Search Results (184)

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: The consumption of ultra-processed foods (UPFs) represents an important public health challenge, especially among education workers, whose intense routine can negatively impact eating habits. This study aimed to analyze the factors associated with the regular consumption of UPF among employees of the Federal Network of Professional, Scientific and Technological Education (RFEPCT) in Brazil. Methods: This was a cross-sectional study, with a quantitative approach, carried out with 1563 education workers. Validated instruments on eating habits (PeNSE), mental health (DASS-21) and quality of life (WHOQOL-bref) were used. The regular consumption of UPF was defined as intake on ≥5 days in the last seven days. The association between the regular consumption of UPF and sociodemographic, occupational, behavioral, mental health and quality of life variables was assessed by Poisson regression with robust variance, generating adjusted prevalence ratios (PRadj) and respective 95% confidence intervals. Results: The regular consumption of UPF was associated mainly with female gender, a lower age group, Southeast and Midwest regions, dissatisfaction with sleep and the body, physical inactivity and poor sleep quality. In addition, the findings suggested a significant relationship between the worst stress scores and soft drinks (PRadj: 2.11; CI: 1.43–3.13), anxiety and soft drinks (PRadj: 1.83; CI: 1.24–2.70) and depression and industrialized/ultra-processed salty foods (PRadj: 2.43; CI: 1.82–3.26). The same was observed in the scores for the worst perception of quality of life, where there was a prevalence of up to 2.32 in the psychological domain and the consumption of industrialized/ultra-processed salty foods. Conclusions: The findings indicate that multiple interrelated factors—individual, psychosocial and occupational—are associated with the consumption of UPF among education workers. These results reinforce the importance of institutional policies that integrate actions to promote dietary health, mental health care and improved working conditions in the education sector. Full article

Background: Western dietary patterns worldwide are increasingly dominated by energy-dense, nutrient-deficient industrial foods, often identified as ultra-processed foods (UPFs). Such products may have detrimental health implications, particularly if nutritionally inadequate. This study aimed to examine the intake of unhealthy UPFs among children and adolescents from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) involved in the DELICIOUS project and to assess the association with dietary quality indicators. Methods: A survey was conducted with a sample of 2011 parents of children and adolescents aged 6 to 17 years to evaluate their dietary habits. Diet quality was assessed using the Youth Healthy Eating Index (Y-HEI), the KIDMED index to determine adherence to the Mediterranean diet, and compliance with national dietary guidelines. Results: Increased UPF consumption was not inherently associated with healthy or unhealthy specific food groups, although children and adolescents who consumed UPF daily were less likely to exhibit high overall diet quality and adherence to the Mediterranean diet. In all five countries, greater UPF intake was associated with poorer compliance with dietary recommendations concerning fats, sweets, meat, and legumes. Conclusions: Increased UPF consumption among Mediterranean children and adolescents is associated with an unhealthy dietary pattern, possibly marked by a high intake of fats, sweets, and meat, and a low consumption of legumes. Full article

Background/Objectives: Recent studies linked a diet rich in ultra-processed foods (UPFs) with depression and diabetes. Although common risk factors, such as aging, are defined for both diseases, how UPFs are associated with the bidirectional relationship between them is not known. This study aimed to investigate whether UPF intake modifies the association between depression and diabetes within the Brazilian adult population. Methods: This cross-sectional analysis utilized data from the 2019 Brazilian National Health Survey, involving over 87,000 adults (aged 18–92 years). Participants provided self-reported data on diabetes and depression diagnoses, dietary habits (assessed by qualitative FFQ), as well as demographic, and socioeconomic variables. Multivariate logistic regression models were used to evaluate the associations, employing two classification methods—UPF1 and UPF2—based on different thresholds of weekly consumption, for high/low UPF intake. Analyses were stratified by age groups to identify variations in associations. Results: There was a significant association between depression and diabetes, especially among participants with high UPF consumption. Models adjusted by demographic characteristics, as well as meat and vegetable consumptions, demonstrated elevated odds ratios (ORs) for diabetes among individuals with depression consuming high levels of UPF, compared to those with a low UPF intake (OR: 1.258; 95% CI: 1.064–1.489 for UPF1 and OR: 1.251; 95% CI: 1.059–1.478 for UPF2). Stratified analysis by age further amplified these findings, with younger individuals showing notably stronger associations (non-old adult group OR: 1.596; 95% CI: 1.127–2.260 for UPF1, and OR: 6.726; 95% CI: 2.625–17.233 for UPF2). Conclusions: These findings suggest that high UPF intake may influence the relationship between depression and diabetes, especially in younger adults. Future longitudinal studies are warranted to establish causality, investigate underlying biological mechanisms, and examine whether improving overall nutrient intake through dietary interventions can reduce the co-occurrence of depression and diabetes. 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

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: A faster eating rate is associated with increased energy intake and risk of obesity. High consumption of ultra-processed foods (UPFs) is associated with a faster eating rate. Psychobehavioral aspects, such as body image self-perception, eating disorders, and anxiety, may modulate this eating behavior. Therefore, this study examined the moderating role of psychobehavioral factors in the association between meal type (UPF vs non-UPF) and eating rate among individuals with obesity. Methods: It is a secondary analysis of a randomized, parallel clinical trial conducted with 39 adults who have obesity. Participants were assigned to consume either a UPF-only composed meal or a UPF-free meal, both of which were isoenergetic (~550 kcal). Psychobehavioral variables (food addiction—mYFAS 2.0, body image perception and satisfaction—Silhouette Rating Scale, eating disorders—EAT-26, and anxiety—GAD-7) were assessed. Eating rate was measured in kcal/min. Results: Body image perception and satisfaction significantly interacted with the type of meal. In the UPF group, lower body image dissatisfaction was associated with a higher eating rate (β = 4.79 kcal/min; 95% CI: 1.40; 8.19; p = 0.007), while a higher body image perception score was associated with a lower eating rate (β = −4.61 kcal/min; 95% CI: −8.57; −0.65; p = 0.024). No significant associations were observed for food addiction scores, eating disorders or anxiety. Conclusions: Body image modulates the eating rate in the context of UPF consumption. These findings suggest that interventions against obesity should consider individual psychobehavioral characteristics. 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

The global increase in early-onset cancers among adolescents and young adults has happened at the same time as the rise in the consumption of ultra-processed foods (UPFs). Far beyond their poor nutritional quality, UPFs are increasingly seen as Trojan horses, complex biological agents that interfere with many functions of the human organism. In this review, we utilise the Trojan horse model to explain the quiet and building health risks from UPFs as foods that seem harmless, convenient, and affordable while secretly delivering endocrine-disrupting chemicals (EDCs), causing chronic low-grade inflammation, altering the microbiome, and producing epigenetic alterations. We bring together new proof showing that UPFs mess up hormonal signals, harm the body’s ability to fight off harmful germs, lead to an imbalance of microbes, and cause detrimental changes linked to cancer. Important components, such as bisphenols and phthalates, can migrate from containers into food, while additional ingredients and effects from cooking disrupt the normal balance of cells. These exposures are especially harmful during vulnerable developmental periods and may lay the groundwork for disease many years later. The Trojan horse model illustrates the hidden nature of UPF-related damage, not through a sudden toxin but via chronic dysregulation of metabolic, hormonal, and genetic control. This model changes focus from usual diet worries to a bigger-picture view of UPFs as causes of life-disrupting damage. Ultimately, this review aims to identify gaps in current knowledge and epidemiological approaches and highlight the need for multi-omics, long-term studies and personalised nutrition plans to assess and reduce the cancer risk associated with UPFs. Recognising UPFs as a silent disruptor is crucial in shaping public health policies and cancer prevention programs targeting younger people. Full article

Background: Ultra-processed food (UPF) intake, particularly that of industrial breads rich in food additives (FAs) like emulsifiers, has been linked to higher risk of inflammatory bowel diseases (IBD). Here, we screened the ingredients and FAs used in the bread industry and reviewed their potential biological effects. Methods: We consecutively screened breads available at supermarket and health food store chains in Israel. Bread products were analyzed by dietitians and categorized into three categories based on their composition: low processed (traditional ingredients), medium processed (additives like malt and fibers), and highly processed (FAs like emulsifiers and preservatives). We conducted a literature review to explore the links between the identified FAs, microbial composition and intestinal inflammation. Results: Of the 233 breads screened, 195 (84%) were highly processed, 9 (4%) medium-processed and 29 (12%) low-processed. We identified 37 different FAs and ingredients used. Most breads contained preservatives—189 (81%), and emulsifiers—178 (76%). Calcium propionate (E-282) was the most prevalent preservative present in 112 (48%) breads, while sodium-stearoyl-2-lactylate (SSL-E-481) was the most prevalent emulsifier present in 86 (37%) breads. The literature review revealed that 19 (51%) FAs used in the bread industry were associated with the exacerbation of inflammation or gut microbiome dysbiosis by increasing cytokine production and adversely affecting microbial composition. Conclusions: Most of the available breads in Israel are highly processed, containing FAs that may mediate intestinal inflammation. Low-processed breads are available and may be more recommended to patients with IBD. Further understanding of the role of FAs in IBD etiology may guide dietary recommendations. Full article

Ultra-processed foods (UPFs) are foods that have undergone extensive industrial processing, with the addition of emulsifiers and sweeteners together with various chemicals originating during preparation and the packaging procedures. UPFs are intended to be more palpable, long lasting, and easier to find and consume. However, their widespread use has been linked to various disorders, including insulin resistance, type 2 diabetes (T2D), obesity, and lately metabolic dysfunction-associated steatotic liver disease (MASLD). Given that MASLD is primarily driven by excessive fat accumulation in the liver and considering the high energy density and poor nutritional quality of UPFs, a plausible link has emerged between elevated UPF intake and increased MASLD risk. The aim of this review is to synthesize current data regarding the pathophysiological mechanisms underlying MASLD, the role of UPF overconsumption in its development, and potential strategies to prevent disease progression towards metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, and cirrhosis. Special focus is placed on the contribution of UPFs to these processes, highlighting the importance of minimizing their consumption as supported by contemporary research. Full article

Background/Objectives: Male infertility is multifactorial, involving genetic, environmental, lifestyle, and medical factors. Recent research has underscored the influence of lifestyle choices, such as dietary habits, smoking, alcohol abuse, and metabolic disturbances, on sperm quality. In this context, nutrition plays a pivotal role: adherence to a healthy diet like the Mediterranean Diet (MD), which emphasizes seasonal, fresh, and whole foods, has been linked to improved sperm performance. Conversely, a high intake of ultra-processed foods (UPFs), characterized by additives, high levels of sugars, fats, and salt, and a nutrient-poor profile, may impair sperm quality. Methods: Based on data supporting the reproductive health benefits of the MD, this observational cross-sectional study aimed at evaluating the possible relationship between MD adherence, assessed using the 14-point a priori Mediterranean Diet Adherence Screener (MEDAS) and intake of ultra-processed foods (UPFs), based on the NOVA classification, and sperm quality in 358 individuals (mean age 34.6 ± 9.3 years) who spontaneously referred to our center of reproductive medicine. Semen analyses were performed according to the WHO 2021 criteria. Hormonal profiles (FSH, LH, testosterone, SHBG, bioavailable testosterone, and calculated free testosterone) were also determined. Results: MD adherence score was significantly and positively correlated with semen parameters, whilst negatively correlated with FSH and LH levels. In contrast, UPF intake was correlated with poor semen parameters, whilst no association was observed with hormonal levels. Multivariate analyses confirmed these associations and showed the independency from age and BMI. Notably, among men with FSH levels < 8 IU/mL, higher quartiles of UPF intake had lower markers of sperm quality, particularly for viability and typical morphology. Differently, high MD adherence scores were associated with high quality sperm parameters even when FSH levels were >8 IU/mL. Conclusions: This study provides evidence that the adherence to MD, and conversely reduced intake of ultra-processed foods, is associates with a better semen profile. These findings suggest the possible role of dietary interventions as a modifiable factor in the management of male infertility. Full article

Ultraprocessed foods (UPFs), now dominant in global diets, pose health risks that go beyond poor nutrition due to the synergistic effects of compounds in their ultracomplex industrial formulations. This narrative review aims to provide researchers and health professionals in the field of cancer with updated and critical information, as they are often unaware of the complex and evolving evidence linking UPFs to carcinogenesis. The review discusses potential mechanisms through which UPFs may contribute to cancer development, including harmful additives, neo-formed contaminants, and packaging-derived substances, as well as the displacement of protective nutrients found in whole foods. Despite limitations in establishing direct causality, epidemiological studies consistently associate high UPF intake with increased incidence of various cancers, notably colorectal, breast, and pancreatic cancers. These findings reflect a broader paradigm shift in nutritional epidemiology, recognizing that food processing is an essential dimension of diet-related health risks. To mitigate the impact of UPFs, the review emphasizes the need for preventive strategies that integrate clear dietary guidelines, regulatory measures on food labeling and additives, and public education campaigns. Successful international experiences in regulating marketing and improving transparency serve as important references. Moreover, eliminating corporate influence and conflicts of interest is crucial to ensure that public health, rather than industry agendas, guides nutrition policy. As scientific research advances to clarify the mechanisms of action and synergistic effects of harmful compounds in UPFs, coordinated efforts are needed to reduce their consumption and ultimately alleviate the global cancer burden. Full article

Background/Objectives: Adolescents in Latin America are experiencing rising rates of overweight/obesity and non-communicable diseases, while public health nutrition efforts targeting this group remain limited. This study explores adherence to the EAT-Lancet diet and its relationship with micronutrient adequacy and ultra-processed food (UPF) consumption. Methods: Cross-sectional data from national nutrition surveys of 19,601 adolescents across six Latin American countries were analyzed. Data on sociodemographics, anthropometrics, and dietary habits were collected using standardized questionnaires and 24 h dietary recalls or food records. Nutrient intake was estimated via statistical modeling, and nutrient adequacy ratios were based on age- and sex-specific requirements. UPF intake was classified using the NOVA system, and adherence to the EAT-Lancet diet was assessed with the Planetary Health Diet Index. Results: Overall adherence to the EAT-Lancet diet was low (mean score: 28.3%). Rural adolescents had higher adherence than urban adolescents, and those aged 10–13 and 17–19 showed better adherence compared to adolescents aged 14–16. Adolescents from lower socioeconomic backgrounds adhered more than those from higher socioeconomic backgrounds. Adherence varied from 20.2% in Argentina to 30.2% in Brazil and Chile. Higher adherence was associated with lower UPF intake. Among urban adolescents, greater adherence was linked to a higher risk of inadequate riboflavin, niacin, and cobalamin intake, a trend not observed in rural adolescents. Conclusions: Adherence to the EAT-Lancet diet is low among Latin American adolescents, particularly in urban areas. Public health efforts should prioritize reducing UPF consumption, improving access to nutrient-dense, culturally appropriate foods, and supporting fortified staple foods. Full article