.
Recent findings:
Economic development in most areas of the world has resulted in increased purchasing power and available per capita food. Supermarkets and a growing fast-food industry have transformed our dietary pattern. Ultra-processed food rich on sugars and saturated fat is now the major source of energy in most countries. The shift in food supply is considered a major driver of the obesity epidemic and the increasing prevalence of accompanying complications, such as type 2 diabetes, cardiovascular disease and cancer. However, the global shift might also have direct effects on the increase in type 2 diabetes, cardiovascular disease and cancer, independently of overweight and obesity. The shift in the food supply is a major driver of the obesity epidemic.
The concept of food addiction (FA) is a potentially important contributing factor to the development of obesity in the general population; however, little is known about the hormonal and dietary differences between obesity with and without FA. Therefore, the aim of our study was to explore potential biomarkers, including various hormones and neuropeptides, which regulate appetite and metabolism, and dietary components that could potentially differentiate obesity with and without FA. Of the 737 adults recruited from the general Newfoundland population, 58 food-addicted and non-food-addicted overweight/obese individuals (FAO, NFO) matched for age, sex, BMI and physical activity were selected. A total of 34 neuropeptides, gut hormones, pituitary polypeptide hormones and adipokines were measured in fasting serum. We found that the FAO group had lower levels of TSH, TNF-α and amylin, but higher levels of prolactin, as compared to NFO group. The total calorie intake (per kg body weight), the dietary intake of fat (per g/kg body weight, per BMI and per percentage of trunk fat) and the percent calorie intake from fat and carbohydrates (g/kg) was higher in the FAO group compared to the NFO group. The FAO subjects consumed more sugar, minerals (including sodium, potassium, calcium and selenium), fat and its components (such as saturated, monounsaturated and trans fat), omega 3 and 6, vitamin D and gamma-tocopherol compared to the NFO group. To our knowledge, this is the first study indicating possible differences in hormonal levels and micro-nutrient intakes between obese individuals classified with and without food addiction. The findings provide insights into the mechanisms by which FA could contribute to obesity.
The idea that food intake is motivated by (or in anticipation of) ‘hunger’ arising from energy depletion is apparent in both public and scientific discourse on eating behaviour. In contrast, our thesis is that eating is largely unrelated to short-term energy depletion. Energy requirements meal-to-meal are trivial compared with total body energy stores, so energy supply to the body's tissues is maintained if a meal or even several meals are missed. Complex and exquisite metabolic machinery ensures that this happens, but metabolic regulation is only loosely coupled with the control of energy intake. Instead, food intake needs to be controlled because the limited capacity of the gut means that processing a meal presents a significant physiological challenge and potentially hinders other activities. We illustrate the relationship between energy (food) intake and energy expenditure with a simple analogy in which: (1) water in a bathtub represents body energy content, (2) water in a saucepan represents food in the gut, and (3) the bathtub is filled via the saucepan. Furthermore, (4) it takes hours to process and pass the full energy (macronutrient) content of the saucepan to the bathtub, and (5) both the saucepan and bathtub resist overfilling, representing negative feedbacks on appetite (desire to eat). This model is consistent with the observations that appetite is reduced acutely by energy intake (a meal added to the limited capacity of the saucepan/gut), but not by an increase in acute energy expenditure (energy removed from the large store of energy in the bathtub/body). The existence of a relatively weak but chronic negative feedback effect on appetite proportional to body fatness is supported by observations on the dynamics of energy intake and weight gain in rat dietary obesity. (We use the term ‘appetite’ here because ‘hunger’ implies energy depletion.) In our model, appetite is motivated by the accessibility of food and the anticipated and experienced pleasure of eating it. The latter, which is similar to food reward, is determined primarily by the state of the emptiness of the gut and food liking related to the food's sensory qualities and macronutrient value and the individual's dietary history. Importantly, energy density adds value because energy dense foods are less satiating kJ for kJ and satiation limits further intake. That is, energy dense foods promote energy intake by virtue (1) of being more attractive and (2) having low satiating capacity kJ for kJ, and (1) is partly a consequence of (2). Energy storage is adapted to feast and famine and that includes unevenness over time of the costs of obtaining and ingesting food compared with engaging in other activities. However, in very low-cost food environments with energy dense foods readily available, risk of obesity is high. This risk can be and is mitigated by dietary restraint, which in its simplest form could mean missing the occasional meal. Another strategy we discuss is the energy dilution achieved by replacing some sugar in the diet with low-calorie sweeteners. Perhaps as or more significant, though, is that belief in short-term energy balancing (the energy depletion model) may undermine attempts to eat less. Therefore, correcting narratives of eating to be consistent with biological reality could also assist with weight control.
Addiction to a wide range of substances of abuse has been suggested to reflect a ‘Reward Deficiency Syndrome’. That is, drugs are said to stimulate the reward mechanisms so intensely that, to compensate, the population of dopamine D2 receptors (DD2R) declines. The result is that an increased intake is necessary to experience the same degree of reward. Without an additional intake, cravings and withdrawal symptoms result. A suggestion is that food addiction, in a similar manner to drugs of abuse, decrease DD2R. The role of DD2R in obesity was therefore examined by examining the association between body mass index (BMI) and the Taq1A polymorphism, as the A1 allele is associated with a 30–40% lower number of DD2R, and is a risk factor for drug addiction. If a lower density of DD2R is indicative of physical addiction, it was argued that if food addiction occurs, those with the A1 allele should have a higher BMI. A systematic review found 33 studies that compared the BMI of those who did and did not have the A1 allele. A meta-analysis of the studies compared those with (A1/A1 and A1/A2) or without (A2/A2) the A1 allele; no difference in BMI was found (standardized mean difference 0.004 (s.e. 0.021), variance 0.000, Z=0.196, P<0.845). It was concluded that there was no support for a reward deficiency theory of food addiction. In contrast, there are several reports that those with the A1 allele are less able to benefit from an intervention that aimed to reduce weight, possibly a reflection of increased impulsivity.
OBJECTIVE
To describe food and macronutrient intake profile and estimate the prevalence of inadequate micronutrient intake of Brazilian adolescents.
METHODS
Data from 71,791 adolescents aged from 12 to 17 years were evaluated in the 2013-2014 Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). Food intake was estimated using 24-hour dietary recall (24-HDR). A second 24-HDR was collected in a subsample of the adolescents to estimate within-person variability and calculate the usual individual intake. The prevalence of food/food group intake reported by the adolescents was also estimated. For sodium, the prevalence of inadequate intake was estimated based on the Tolerable Upper Intake Level (UL). The Estimated Average Requirement (EAR) method used as cutoff was applied to estimate the prevalence of inadequate nutrient intake. All the analyses were stratified according to sex, age group and Brazilian macro-regions. All statistical analyses accounted for the sample weight and the complex sampling design.
RESULTS
Rice, beans and other legume, juice and fruit drinks, breads and meat were the most consumed foods among the adolescents. The average energy intake ranged from 2,036 kcal (girls aged from 12 to 13 years) to 2,582 kcal (boy aged from14 to 17 years). Saturated fat and free sugar intake were above the maximum limit recommended (< 10.0%). Vitamins A and E, and calcium were the micronutrients with the highest prevalence of inadequate intake (> 50.0%). Sodium intake was above the UL for more than 80.0% of the adolescents.
CONCLUSIONS
The diets of Brazilian adolescents were characterized by the intake of traditional Brazilian food, such as rice and beans, as well as by high intake of sugar through sweetened beverages and processed foods. This food pattern was associated with an excessive intake of sodium, saturated fatty acids and free sugar.
Objective: to know the food intake of eutrophic and overweight adolescents. Methods: casecontrol study that analyzed the food intake and habits of adolescents with normal weight and overweight, matched for age and sex, using a food frequency questionnaire and food diaries for 3 days, compared with the Food Guide for the Brazilian Population and analyzed by the software Virtual Nutri. Results: Mean body mass index (BMI) and percent body fat were 29.5 and 49.4 for the overweight group and 21.0% and 29.1% for the normal group, respectively (p < 0.01). Among normal individuals the average daily intake of calories was 1915.5 while overweight adolescents consumed 1761.8 calories. Most adolescents ate the three main meals: breakfast (86%), lunch (98,9%) and dinner (96.8%). For eutrophic teenagers the average percentage of energy consumed was 56.7% for carbohydrates, 154% for proteins and 27.9% for lipids, while the overweight group consumed 52.7%, 17.1% and 30.2%, respectively. Conclusions: the study showed that both groups of adolescents consume the same types and similar amounts of foods, except when considering the group of cereals, roots and tubers whose consumption was higher among eutrophic adolescents (p < 0.01).
In recent years, the concept of food addiction has gained more and more popularity. This approach acknowledges the apparent parallels between substance use disorders and overeating of highly palatable, high-caloric foods. Part of this discussion includes that ‘hyperpalatable’ foods may have an addictive potential because of increased potency due to certain nutrients or additives. Although this idea seems to be relatively new, research on food addiction actually encompasses several decades, a fact that often remains unrecognized. Scientific use of the term addiction in reference to chocolate even dates back to the 19th century. In the 20th century, food addiction research underwent several paradigm shifts, which include changing foci on anorexia nervosa, bulimia nervosa, obesity, or binge eating disorder. Thus, the purpose of this review is to describe the history and state of the art of food addiction research and to demonstrate its development and refinement of definitions and methodologies.
Objectives:
The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents.
Methods:
We used cross-sectional data on 30,243 individuals aged ≥10years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity.
Results:
Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption.
Conclusion:
Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.
to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents.
We used cross-sectional data on 30,243 individuals aged ≥10 years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-hour food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity.
Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94 kg/m(2); 95%CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95%CI: 1.26,3.12) and excess weight (OR=1.26; 95%CI: 0.95,1.69) compared with those in the lowest quintile of consumption.
Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.
Copyright © 2015. Published by Elsevier Inc.
Background
It has been suggested that addictive behaviors related to consumption of specific foods could contribute to overeating and obesity. Although energy-dense, hyper-palatable foods are hypothesized to be associated with addictive-like eating behaviors, few studies have assessed this in humans. Objective
To evaluate in young adults whether intakes of specific foods are associated with 'food addiction', as assessed by the Yale Food Addiction Scale (YFAS), and to describe the associated nutrient intake profiles. DesignAustralian adults aged 18-35. years were invited to complete an online cross-sectional survey including demographics, the YFAS and usual dietary intake. Participants were classified as food addicted (FAD) or non-addicted (NFA) according to the YFAS predefined scoring criteria. ResultsA total 462 participants (86% female, 73% normal weight) completed the survey, with 14.7% (n = 68) classified as FAD. The FAD group had a higher proportion of females (p =. 01) and higher body mass index (p< .001) compared to NFA. Higher YFAS symptom scores were associated with higher percentage energy intake (%E) from energy-dense, nutrient-poor foods including candy, take out and baked sweet products, as well as lower %E from nutrient-dense core foods including whole-grain products and breakfast cereals. These remained statistically significant when adjusted for age, sex and BMI category (p = .001). Conclusions
Statistically significant associations were identified between YFAS assessed food addiction and dietary intake, specifically intakes of energy-dense, nutrient-poor foods. However, the effect sizes were small limiting clinical applications. Further examination of the relationship between addictive-like eating and intake of specific foods in a nationally representative sample is warranted.
The aim of this study was to test a weight loss program for young people based on an addiction treatment approach.
A pilot study (n=43) was conducted of a 20-week child/adolescent obesity intervention based on an addiction treatment model (staged, incremental withdrawal from problem foods, snacking/grazing, and excessive amounts at meals) and implemented by a server-integrated smartphone app with health professional support. The primary outcome was standardized %overBMI measured at four time points. Secondary outcomes were participants' self-ratings of self-esteem, control over food, and the degree they turned to food when stressed. User satisfaction data were collected with an online questionnaire. Latent growth modeling techniques were used to identify independent variables and possible mediating treatment process variables associated with weight change.
Mean age of participants was 16 years (range, 10-21), 65% girls, and 84% Caucasian. Twenty-seven (63%) completed the program. There was a significant decrease in %overBMI over time of 7.1. There were significant improvements in participant ratings of self-esteem, control over food, and a reduction in turning to food when stressed. Males, younger participants, and participants with higher levels of program compliance achieved better weight loss. Participants who reported that calling obesity an addiction made their guilt worse experienced poorer weight loss. Females were more likely than males to report "addiction guilt," and this partly mediated the overall gender effect.
The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys.
We propose that highly processed foods share pharmacokinetic properties (e.g. concentrated dose, rapid rate of absorption) with drugs of abuse, due to the addition of fat and/or refined carbohydrates and the rapid rate the refined carbohydrates are absorbed into the system, indicated by glycemic load (GL). The current study provides preliminary evidence for the foods and food attributes implicated in addictive-like eating.
Cross-sectional.
University (Study One) and community (Study Two).
120 undergraduates participated in Study One and 384 participants recruited through Amazon MTurk participated in Study Two.
In Study One, participants (n = 120) completed the Yale Food Addiction Scale (YFAS) followed by a forced-choice task to indicate which foods, out of 35 foods varying in nutritional composition, were most associated with addictive-like eating behaviors. Using the same 35 foods, Study Two utilized hierarchical linear modeling to investigate which food attributes (e.g., fat grams) were related to addictive-like eating behavior (at level one) and explored the influence of individual differences for this association (at level two).
In Study One, processed foods, higher in fat and GL, were most frequently associated with addictive-like eating behaviors. In Study Two, processing was a large, positive predictor for whether a food was associated with problematic, addictive-like eating behaviors. BMI and YFAS symptom count were small-to-moderate, positive predictors for this association. In a separate model, fat and GL were large, positive predictors of problematic food ratings. YFAS symptom count was a small, positive predictor of the relationship between GL and food ratings.
The current study provides preliminary evidence that not all foods are equally implicated in addictive-like eating behavior, and highly processed foods, which may share characteristics with drugs of abuse (e.g. high dose, rapid rate of absorption) appear to be particularly associated with "food addiction."
Conflict of interest: The authors declare no conflicts of interest and no funding associated with this paper.
Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.