Search Results (155)

Background/Objectives: The global increase in the consumption of ultra-processed foods (UPFs) parallels the rise in obesity and non-communicable chronic diseases. Although several large-scale studies associate UPF intake with adverse health outcomes, the biological mechanisms remain unclear. Epigenetic alterations, such as changes in DNA methylation, may represent a potential pathway by which diet influences metabolic health. The aim of this study was to investigate whether higher UPF consumption is associated with genome-wide DNA methylation patterns in women. Methods: This was a cross-sectional observational study with exploratory epigenetic analysis. We selected 30 women, who were divided into tertiles based on their UPF consumption (expressed as a percentage of total energy intake) according to the NOVA food classification system. Dietary intake was assessed using a three-day food record. Anthropometric data, body composition and laboratory parameters were evaluated. The analysis of DNA methylation was performed utilizing DNA extracted from peripheral blood leukocytes of participants in the first and third tertiles of UPF consumption. Genome-wide methylation patterns were performed using next-generation sequencing. Results: Participants had a median (IQR) age of 31 years (26.0–36.5) and a BMI of 24.7 (23.6–35.8) kg/m². For the epigenetic analyses, 15 women were included. Of the 30 women initially evaluated, 20 were included as they belonged to the first and third tertile of UPF consumption. Of these, five were excluded due to a low number of reads obtained by NGS. A total of 80 differentially methylated regions were identified between groups, most of which were hypomethylated in the high-UPF-intake group. Conclusions: High UPF consumption was associated with altered DNA methylation patterns, suggesting a potential epigenetic mechanism underlying the negative health effects of UPFs. This pilot study provides a model for future research with larger samples. Full article

Background/Objective: Temporal eating patterns and ultra-processed food (UPF) consumption have independently been associated with obesity and non-communicable diseases. Little is known about the temporal patterns of UPF consumption, as data is challenging to collect. Temporal data can be extracted from mobile food records (mFRs). The aim of this study was to identify the temporal eating patterns of those consuming UPFs using an mFR. Methods: A combined sample of 243 young (18–30 years) and 148 older (>30 years) adults completed a 4-day mFR. The time of eating was extracted from the mFR image metadata. UPFs were identified using the NOVA food classification system. The proportion of total energy intake (EI) from UPFs was calculated hourly. Using chi-square tests, a day-of-the-week analysis compared weekends (Friday–Sunday) with weekdays (Monday–Thursday). A multivariate logistic regression of UPF EI terciles was conducted, expressed as odds ratios and 95% confidence intervals. Results: The proportion of total EI from UPFs was significantly different between younger adults (mean ± SD = 48.8 ± 15.6%) and older adults (36.1 ± 15.1%) (p < 0.001). Age-differentiated 24 h temporal eating pattern analysis found that younger adults had two distinct UPF EI peaks, with the highest at 8 pm, followed by 1 pm. Older adults followed a more conventional three-meal pattern with an additional peak at 7 am. Weekend UPF EI was higher than on weekdays for older adults (~560 kJ, p = 0.003), with no difference for younger adults. Multivariable logistic regression found no significant associations between UPF intake terciles and demographic variables (sex, BMI, education). Conclusions: The peak UPF EI occurred at conventional mealtimes, and UPFs accounted for a substantial proportion of energy intake, especially for younger adults. The timing of UPF EI provides important information for developing public health nutrition interventions. Full article

Background/Objectives: Ultra-processed food consumption has been shown to be linked with clinical cardiovascular disease. This study aims to examine the associations of ultra-processed food consumption with biomarkers for subclinical-level myocardial damage [high-sensitivity cardiac troponin I and T (hs-cTnI and hs-cTnT)] and myocardial stretch (NT-proBNP) in U.S. adults. Methods: We used data from 6615 U.S. adults aged ≥20 years without prevalent cardiovascular disease from the National Health and Nutrition Examination Survey 2001–2004. We identified ultra-processed food by applying the Nova classification to dietary recall data, and we divided participants into quartiles based on their consumption, expressed as a proportion of total daily energy (%kcal) and gram intakes (%grams). We defined elevated cardiac biomarkers as hs-cTnI > 12 ng/L in men and >10 ng/L in women, hs-cTnT ≥ 14 ng/L for all participants, and NT-proBNP ≥ 125 pg/mL for age < 75 y and ≥450 pg/mL for age ≥ 75 y. We used multivariable logistic regression with adjustment for socio-demographic, total energy intake, behavioral, and clinical characteristics. Results: Higher ultra-processed food intake in %grams was associated with elevated NT-proBNP [odds ratio (OR) for quartile 4 vs. 1: 1.27, 95% CI: 1.00–1.61] when socio-demographic characteristics and total energy intake were adjusted for, but this was not the case with hs-cTnI or hs-cTnT. Further adjusting for clinical characteristics attenuated the association with NT-proBNP (OR: 1.26, 95% CI: 0.98, 1.61). There was no consistent association between ultra-processed food in %kcal and elevated NT-proBNP, hs-cTnT, or hs-cTnI. Conclusions: Ultra-processed food consumption is associated with subclinical myocardial stretch, a precursor to early heart failure. This supports the potential risks of subclinical cardiovascular disease associated with consuming ultra-processed food. Full article

Background/Objectives: As individuals age, they experience declines in multiple physiological domains, which increases their vulnerability to health challenges and frailty. While adherence to healthy dietary patterns has been shown to protect against frailty, consuming ultra-processed foods (UPFs)—which are high in added sugars and saturated fat—may contribute to frailty risk. This study investigates the association between UPF consumption and frailty progression among 938 participants aged 65 years and older who were in the InCHIANTI study, Italy. Methods: The patients’ dietary intakes over the past year were assessed using a validated food frequency questionnaire, with items categorized into food groups based on the Nova classification. Frailty was operationalized using a 42-item frailty index (FI). Multivariable linear regression was used to examine the association between the baseline UPF consumption frequency and baseline frailty status, while linear mixed-effects models were used to examine the frailty progression over time. Results: Overall, the participants with the lowest UPF consumption frequency were younger, had more years of education, and had a lower baseline FI. Higher UPF consumption was significantly associated with a greater baseline FI after adjustments for the sociodemographic and health characteristics (β = 0.026, 95% CI = 0.010–0.041, p = 0.001), and this difference persisted over a 16.1-year follow-up period (β = 0.022, 95% CI = 0.006–0.037, p = 0.006). Conclusions: These findings underscore the potential negative health impacts of UPF on frailty prevalence and progression in older adults. Full article

Background/Objectives: Coinciding with an increasing trend of ultra-processed food (UPF) consumption, nations are experiencing a surge of diet-related chronic diseases such as diabetes and other metabolic conditions. While many studies have found positive associations of UPF consumption with physical health outcomes, few studies have examined the effects of UPF consumption on mental health conditions. Therefore, the purpose of this systematic review is to understand the variability of associations between higher UPF consumption and depression severity across research studies with adult populations. Methods: Using PsychINFO, CINAHL Ultimate and Web of Science databases, we conducted a systematic review of recent observational studies examining the association of UPF consumption with self-reported depression in adult populations. To assess the quality of each study, Strengthening the Reporting of Observational Studies in Epidemiology—Modified (STROBE-M) checklist was used to assess risk of bias in each of the included studies. Results: Of the 530 records retrieved, 13 studies with a total of 264,519 participants met all eligibility criteria and were included in this review. All 13 studies reported a positive association between higher UPF consumption and depression severity, ranging from 1.15–2.04 (Hazard, Odds, and Relative Risk ratios). Some of the studies likely experienced selection bias due to loss of participants to follow-up. Conclusions: In adult populations, observational studies indicated a low to moderately increased risk of self-reported depression among those with diets that include higher amounts of ultra-processed foods. Full article

This descriptive ecological study evaluated the food environment of 18 public and private schools in the Federal District (DF), Brazil, by analyzing food availability within schools and in their surroundings (250 m, 400 m, and 800 m buffers). Food retail outlets (FROs) were georeferenced and classified according to the NOVA food classification. School principals were interviewed to assess the in-school food environment. Analyses considered the Social Vulnerability Index (SVI; low or medium/high) and school type. Among 911 FROs identified, 40.2% predominantly sold ultra-processed products. Most schools (83.3% within a 250 m radius) had at least one nearby FRO. Private schools—mostly in low-SVI areas—had higher densities of surrounding FROs at all buffer distances, with significance for total density at 400 m (p = 0.03) and for unhealthy outlets at 800 m (p < 0.01). Low-SVI areas had higher densities of both healthy (p = 0.01) and unhealthy (p < 0.01) outlets, with differences across multiple buffers. In canteens, sugar-sweetened beverages were the most common ultra-processed items (75%). The median ratio of ultra-processed to minimally processed food subgroups was 2.7 (0.5–6.0), and all private schools with a canteen sold at least one item prohibited by current regulations. Overall, the DF school food environment was characterized by a predominance of unhealthy foods, with disparities by school type and social vulnerability. Full article

Background: One’s dietary pattern throughout life is established during the perinatal period, especially in the intrauterine environment. This study aims to analyze whether maternal and birth characteristics are associated with food consumption in young adults using baseline data from the Nutritionists’ Health Study (NutriHS). Methods: We employed cross-sectional analysis of data from 386 undergraduate nutrition students and nutritionists. Current food consumption was evaluated as per the NOVA classification. The maternal and birth factors included maternal age, parity, type of childbirth, health problems during pregnancy, prematurity, and birth weight, and multiple correspondence analysis of these variables was performed to identify patterns in them. Results: The energy contribution of ultra-processed foods was positively associated with the pattern characterized by participants whose mothers were 19 years of age or younger, primiparous, and had a vaginal delivery (β = 0.48; 95% confidence interval = 0.02, 1.66). Conclusions: We concluded that maternal age at birth was associated with the dietary patterns of adult children. Participants whose mothers were 19 or younger at birth had significantly higher consumption of ultra-processed foods in adulthood compared to those whose mothers were older. Full article

Background/Objectives: Food insecurity (FI) is a well-defined factor in pediatric health outcomes and has been associated with lower diet quality. While poor diet quality has been linked to the rising prevalence of inflammatory bowel disease (IBD), little is known about the impact of FI on pediatric IBD. This pilot study explores the feasibility and potential impact of FI on dietary intake and clinical outcomes in children with newly diagnosed IBD. Methods: This pilot study included newly diagnosed IBD patients aged 5 to 18. FI screening was completed using the USDA 6-item and AAP 2-item screeners at diagnosis and 6 months. Dietary intake was classified according to their degree of processing (NOVA classification). Clinical data, anthropometrics, and healthcare utilization were collected over 6 months. Results: Among 20 patients, FI was identified in 40% of families. Food-insecure patients had significantly lower weight and BMI z-scores at diagnosis compared to food-secure peers (p = 0.002 and p = 0.0013, respectively). Food-insecure patients consumed more ultra-processed foods (UPFs, 70.6% vs. 66.7%, p = 0.473). However, most patients consumed diets high in ultra-processed foods. FI status was dynamic over the study period. Hospitalizations were more frequent among food-insecure patients. Conclusions: FI is common in pediatric IBD and associated with poorer nutritional status. FI was associated with higher consumption of UPFs, although diet quality was poor among most patients. Future studies should validate these findings in large cohorts and evaluate longitudinal interventions. Full article

Background: Understanding how food processing impacts type 2 diabetes (T2DM) control is essential for disease management. This study aimed to assess the association between ultra-processed food (UPF) consumption, as defined by the NOVA classification, and metabolic parameters in T2DM patients. Methods: This was a cross-sectional analysis using baseline data from the NUGLIC study, a multicenter randomized clinical trial. Multiple linear and Poisson regressions were used to evaluate associations between quintiles of processed and ultra-processed food consumption and glycated hemoglobin (HbA1c) as the primary outcome. Secondary outcomes included fasting glucose, lipid profile, body mass index (BMI), and waist circumference. Results: This study included 326 participants. UPF consumption accounted for approximately 16.4% of total daily energy intake. No significant linear associations were observed between higher consumption of industrialized foods and anthropometric or glycemic markers. However, intermediate and high consumption levels were associated with an increased total cholesterol (Q3: β = 26.6; Q4: β = 26.7) and LDL-cholesterol (Q4: β = 19.8; Q5: β = 17.5). Conclusion: In T2DM patients, a higher intake of processed and ultra-processed foods was linked to elevated cholesterol and LDL levels. These findings highlight potential cardiovascular risks but do not support causality due to the study’s cross-sectional design. Full article

Background: Ultra-Processed Foods (UPFs) make up a growing share of older adults’ diets and may contribute to frailty through pro-inflammatory pathways. The objective of this study was to examine the association of UPF intake with frailty development and with annual changes in select frailty components. Methods: This prospective cohort study used data from 2547 participants in the Framingham Offspring Cohort. UPF intake was assessed using a food frequency questionnaire and classified according to the NOVA framework, and frailty was defined by the Fried frailty phenotype. We used cumulative and mixed logistic regression models to examine the association between daily servings of UPF and odds of developing frailty, adjusting for baseline age, education, energy intake, multivitamin use, smoking, self-rated health, history of diabetes, cancer, cardiovascular disease, and diet quality. For the frailty component analysis, we used cumulative linear regression models to assess the association between UPF intake and annual changes in grip strength, gait speed, and weight, further adjusting for BMI and physical activity. We also evaluated potential effect modification by sex and baseline age (<60 vs. ≥60 years). Results: The study population was 55.1% female, with a mean age of 60.3 ± 8.9 years. Over an average follow-up of 10.8 years, 233 participants (9.2%) developed frailty. UPF intake was not associated with frailty development in either the cumulative or mixed regression models. UPF intake was not associated with annual weight change but was inversely associated with annual change in gait speed and with annual change in grip strength in men only. Conclusions: Our findings contribute preliminary evidence that, in middle-aged and older adults, increased UPF intake is not associated with frailty but may be related to worsening muscle strength and function. Further research with a more granular approach to UPF classification is required to translate these findings to practical recommendations and to clarify their clinical significance. Full article

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Background/Objectives: Higher energy density (ED; kJ/g) and higher levels of processing of foods and beverages have been associated with childhood obesity and reduced diet quality. This study described and examined the distribution of ED and levels of processing of new food and beverage products intended for Australian children (0–4 years, 5–12 years). Methods: This study used 2013–2023 data from the Mintel Global New Products Database. Products were classified by ED (low ≦ 4.184 kJ/g, medium > 4.184 kJ/g and <12.552 kJ/g, or high ≧ 12.552 kJ/g) and level of processing (using the NOVA classification system; unprocessed/minimally processed foods; processed culinary ingredients; processed foods; ultra-processed foods (UPFs)). Non-parametric statistics were used to examine ED and level of processing by age and ‘Food’ and ‘Drink’ groups. Results: Of the 1770 products analysed, 56% were classified as high-ED and 81% as UPF. Among ‘Food’ products intended for children ‘5–12 years’, 93% were classified as UPFs. The differences in ED classification between non-UPFs and UPFs were significant for ‘Food’ products intended for children aged ‘0–4 years’ (p < 0.001) but not for children aged ‘5–12 years’ (p = 0.149). Conclusions: The prevalence of high-ED and UPFs in the Australian packaged food supply demonstrates the need to tighten regulations around products intended for children. The regulation of low-ED UPFs (i.e., recognised by Australian Dietary Guidelines as ‘healthy’) may also be required. Full article

Front-of-pack labels (FOPLs) have been identified as a potential key tool to enable consumers to make healthier and more sustainable food choices. The simplification of complex nutritional, environmental, and processing data into clear and immediate formats is an essential function of FOPLs, which facilitates a more efficient connection between detailed product information and real-world purchasing decisions. This review critically evaluates the three main categories of FOPL—nutritional (e.g., Nutri-Score), environmental (e.g., Eco-Score) and processing-based (e.g., NOVA)—and examines emerging efforts to weave these dimensions into unified labelling frameworks. A bibliometric analysis of 1803 publications from Scopus, Web of Science, and Google Scholar was conducted, using VOS viewer to identify co-occurrence networks and thematic clusters. A narrative synthesis of label design methods, regulatory steps and consumer impact research followed this. Despite the considerable maturation of individual FOPLs, their combined application remains ad hoc. Establishing harmonized, multidimensional criteria is therefore essential to ensure consistent labelling that informs consumers and promotes public health and sustainability goals. Full article

Background/Objectives: Ultra-processed foods (UPFs) constitute a large proportion of the daily energy intake of Europeans, particularly among children and adolescents. High UPFs consumption is associated with poor dietary quality and adverse health outcomes. This study aimed to examine whether high UPFs consumption is associated with metabolic health in children, adolescents, and adults, using data from the I.Family study. Methods: This cross-sectional analysis (2013/2014) included 2285 participants: 147 children (6–9 years), 645 adolescents (10–19 years), and 1493 adults (≥20 years). For the children and adolescents, a metabolic syndrome (MetS) z-score was calculated, consisting of age- and sex-standardized z-scores of WC, HOMA index, HDL-C, TRG, systolic blood pressure (SBP), and diastolic blood pressure (DBP). For the adults, MetS was defined according to the criteria of the International Diabetes Federation Task Force and other societies. The participants completed at least one 24 h recall, from which their UPFs consumption was estimated using the NOVA classification. The consumption levels were divided into age- and sex-specific quintiles based on the relative energy contribution of these foods. Multivariable regression analyses were conducted to evaluate the associations between UPFs consumption and MetS or its components. Results: No statistically significant associations were found between UPFs consumption and MetS or its components in any age group. The effect sizes were negligible across the quintiles (η² = 0.0065 in children, 0.015 in adolescents, and 0.0009 in adults). While the mean MetS score showed little variation, the prevalence of MetS scores above the 90th percentile increased in the highest UPFs quintile among the children. The diet quality decreased with increasing UPFs consumption. Conclusions: UPFs consumption was not associated with MetS or its components across the age groups. However, a decline in diet quality was observed with increasing UPFs intake, highlighting the importance of public health strategies to reduce UPFs consumption and improve dietary patterns, particularly among younger populations. Full article

Background/Objectives: The nutritional importance of grain-based foods (GBFs) and whole grains (WGs) is underscored by their central position in dietary guidance worldwide. Many jurisdictions recommend consumers increase WG intake because they are associated with multiple health benefits, with evidence quality rated as moderate to high. High intakes of ultra-processed foods (UPFs), as defined by NOVA that classifies food by level of processing, are associated with numerous negative health outcomes, with evidence less convincing than for WGs. Yet, some dietary guidance recommends consumers to avoid UPFs. This creates two divergent guidelines since NOVA designates most commonly eaten grain-based foods (GBFs) as UPFs. These contradictory guidelines fail to comply with recommended principles of dietary guidance and generate questions about underlying assumptions and definitions that classify WG staples and colas together. Methods: Definitions and assumptions for systems ostensibly categorizing foods by level of processing were evaluated for validity by various methods. Special attention was paid to the ability of different classifications to differentiate between WGs, RGs staples, and indulgent GBFs. Findings from meta-analyses associating high intakes of WGs with numerous health benefits were compared with those associating high intakes of UPFs. Menus and modeling studies were assessed for ability to meet recommendations for WGs and the grain food group with customary GBFs while avoiding UPFs. Advice to “avoid UPFs” was tested against principles for effective dietary guidance. Results: Definitions and categorizations of foods by levels of processing vary markedly. Assumptions for NOVA and other systems are questionable. While meta-analyses consistently show high intakes of UPFs are associated with adverse health outcomes, high intake of WG foods, nearly all designated as UPFs, are associated with better health outcomes, although evidence quality for the latter is rated stronger. These findings add to the body of evidence suggesting flawed assumptions behind categorizing WG staples in terms of level of processing. Conclusions: NOVA deems 90% of WGs as UPFs. Adding statements to dietary guidance to “Avoid UPFs”, while asking consumers to increase WG intakes, confuses. Further, it jeopardizes efforts to increase intake of fiber and WG foods because it excludes top sources of fiber and WG-based breads, rolls, tortillas, or cold cereals in Western diets. NOVA advice to avoid UPFs challenges principles for usable dietary guidance and the construction of culturally appropriate, healthy dietary patterns containing WG staples from all levels of processing. Full article