ORCID Profile
0000-0003-4607-5094
Current Organisation
Deakin University
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Publisher: Cambridge University Press (CUP)
Date: 31-07-2017
DOI: 10.1017/S1368980017001410
Abstract: To analyse the association between food store type and the consumption of ultra-processed products in Brazil. Data from the 2008–2009 Household Budget Survey involving a probabilistic s le of 55 970 Brazilian households. Food stores were grouped into nine categories. Foods and drinks were grouped according to characteristics of food processing. The contribution of each food store type to the total energy acquired from each food processing group, and according to quintiles of consumption of ultra-processed products, was estimated. Exploratory factor analysis was conducted to identify a pattern of food store usage. Linear regression models were performed to estimate the relationship between the purchase pattern and the consumption of ultra-processed products. In line with their larger market share, supermarkets accounted for 59 % of total energy and participated most in acquisition for three food groups, with emphasis on ultra-processed products (60·4 % of energy). The participation of supermarkets in total purchase tended to increase in populations with higher consumption of ultra-processed products, while the participation of small markets and small producers tended to decrease. The purchase pattern characterized by use of traditional retail (street fairs and vendors, small markets, small farmers, butcheries) was associated with a smaller consumption of ultra-processed products. Food policies and interventions aiming to reduce the consumption of ultra-processed products should consider the influence of supermarkets on the consumption of these products. A purchase pattern based on traditional retail constitutes an important tool for promoting healthy eating in Brazil.
Publisher: Emerald
Date: 04-07-2016
Abstract: – The purpose of this paper is to analyse and compare the serving sizes and energy values reported on the nutrition information of all processed and ultra-processed dairy products in their regular and diet/light versions available for sale in a large supermarket in Brazil. – A check was done for associations between the compliance of reported serving sizes, energy values per serving and energy density for regular foods and foods advertised at “diet/light” (with reduced fat and calories). – The data included information from 451 dairy product labels. Most of the products had serving sizes smaller than the reference set by Brazilian law. A high variability of serving sizes was found for similar products. “Diet/light” foods tend to report serving sizes that are even smaller and more inadequate. Moreover, the energy density of these products was similar to that of the regular foods. Smaller serving sizes may be being presented on “diet/light” foods in order to report lower energy values and on similar foods to show non-existent differences in energy values. These results point to the importance of standardizing serving size information on food labels so that consumers have access to clear and accurate information about food products. – This was the first census-type study to analyse the serving size information of dairy products at a supermarket of one of the ten largest supermarket chains in Brazil. This work extends the scope of current food labelling and contributes to the discussion about how nutrition labelling has been presented to Brazilian consumers and its possible consequences for food choices and the guarantee of consumer rights.
Publisher: Cold Spring Harbor Laboratory
Date: 05-10-2023
Publisher: FapUNIFESP (SciELO)
Date: 2019
DOI: 10.1590/0102-311X00153918
Abstract: Resumo: O objetivo foi investigar a frequência com que os adolescentes brasileiros realizam as refeições com os pais e verificar a associação deste hábito com a qualidade da dieta. Foram utilizados dados da Pesquisa Nacional de Saúde do Escolar - 2015 (PeNSE). A amostra foi composta por adolescentes matriculados no nono ano do ensino fundamental de escolas públicas e privadas, com idades entre 11 e 19 anos. A exposição de interesse foi realizar refeições com os pais (0-4 e ≥ 5 dias/semana) e os desfechos estudados foram consumo frequente (≥ 5 dias/semana) de alimentos marcadores de alimentação saudável e não saudável. Escores de alimentação saudável (variação 0-21) e não saudável (variação 0-35) foram elaborados com base no somatório dos dias que o adolescente relatou consumir cada um dos marcadores de alimentação. Foram usados modelos de regressão de Poisson e linear, ajustados por variáveis sociodemográficas. A realização frequente de refeições com os pais (≥ 5 dias/semana) foi observada em 74% (IC95%: 73,4-74,7) dos adolescentes. Aqueles que afirmaram ter esse hábito apresentaram maior probabilidade do consumo frequente de feijão (RP = 1,22 IC95%: 1,19-1,26), frutas (RP = 1,34 IC95%: 1,28-1,39) e hortaliças (RP = 1,39 IC95%: 1,34-1,44) e menor probabilidade de consumo frequente de guloseimas (RP = 0,91 IC95%: 0,88-0,94), ultraprocessados salgados (RP = 0,91 IC95%: 0,87-0,94) e salgados fritos (RP = 0,85 IC95%: 0,80-0,90). Realizar as refeições com os pais foi positivamente associado ao escores de alimentação saudável e inversamente associado ao escores de alimentação não saudável. O hábito de realizar refeições com os pais é frequente entre adolescentes brasileiros e está associado à melhor qualidade da alimentação.
Publisher: Springer Science and Business Media LLC
Date: 05-10-2023
Publisher: Cambridge University Press (CUP)
Date: 20-06-2019
DOI: 10.1017/S1368980019001514
Abstract: To estimate the consumption of ultra-processed foods and determine its association with dietary quality among middle-aged Japanese adults. Cross-sectional study using data from the Saitama Prefecture Health and Nutrition Survey 2011. Dietary intake was assessed using one- or two-day dietary records. Sociodemographic and lifestyle factors were obtained via self-administered questionnaire. Food items were classified according to the NOVA system into four groups: unprocessed or minimally processed foods processed culinary ingredients processed foods and ultra-processed foods. The dietary share of each NOVA food group and their subgroups was calculated in relation to total energy intake, and the average dietary content of key nutrients was determined across tertiles of the dietary energy share of ultra-processed foods (low, middle and high intake). Saitama Prefecture in Japan. Community-dwelling adults aged 30–59 years (256 men, 361 women). Consumption of unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods contributed 44·9 ( se 0·8) %, 5·5 ( se 0·2) %, 11·3 ( se 0·4) % and 38·2 ( se 0·9) % of total daily energy intake, respectively. A positive and statistically significant linear trend was found between the dietary share of ultra-processed foods (tertiles) and the dietary content of total and saturated fat, while an inverse relationship was observed for protein, vitamin K, vitamin B 6 , dietary fibre, magnesium, phosphorus and iron. Our findings show that higher consumption of ultra-processed foods was associated with decreased dietary quality among Japanese adults.
Publisher: Springer Science and Business Media LLC
Date: 06-2023
Publisher: BMJ
Date: 08-2019
DOI: 10.1136/BMJOPEN-2019-029544
Abstract: This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs). Cross-sectional study. National Nutrition and Physical Activity Survey (2011-2012). 12,153 participants aged 2+ years. Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined. Ultra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p .001) total (β 0.08, p .001), saturated (β 0.18, p .001) and trans fats (β 0.10, p .001) sodium (β 0.21, p .001) and diet energy density (β 0.41, p .001), while an inverse relationship was observed for dietary fibre (β -0.21, p .001) and potassium (β -0.27, p .001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile. The high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.
Publisher: MDPI AG
Date: 30-06-2020
DOI: 10.3390/NU12071955
Abstract: The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature integration and interpretation of findings from erse study types, populations, health outcomes and dietary assessments and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks cancer, type-2 diabetes and cardiovascular diseases irritable bowel syndrome, depression and frailty conditions and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the ‘healthiness’ of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.
Publisher: Wiley
Date: 23-05-2019
DOI: 10.1111/MCN.12819
Publisher: Wiley
Date: 29-05-2018
DOI: 10.1111/PAI.12911
Abstract: Although both consumptions of ultra-processed products and asthma are common during adolescence, the epidemiological evidence in regarding their association is unclear. We investigated the associations of ultra-processed products consumption with asthma and wheezing in a representative s le of Brazilian adolescents. We used data from a representative s le of 109 104 Brazilian adolescents enrolled in the National Survey of School Health, 2012. The consumption of ultra-processed products was based on the weekly consumption (0-2, 3-4, ≥5 d/wk) of sweet biscuits, salty biscuits, ultra-processed meats, sweets/candies, soft drinks, and packaged snacks over the previous 7 days. We also calculated an ultra-processed consumption score by adding partial scores corresponding to weekly frequency intake of each ultra-processed product. The ultra-processed consumption score ranged from 0 to 42, the higher score, the higher the intake of these products. The presence of wheezing in the previous 12 months and asthma at any time in the past was self-reported. The adjusted odds ratios of asthma comparing the extreme categories ranged from 1.08 (95% CI 1.03-1.13) for sweets/candies to 1.30 (1.21-1.40) for ultra-processed meats. Similar magnitude of associations was found for wheezing outcome. The ultra-processed consumption score was positively associated with the presence of asthma and wheezing in a dose-response manner. The adjusted OR of asthma and wheezing comparing highest to lowest quintile of ultra-processed consumption score was 1.27 (95% CI 1.15-1.41) and 1.42 (1.35-1.50), respectively. The consumption of ultra-processed products was positively associated with the presence of asthma and wheezing in adolescents.
Publisher: SAGE Publications
Date: 19-10-2020
Abstract: Relevant evidence has addressed the negative impact of food processing on health. However, maternal ultra-processed food consumption is poorly investigated. To analyze food consumption according to the degree of food processing, dietary ersity, and associated socio-demographic factors during pregnancy. Cross-sectional data was taken from a birth cohort in Rio de Janeiro, Brazil, with 142 pregnant women. We assessed diet using a qualitative food frequency questionnaire and classified food items according to the NOVA classification system as non-ultra-processed-foods and ultra-processed-foods. Non-ultra-processed-food and ultra-processed-food scores were calculated, reflecting weekly intake of more than one subgroup. Dietary ersity of the non-ultra-processed-food diet fraction was described according to the Food and Agriculture Organization guidelines. The association between food consumption and socio-demographic factors were investigated using logistic regression models. Over 60% of the pregnant women reported consumption of at least three non-ultra-processed-food groups. However, only 25% had adequate dietary ersity. The level of education (Complete high school: odds ratio, 5.36 95% confidence interval, 1.73–16.65) was associated with regular intake of “meat and eggs.” Among the ultra-processed-food score, 27% of the participants described a weekly consumption of at least two ultra-processed-food subgroups. White women (odds ratio, 2.63 95% confidence interval, 1.05–6.63) had a higher chance of reporting “packaged ready meals” consumption. This study shows a high weekly consumption of ultra-processed-food subgroups and low dietary ersity of the non-ultra-processed-food fraction of the diet of pregnant women in Brazil. Our results elucidate the influence of socio-demographic characteristics on diet quality during pregnancy.
Publisher: Elsevier BV
Date: 09-2023
Publisher: FapUNIFESP (SciELO)
Date: 09-2021
DOI: 10.1590/1413-81232021269.15462020
Abstract: Resumo Foi avaliado o consumo de fibras alimentares no Brasil e sua relação com a ingestão de alimentos ultraprocessados. Foram utilizados dados de consumo alimentar, via registro alimentar de 24 horas, com in íduos de idade ≥10 anos (n=34.003) oriundos da Pesquisa de Orçamentos Familiares 2008-2009. Os alimentos foram ididos em grupos: in natura ou minimamente processados, ingredientes culinários processados, processados e ultraprocessados, estimando-se sua contribuição para o consumo de fibras. Verificou-se a relação entre quintos de consumo de ultraprocessados (avaliado pelo % do total de energia consumida) e teor médio de fibras na dieta (g/1.000kcal), e a prevalência de inadequação no consumo de fibras. Alimentos in natura ou minimamente processados apresentaram densidade de fibras significativamente maior do que os ultraprocessados e corresponderam à majoritária contribuição percentual de fibras na dieta, notavelmente a partir do arroz e feijão. In íduos do maior quintil de consumo de ultraprocessados tiveram 1,5 vez mais chance de apresentar ingestão de fibras inadequada. O consumo de ultraprocessados impactou negativamente na ingestão de fibras. Reduzir o consumo desses alimentos pode trazer benefícios à qualidade da dieta brasileira.
Publisher: FapUNIFESP (SciELO)
Date: 2021
DOI: 10.1590/0102-311X00152021
Abstract: Abstract: Evolving evidence shows that ultra-processed food consumption may increase exposure to chemicals used in food packaging and production, such as per- and poly-fluoroalkyl substances, phthalates, and bisphenols. Studies suggested that these contaminants may be transferred from mother to child through placenta, increasing concerns for both maternal and child health. This study aimed to investigate the association of maternal consumption of ultra-processed foods with newborn exposure to perfluoroalkyl substances (PFAS) in the PIPA Project (The Rio Birth Cohort Study on Environmental Exposure and Childhood Development). The pilot cohort study conducted with 131 pregnant women-child pairs in a public maternity school in Rio de Janeiro, Brazil, was assessed. Maternal dietary intake in the third trimester of pregnancy was evaluated using a qualitative food frequency questionnaire. Food items were classified as non-ultra-processed food and ultra-processed food using the NOVA system and regular consumption of ultra-processed foods was estimated. Newborns of pregnant women who weekly consumed three or more subgroups of ultra-processed food presented the highest level of PFAS (2.47ng/mL 95%CI: 1.22 3.72), compared to non-consumption of ultra-processed food investigated (0 ultra-processed food = 1.86ng/mL 95%CI: 1.38 2.50). Additionally, cluster analysis grouped ultra-processed food, fish, and PFAS levels. In conclusion, we found increased levels of PFAS in newborns whose mothers were higher consumers of ultra-processed foods.
Publisher: Maad Rayan Publishing Company
Date: 16-02-2022
Abstract: As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally. Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework. 99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs. Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 08-12-2021
DOI: 10.11606/S1518-8787.2021055003614
Abstract: OBJETIVO: Estimar a pegada de carbono da dieta brasileira e de estratos sociodemográficos dessa população. MÉTODOS: A pegada de carbono da dieta foi estimada com base nos dados de dois registros alimentares de 24 horas, obtidos em 2008 e 2009, de uma amostra probabilística da população brasileira com 10 ou mais anos de idade (n = 34.003) e em coeficientes de impacto ambiental de alimentos e preparações culinárias consumidos no Brasil (gCO2e/kg). Médias com intervalos de confiança de 95% do consumo alimentar (kcal essoa/dia) e da pegada de carbono da dieta (gCO2e essoa/dia e em gCO2e/2.000kcal) foram calculadas para o conjunto da população e para estratos segundo sexo, idade, renda, escolaridade, macrorregiões e Unidade Federativa. Modelos de regressão linear foram utilizados para identificar diferenças significativas (p 0,05) na pegada de carbono da dieta de diferentes estratos sociodemográficos. RESULTADOS: A pegada média de carbono da dieta brasileira foi de 4.489gCO2e essoa/dia. Foi maior para o sexo masculino, para a faixa etária de 20 a 49 anos e para as regiões Norte e Centro-Oeste, e tendeu a aumentar com a renda e a escolaridade. O padrão de associação da pegada a variáveis sociodemográficas não se alterou substancialmente com o ajuste para diferenças na quantidade consumida de alimentos, exceto por uma redução no excesso relativo da pegada entre homens e pelo aumento no excesso relativo da pegada na região Centro-Oeste. CONCLUSÃO: A pegada de carbono da dieta brasileira excede em cerca de 30% a pegada da dieta humana que poderia atender, simultaneamente, os requisitos nutricionais de uma dieta saudável e a meta global de contenção do aumento da temperatura média do planeta. O padrão de associação dessa pegada às variáveis sociodemográficas pode auxiliar na identificação de alvos prioritários para ações públicas que visem a reduzir os impactos ambientais do consumo alimentar no Brasil.
Publisher: Springer Science and Business Media LLC
Date: 05-12-2020
DOI: 10.1038/S41387-020-00141-0
Abstract: Rapid simultaneous increases in ultra-processed food sales and obesity prevalence have been observed worldwide, including in Australia. Consumption of ultra-processed foods by the Australian population was previously shown to be systematically associated with increased risk of intakes of nutrients outside levels recommended for the prevention of obesity. This study aims to explore the association between ultra-processed food consumption and obesity among the Australian adult population and stratifying by age group, sex and physical activity level. A cross-sectional analysis of anthropometric and dietary data from 7411 Australians aged ≥20 years from the National Nutrition and Physical Activity Survey 2011–2012 was performed. Food consumption was evaluated through 24-h recall. The NOVA system was used to identify ultra-processed foods, i.e. industrial formulations manufactured from substances derived from foods and typically added of flavours, colours and other cosmetic additives, such as soft drinks, confectionery, sweet or savoury packaged snacks, microwaveable frozen meals and fast food dishes. Measured weight, height and waist circumference (WC) data were used to calculate the body mass index (BMI) and diagnosis of obesity and abdominal obesity. Regression models were used to evaluate the association of dietary share of ultra-processed foods (quintiles) and obesity indicators, adjusting for socio-demographic variables, physical activity and smoking. Significant ( P -trend ≤ 0.001) direct dose–response associations between the dietary share of ultra-processed foods and indicators of obesity were found after adjustment. In the multivariable regression analysis, those in the highest quintile of ultra-processed food consumption had significantly higher BMI (0.97 kg/m 2 95% CI 0.42, 1.51) and WC (1.92 cm 95% CI 0.57, 3.27) and higher odds of having obesity (OR = 1.61 95% CI 1.27, 2.04) and abdominal obesity (OR = 1.38 95% CI 1.10, 1.72) compared with those in the lowest quintile of consumption. Subgroup analyses showed that the trend towards positive associations for all obesity indicators remained in all age groups, sex and physical activity level. The findings add to the growing evidence that ultra-processed food consumption is associated with obesity and support the potential role of ultra-processed foods in contributing to obesity in Australia.
Publisher: Wiley
Date: 03-11-2021
DOI: 10.1111/MCN.13097
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 18-11-2022
DOI: 10.11606/S1518-8787.2022056004830
Abstract: OBJETIVO: Estimar o consumo de carne bovina e a sua influência nas pegadas de carbono e na pegada hídrica, bem como mesurar a qualidade nutricional da dieta no Brasil. MÉTODOS: A quantidade consumida de carne bovina e dos demais alimentos foi avaliada por dois registros alimentares de 24 horas em amostra representativa da população brasileira ≥ 10 anos de idade (n = 32.853) entre 2008 e 2009. O impacto ambiental da dieta considerou os coeficientes da pegada de carbono (gCO2e/kg) e da pegada hídrica (litros/kg) dos alimentos, bem como sua qualidade nutricional considerando a composição de cada alimento em nutrientes associados à prevenção de deficiências nutricionais ou ao aumento/diminuição do risco de doenças crônicas. Modelos de regressão linear e logística, brutos e ajustados para sexo, idade, escolaridade, renda, região e área, foram utilizados para estudar, respectivamente, a associação de quintos da contribuição calórica de carne bovina com os impactos ambientais da dieta e com a ingestão inadequada de nutrientes. RESULTADOS: As pegadas de carbono e hídrica e os teores de proteína, ferro, zinco, vitamina B12, gordura saturada e sódio foram maiores na fração da dieta composta por carnes bovinas, enquanto o teor de fibra e de açúcar de adição foram maiores na fração composta pelos demais alimentos. A contribuição dietética de carne bovina mostrou-se associada diretamente com as pegadas de carbono e hídrica da dieta e com o risco de ingestão excessiva de gordura saturada e de sódio, além de ingestão insuficiente de fibra, associando-se inversamente com o risco de ingestão insuficiente de proteína, ferro, zinco e vitamina B12. CONCLUSÃO: A redução no consumo de carne bovina no Brasil diminuiria as pegadas de carbono e hídrica da dieta, assim como o risco de doenças crônicas relacionadas à alimentação. Portanto, para não aumentar o risco de deficiências nutricionais, é sugerido o acompanhamento do aumento da ingestão de outros alimentos fontes de proteína, ferro, zinco e vitamina B12.
Publisher: Springer Science and Business Media LLC
Date: 11-2019
DOI: 10.1007/S00394-019-02125-Y
Abstract: To analyze the contribution of ultra-processed foods to the intake of free sugars among different age groups in Australia. Dietary intakes of 12,153 participants from the National Nutrition and Physical Activity Survey (2011-12) aged 2+ years were evaluated. Food items collected through two 24-h recalls were classified according to the NOVA system. The contribution of each NOVA food group and their subgroups to total energy intake was determined by age group. Mean free sugar content in diet fractions made up exclusively of ultra-processed foods, or of processed foods, or of a combination of un/minimally processed foods and culinary ingredients (which includes table sugar and honey) were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of free sugars, as well as in the prevalence of excessive free sugar intake (≥ 10% of total energy) were examined. Ultra-processed foods had the highest energy contribution among children, adolescents and adults in Australia, with older children and adolescents the highest consumers (53.1% and 54.3% of total energy, respectively). The diet fraction restricted to ultra-processed items contained significantly more free sugars than the two other diet fractions. Among all age groups, a positive and statistically significant linear association was found between quintiles of ultra-processed food consumption and both the average intake of free sugars and the prevalence of excessive free sugar intake. Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia.
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 18-02-2022
DOI: 10.11606/S1518-8787.2022056004551
Abstract: OBJECTIVE: To study the association between ultra-processed food consumption and carbon and water footprints of the Brazilian diet. METHODS: Cross-sectional analysis on data collected in 2008-9 on a probabilistic s le of the Brazilian population aged ≥ 10 years (n = 32,886). In idual food intake was assessed using two food records. The environmental impact of in idual diets was calculated by multiplying the amount of each food by coefficients that quantify the atmospheric emissions of greenhouse gases in grams of carbon dioxide equivalent (carbon footprint) and freshwater use in liters (water footprint), both per gram or milliliter of food. The two coefficients consider the food life cycle ‘from farm to fork.’ Crude and adjusted linear regression models and tests for linear trends assessed the association between the ultra-processed food contribution to total energy intake (quintiles) and the diet carbon and water footprints. Potential confounders included age, sex, education, income, and region. Total energy intake was assessed as a potential mediation variable. RESULTS: In the crude models, the dietary contribution of ultra-processed foods was linearly associated with the carbon and water footprints of the Brazilian diet. After adjustment for potential confounders, the association remained significant only regarding the diet water footprint, which increased by 10.1% between the lowest and highest quintile of the contribution of ultra-processed foods. Additional adjustment for total energy intake eliminated this association indicating that the dietary contribution of ultra-processed foods increases the diet water footprint by increasing energy intake. CONCLUSIONS: The negative impact of ultra-processed foods on the diet water footprint, shown for the first time in this study, adds to the negative impacts of these foods, already demonstrated regarding dietary nutrient profiles and the risk for several chronic non-communicable diseases. This reinforces the recommendation to avoid ultra-processed foods made in the official Brazilian Dietary Guidelines and increasingly in dietary guidelines of other countries.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.APPET.2017.05.027
Abstract: To evaluate the influence of convenience and price of ultra-processed foods and beverages on purchases at supermarkets. The study used data on food and beverage acquisition for household consumption from the Brazilian Household Budget Survey, performed in a random s le of 55,970 households between 2008 and 2009. Foods and beverages were categorized into four groups, according to characteristics of food processing. Retail stores were grouped into supermarkets and other food stores. Proportion of calories from foods and beverages purchased at supermarkets and other food stores, and respective mean prices (R$/1000 kcal), were calculated according to households' geographical and socioeconomic characteristics. Effect of convenience in household purchases at retail stores was expressed by the acquisition of several food items at the same store. The influence of convenience and prices of ultra-processed products on purchases at supermarkets was analyzed using log-log regression model with estimation of elasticity coefficients. The mean prices of foods and beverages purchased at supermarkets were 37% lower in comparison to other food stores. The share of ultra-processed foods and beverages in purchases made at supermarkets was 25% higher than at other food stores. An increase of 1% in prices of ultra-processed food items led to a 0.59% reduction in calorie acquisition at supermarkets (R Convenience and lower relative prices of food items purchased at supermarkets, in comparison to other food stores, are relevant to explain higher share of purchases of ultra-processed foods and beverages at supermarkets.
Publisher: FapUNIFESP (SciELO)
Date: 06-2016
DOI: 10.1590/S0104-12902016151741
Abstract: Resumo A caracterização do alimento enquanto mercadoria surge por meio de um sistema alimentar cada vez mais concentrado e determinado por poucas empresas transnacionais, sendo essa uma das consequências da crise estrutural do capitalismo. Entender como a alimentação está dominada pela lógica privada do capital e como o alimento virou mercadoria é uma das chaves para explicar o atual cenário produtor de doenças e de desigualdades econômicas e sociais. A metodologia utilizada neste artigo partiu da perspectiva teórica marxista determinada pela concepção crítica-dialética e de outras abordagens heterodoxas sobre a fase atual do capitalismo. Propõe-se uma discussão sobre o contexto recente do sistema alimentar global e o processo de massificação do alimento em mercadoria, sobre os traços gerais da dinâmica do capitalismo contemporâneo e sua crise com impactos sobre o sistema alimentar e sobre como esse novo contexto constrange o Estado brasileiro na garantia da Segurança Alimentar e Nutricional e no Direito Humano à Alimentação Adequada, impondo desafios importantes no c o da saúde pública e na garantia de direitos humanos.
Publisher: Springer Science and Business Media LLC
Date: 16-01-2022
DOI: 10.1007/S00394-021-02740-8
Abstract: To investigate intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. Dietary intakes of 12,153 participants from the Australian Health Survey (2011-12) aged 2 + years were evaluated. Food items reported during a 24 h recall were classified using the NOVA system. The Pan-American Health Organization Nutrient Profile Model (PAHO NPM) was applied to identify processed and ultra-processed products with excessive content of critical nutrients. Differences in mean intakes and prevalence of excessive intakes of critical nutrients for groups of the population whose diets were made up of products with and without excessive content in critical nutrients were examined. The majority of Australians consumed daily at least three processed and ultra-processed products identified as excessive in critical nutrients according to the PAHO NPM. In iduals consuming these products had higher intakes of free sugars (β = 8.9), total fats (β = 11.0), saturated fats (β = 4.6), trans fats (β = 0.2), and sodium (β = 1788 for adolescents and adults β = 1769 for children 5-10 years β = 1319 for children aged < 5 years) (p ≤ 0.001 for all nutrients) than in iduals not consuming these foods. The prevalence of excessive intake of all critical nutrients also followed the same trend. The PAHO NPM has shown to be a relevant tool to predict intake levels of nutrients linked to non-communicable diseases in Australia and, therefore, could be used to inform policy actions aimed at increasing the healthiness of food environments.
Publisher: Cambridge University Press (CUP)
Date: 2021
DOI: 10.1017/JNS.2021.30
Abstract: Cross-sectional nutritional survey data collected in eight countries were used to estimate saturated fatty acid intakes. Our objective was to estimate the proportion of excessive saturated fatty acid intakes ( % of total energy intake) that could be avoided if ultra-processed food consumption was reduced to levels observed in the first quintile of each country. Secondary analysis was performed of 24 h dietary recall or food diary/record data collected by the most recently available nationally representative cross-sectional surveys carried out in Brazil (2008–9), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011–12), the UK (2008–16), Canada (2015) and the US (2015–16). Population attributable fractions estimated the impact of reducing ultra-processed food consumption on excessive saturated fatty acid intakes (above 10 % of total energy intake) in each country. Significant relative reductions in the percentage of excessive saturated fatty acid intakes would be observed in all countries if ultra-processed food consumption was reduced to levels observed in the first quintile's consumption. The reductions in excessive intakes ranged from 10⋅0 % (95 % CI 6⋅2–13⋅6 %) in Canada to 35⋅0 % (95 % CI 28⋅7–48⋅0 %) in Mexico. In all eight studied countries, all presenting more than 30 % of intakes with excessive saturated fatty acids, lowering the dietary contribution of ultra-processed foods to attainable, context-specific levels was shown to be a potentially effective way to reduce the percentage of intakes with excessive saturated fatty acids, which may play an important role in the prevention of non-communicable diseases, particularly cardiovascular diseases.
Publisher: MDPI AG
Date: 15-08-2023
DOI: 10.20944/PREPRINTS202308.1110.V1
Abstract: Background: In this secondary analysis of the Supporting the Modification of Lifestyle In Lowered Emotional States (SMILES) randomised controlled trial, we investigated if the beneficial effects of a dietary intervention on clinical depression were driven, in part, by reducing the consumption of foods classified as ultra-processed.Methods: The SMILES trial enrolled 67 adults with major depressive disorder, randomly assigning them to either a 12-week modified Mediterranean dietary intervention or a social support control. Our analysis included 44 participants with non-missing dietary data and at least one valid Montgomery& ndash & Aring sberg Depression Rating Scale (MADRS) assessment at 12 weeks of follow-up. The Nova food classification system was used to estimate the proportion of ultra-processed foods in the overall diet (percentage of grams) based on data from seven-day food diaries. We fitted linear regression models under blinded conditions to determine whether ultra-processed food intake-change from baseline to 12 weeks moderated the dietary intervention effects on depressive symptoms. We estimated mean differences in depressive symptoms along with ninety-five per cent confidence intervals (95%CIs).Results: For participants in the dietary intervention, there was an additional 2.5-point improvement in MADRS scores for each 10% reduction in the dietary share of ultra-processed foods compared to participants in the control group (between-group mean differences in depressive symptoms: & minus .46, 95%CIs & minus .71 to & minus .20, p=0.039, & eta p 2 of 0.10).Conclusions: These preliminary findings suggest that the therapeutic benefit of a dietary intervention for depression may stem, at least in part, from reductions in the dietary share of ultra-processed foods.
Publisher: Wiley
Date: 06-08-2020
DOI: 10.1111/OBR.13126
Publisher: Emerald
Date: 02-02-2015
Abstract: – The purpose of this paper is to relate average serving size intake by the Brazilian population and declared serving size, the presence of trans fat and household measure fractioning declared on labels of processed, and ultra-processed food products. – Cross-sectional study that analyzed the food labelling of all processed and ultra-processed food products sold in a supermarket in southern Brazil. – A total of 1,071 processed and ultra-processed food products were analyzed. In 88 per cent of food groups, the average serving size consumed was larger than what was declared on labels. Consumed serving size was up to 9.2 times larger than the declared ones in food products with trans fat among their ingredients list and in false negatives and up to 9.9 times larger in foods with fractioned household measure ( p .001). The Brazilian population consumes, on average, larger serving sizes than those declared on labels, which may represent a significant intake of trans fats without the consumers’ noticing. – This study has been performed with the use of a national database on food consumption, as well as the information from a large number of processed and ultra-processed food labels marketed in Brazil. This study is also proven to be important and novel, contributing with information as to the manner in which nutrition labelling has been presented to Brazilian consumers, discussing its possible consequences for food choices, intake, and the guarantee of consumer rights.
Publisher: MDPI AG
Date: 17-10-2022
DOI: 10.3390/NU14204340
Abstract: Dietary guidelines should be underpinned by high-quality evidence. Quality assessment methods that reflect traditional evidence hierarchies prioritise evidence from randomised controlled trials (RCTs). The Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM) approach is an alternative quality assessment method for research questions that for practical and/or ethical reasons, cannot be answered using RCTs. The aim of this study was to investigate how the HEALM approach could be used to assess the strength of evidence on associations between dietary patterns and all-cause mortality (a research question that is difficult to answer using RCTs). Two data sources were used: an existing systematic review of dietary patterns and all-cause mortality that synthesised evidence from observational studies and an overview of reviews that was conducted to summarise relevant evidence from mechanistic and intervention studies. A set of four criteria were developed and used in the application of HEALM. Using different datasets in combination, the strength of evidence was rated as ‘Grade B: moderate/suggestive’ or ‘Grade C: insufficient/inconclusive’. HEALM is a novel approach for integrating and assessing the strength of evidence from mechanistic, intervention, and observational studies. Further research is needed to address the practical challenges that were identified in the application of HEALM.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.APPET.2019.104452
Abstract: Ultra-processed foods are industrial formulations requiring little if any preparation before consumption. Their consumption is increasing in many countries and one of the possible determinants is the decrease in home cooking. As parents are key for family meals, we analysed the influence of parents' cooking skills confidence on children's consumption of ultra-processed foods at dinner. This is a cross-sectional study with 657 child-parent pairs from nine private schools in São Paulo, Brazil. Food consumption data were collected using two children's dinner dietary recalls while the Cooking Skills Index was used to collect parents' cooking skills, measuring their confidence in their own skills related to cooking 'from scratch', according to the Dietary Guidelines for the Brazilian Population. Food items were classified according to the NOVA classification system, considering the nature, extension and purpose of food processing. We used linear regression models to test associations between parents' cooking skills confidence and the contribution of ultra-processed foods to total energy intake at dinner, adjusting for socio-demographic variables. Parents' mean age was 38.3 and children's mean age was 7.8. These parents were mostly women, white, married, employed, with full secondary education and per capita household incomes up to ~ USD 320.00/month. They reached an average of 78.8 points (SD 14.8) in the Cooking Skills Index. Children's mean energy intake at dinner was 672.2 kcal (31.3% from ultra-processed foods). The increase in parents' cooking skills confidence was directly associated with decrease in consumption of ultra-processed foods (β = -0.17 p = 0.007), which remained after adjustment (β = -0.15 p = 0.026). These findings suggest that parents' cooking skills confidence potentially protect their children against ultra-processed foods, indicating the need for revaluing cooking to promote healthy eating.
Publisher: Elsevier BV
Date: 2022
Publisher: Cambridge University Press (CUP)
Date: 13-09-2021
DOI: 10.1017/S1368980021003967
Abstract: To examine how socio-demographic characteristics and diet quality vary with consumption of ultra-processed foods (UPF) in a cross-sectional nationally representative survey of Australian adults. Using a 24-h 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 UPF. Australian Health Survey 2011–2013. Australian adults aged ≥ 19 years ( n 8209). Consumption of UPF was higher among younger adults (aged 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 UPF 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. This research adds to the evidence on dietary inequalities across Australia and how UPF are detrimental to diet quality. The findings can be used to inform interventions to reduce UPF consumption and improve diet quality.
Publisher: MDPI AG
Date: 12-08-2022
DOI: 10.3390/NU14163309
Abstract: Background: Few studies have examined associations between ultra-processed food intake and biomarkers of inflammation, and inconsistent results have been reported in the small number of studies that do exist. As such, further investigation is required. Methods: Cross-sectional baseline data from the Melbourne Collaborative Cohort Study (MCCS) were analysed (n = 2018). We applied the NOVA food classification system to data from a food frequency questionnaire (FFQ) to determine ultra-processed food intake (g/day). The outcome was high-sensitivity C-reactive protein concentration (hsCRP mg/L). We fitted unadjusted and adjusted linear regression analyses, with sociodemographic characteristics and lifestyle- and health-related behaviours as covariates. Supplementary analyses further adjusted for body mass index (kg/m2). Sex was assessed as a possible effect modifier. Ultra-processed food intake was modelled as 100 g increments and the magnitude of associations expressed as estimated relative change in hsCRP concentration with accompanying 95% confidence intervals (95%CIs). Results: After adjustment, every 100 g increase in ultra-processed food intake was associated with a 4.0% increase in hsCRP concentration (95%CIs: 2.1–5.9%, p 0.001). Supplementary analyses showed that part of this association was independent of body mass index (estimated relative change in hsCRP: 2.5% 95%CIs: 0.8–4.3%, p = 0.004). No interaction was observed between sex and ultra-processed food intake. Conclusion: Higher ultra-processed food intake was cross-sectionally associated with elevated hsCRP, which appeared to occur independent of body mass index. Future prospective and intervention studies are necessary to confirm directionality and whether the observed association is causal.
Start Date: 2015
End Date: 2017
Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo
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Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo
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End Date: 2019
Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo
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Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo
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Funder: Conselho Nacional de Desenvolvimento Científico e Tecnológico
View Funded ActivityStart Date: 2016
End Date: 2019
Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo
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