Ultra-processed food consumption and eating disorder symptoms: Cross-sectional associations among Brazilian adults.

ObjectiveThis study aimed to assess the association between ultraprocessed foods (UPF) consumption, eating disorders (EDs), food addiction and body image concerns.DesignSystematic review following Preferred Reporting Items for Systematic Reviews and...

Background and aimsData regarding the association between ultra-processed food (UPF) consumption and eating disorders (ED) are scarce. Our aim was to investigate whether UPF intake was associated with different ED types in a large population-based study.Methods43,993 participants (mean age = 51.0 years; 76.1% women) of the French NutriNet-Santé web-cohort who were screened for ED in 2014 via the Sick-Control-One stone-Fat-Food (SCOFF) questionnaire, were included in the analysis. The clinical algorithm ExpaliTM tool was used to identify four ED types: restrictive, bulimic, binge eating, and other (not otherwise specified). Mean dietary intake was evaluated from at least 2 self-administered 24-h dietary records (2013–2015); categorization of food as ultra-processed or not relied on the NOVA classification. The associations between UPF intake (as percent and reflecting mean daily UPF quantity (g/d) within the dietary intake, %UPF) and ED types were evaluated using polytomous logistic regression models.Results5,967 participants (13.6%) were categorized as likely ED (restrictive n = 444; bulimic n = 1,575; binge eating n = 3,124; other ED n = 824). The fully-adjusted analyses revealed a positive association between UPF intake and bulimic, binge eating, and other ED: ED risk (odds ratio, OR) for an absolute 10-percentage point incremental increase in %UPF intake were 1.08 (1.01–1.14; P = 0.02), 1.21 (1.16–1.26; P < 0.0001), and 1.11 (1.02–1.20; P = 0.02), respectively. No significant association was detected for restrictive ED.Discussion and ConclusionThis study revealed an association of UPF intake with different ED types among French adults. Future research is needed to elucidate the direction of the observed associations.

ObjectiveThe high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample.Method123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used.ResultsInvariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39).ConclusionWe conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms.A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.

Diagnostic Classification of Eating Disorders in Children and Adolescents: How Does DSM-IV-TR Compare to Empirically-Derived Categories?

Background: Many low- and middle-income countries are now facing the “double burden” of malnutrition, one of them is overweight/obesity. Over 340 million children and adolescents were overweight and obesity in 2016. Obesity among adolescents may increase, in part due to changes in the food system, which now offers a wide range of ultra-processed foods (UPF) that minimize preparation time. Indonesia has also a large and rapidly growing market for unhealthy drinks, which are sold in various places including schools and hospitals. Objective: This study aimed to investigate the association of UPF and beverages consumption and other related factors with nutritional status of senior high school students in Pontianak, West Kalimantan, Indonesia. Methods: This cross-sectional study conducted in Pontianak investigated the association between UPF consumption and nutritional status of SHS students. Data collection was conducted at Imanuel and Petrus SHS Pontianak in June 2023, involving 273 students from grades 10th and 11th. Weight and height measurement was obtained for calculating the BMI for age Z-scores, while UPF and beverages consumption was obtained by FFQ. Structured questionnaire, 24-hours recall, and IPAQ-S were used for assessing sociodemographic status, Total Energy Intake and Physical Activity Level. Data analysis used SPSS version 26. Results: The result found 40.3% of students were overweight-obesity; 51.6% consumed excessive UPF and beverages. It showed an inverse association between UPF consumption and nutritional status. The study identifies UPF and beverages consumption, gender, mother's education level, and family income as factors associated with nutritional status among adolescents. Conclusion: The consumption of ultra-processed Foods was high, with the highest UPF intake came from snacks and sweets (22.4%). There was inverse association between UPF and beverages consumption with nutritional status. There was also significant association between UPF and beverages, gender, mother education level and family income with nutritional status.

Neuroimaging in Eating Disorders: Coming of Age

Objective: To assess the consumption of ultra-processed food and sugar-sweetened beverages and to identify the association of this consumption with overweight among vegetarians. Methods: A cross-sectional study with a convenience sampling method was conducted. Data were collected using an online questionnaire from 8/24/2015 to 10/8/2015. Subjects were male and female vegetarians aged &gt;16 years. Using a food frequency questionnaire, we assessed the weekly consumption of ultra-processed food and sugar-sweetened beverages and described the frequency of daily consumption overall and according to type of vegetarianism. The association between overweight and excessive daily intake of ultra-processed food was analyzed by multiple logistic regression (OR [95CI%]). Results: Information was retrieved from 503 individuals (29.8±8.5 years old); 83.7% were women. The most frequent types of vegetarianism in our sample were ovo-lacto (45.5%) and vegan (41.7%), and the median time of vegetarianism was 5.3 years. The consumption of sugar-sweetened beverages (≥2x/day) and ultra-processed food (≥3x/day) was 21.0% and 16.0%, respectively, and regarding the different vegetarianism types, vegans showed the lowest frequency of excessive daily sugar-sweetened beverages and ultra-processed food consumption. In the multivariable analysis, consumption of ultra-processed food ≥3x/day (2.33 [1.36-4.03]), male sex (1.73 [1.01-2.96]), age ≥35 years (2.03 [1.23-3.36]) and not preparing one’s food (1.67 [0.95-2.94]) were independently associated with overweight. Conclusion: Although vegetarianism is frequently associated with a healthier diet and, consequently, prevention of poor health outcomes, this study found that the excessive consumption of sugar-sweetened beverages and ultra-processed food was associated with overweight.

Introduction: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives: To characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption. Methods: The National Health and Nutrition Examination Survey (NHANES) is an annual, cross-sectional survey representative of the US population. We examined NHANES dietary data, combining years in which AAs were over-sampled (2011-2018). We included 2,404 AAs ≥ 18 years old with valid 24-hour dietary recall data. Using day 1 dietary recalls, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. This framework classifies foods from any culture based on degree of industrial processing. Acculturation was characterized by nativity, nativity/years in the US, home language, and an acculturation index (based on a sum of levels related to nativity/years in the US and home language). We assessed the relationship between each acculturation measure and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality. All analyses accounted for the complex survey design. Results: Among all AAs, the percentage of caloric intake attributable to UPFs was 39.3% (95% CI: 38.1-40.5). In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5-17.5; p&lt;0.05) greater among those with the highest vs. lowest acculturation index score, 12% (95% CI: 8.5-14.7: p&lt;0.05) greater among those who speak English only vs. non-English only in the home, 12% (95% CI: 8.6-14.7: p&lt;0.05) greater among US-born vs. foreign-born AAs, and 15% (95% CI: 10.7-18.3: p&lt;0.05) greater among US-born vs. foreign-born AAs with less than ten years in the US. Conclusions: Among AAs, UPF consumption was common, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research is necessary to characterize trends in dietary patterns across disaggregated AA subgroups to better inform culturally tailored dietary interventions.

The present study aimed to: (1) identify recent temporal changes in the prevalence of different cognitive and behavioral eating disorder (ED) symptoms, current probable EDs, lifetime ED diagnoses, and mental healthcare use among college students across the United States; (2) determine whether established disparities in ED prevalence and receiving mental healthcare have widened or narrowed over time for marginalized groups within this population. Participants included a large national sample of U.S. college students (N=286,720) who completed the repeated cross-sectional Healthy Minds Study from 2013 to 2020. Descriptive statistics and polynomial regressions quantified time-trends in participants' ED symptoms and past 12-month mental healthcare. Moderated regressions examined temporal changes in ED symptoms and mental healthcare based on sociodemographic characteristics. Individuals' engagement in different cognitive and behavioral ED symptoms, and likelihoods of exhibiting current probable EDs, reporting lifetime ED diagnoses, and (for individuals with current probable EDs) receiving therapy or counseling in the past 12-months exhibited nonlinear increases from 2013 to 2020. Further, the prevalence of current and lifetime ED symptoms and (for symptomatic individuals) past 12-month mental healthcare differed over time for individuals with different BMIs and gender, sexual, and racial/ethnic identities (but not ages). In particular, individuals with higher BMIs and those who identified as male, bisexual, and gay, lesbian, or queer exhibited increasing ED pathology over time. These findings provide important information on groups of U.S. college students that have experienced increasing burden of ED symptoms and may help guide ED prevention, treatment, and research priorities. Recent temporal changes in the prevalence of eating disorder (ED) symptoms and mental healthcare were examined in a national sample of U.S. young adults. Non-linear increases in ED symptoms and mental healthcare were identified among U.S. young adults overall from 2013 to 2020. U.S. young adults with higher BMIs, males, bisexual, and gay, lesbian, or queer individuals exhibited increasing ED burden over time.

Impact of Fortified Ultra-Processed Foods on Risk of Anemia: A New Perspective for Pediatric Nutrition

Asthma is a Chronic Non-Communicable Disease (CNCD) characterised by a chronic inflammatory process in the bronchi of the lungs. For a clinical diagnosis of asthma, one or more of the following symptoms must be present: wheezing (the main characteristic), dyspnoea, chest tightness and a dry cough, particularly at night or early in the morning. It is estimated that asthma affects 235 million people worldwide. In recent decades, the increased prevalence of this disease has been associated with environmental, behavioural and dietary changes. In children, some studies have shown a positive association between asthma and the consumption of ultra-processed foods and there is an indication of protection with the consumption of fresh/minimally processed foods. In adults, no significant association was observed between consumption of ultra-processed foods and asthma. Diet is a modifiable factor and can therefore be intervened to reduce the risk of asthma in individuals with a predisposition to the disease. The aim of this study was to assess the association between food consumption and asthma in the Brazilian adult population. This was a cross-sectional study using data from the National Health Survey (PNS, 2019) of 88,531 Brazilian adults. The exposures were two food scores, produced by combining the frequency of consumption of fresh foods and ultra-processed foods (UPP) on the previous day. Thus, a person who reported having consumed 5 UPP had a score of 5. Subsequently, each group was divided into tertiles, the first tertile being the one with the lowest level of food consumption and the third with the highest level of food consumption. The outcome was the self-reported medical diagnosis of asthma. Logistic regression analyses were carried out using Stata 17.0 software, with adjustments for age (years), race/colour (white/black/yellow/brown/indigenous), sex (female and male), smoking (yes and no), schooling (incomplete primary/complete secondary/complete higher education), alcohol consumption (I don't drink/less than once a month/ once a month or more), physical activity (yes and no), per capita income (Brazilian reals) and area of residence (urban or rural). Associations with p<0.05 were considered significant. The prevalence of a medical diagnosis of asthma was 5.5 per cent, and the UPP and in natura/ minimally processed scores ranged from 0.54 to 4.99 and 3.99 to 9.01, respectively. In adults, the UPP score was positively associated with asthma (OR3rd tertile=1.31 95%CI: 1.11-1.53). On the other hand, the in natura food score was not associated with the diagnosis of the disease (OR 3rd tertile = 0.92 95% CI: 0.80-1.07). The study concluded that Brazilian adults who consumed more ultra-processed foods the day before the interview were more likely to be diagnosed with asthma than those who consumed less than one ultra-processed food the day before the interview.

The authors sought to examine changes in prevalence of dieting behavior and eating disorder symptoms from 1982 to 1992. In 1982, 625 women and 276 men participated in a study examining body weight, eating habits, dieting tendencies, and eating disorder symptoms. Ten years later 564 women and 235 men at the same college completed a nearly identical survey. Similar random sampling methods were used for both studies. All respondents were classified into one of five groups (nondieter, dieter, problem dieter, subclinical eating disorder, or eating disorder according to DSM-III-R criteria). On almost all measures there were significant reductions of problematic eating behaviors and disordered attitudes about body, weight, and shape from 1982 to 1992. The estimated prevalence of bulimia nervosa dropped from 7.2% to 5.1% for women and from 1.1% to 0.4% for men. Binge eating, vomiting, diuretic use, and diet pill use also declined for women during this period. Significantly fewer women and men reported chronic dieting in 1992 than in 1982, and there was evidence of improved body image for both sexes. Subjects in 1992 also reported healthier eating habits in terms of dietary intake and meal regularity. Finally, women in 1992 were more likely to be overweight and were, on average, five pounds heavier than their 1982 counterparts. The prevalence of problematic eating behaviors and eating disorder symptoms appears to be abating. However, they remain a significant problem that affects a substantial segment of this population.

Evidence suggests loss of control over eating may be the driving component of binge eating, a transdiagnostic symptom of eating disorders and highly comorbid with depressive symptoms. Prior studies have evaluated eating disorder and depressive symptoms across types of binge episodes among adolescent and young adult samples, yet no studies have focused on middle-aged women who may be particularly vulnerable to both binge eating and depressive symptoms. The goal of this study was to compare eating disorder symptoms and depressive symptoms across different types of binge eating episodes among middle-aged women. Women (N = 347), ages 40-63, completed an online survey about both objective (OBE) and subjective binge episodes (SBE), eating disorder symptoms, and depressive symptoms. Participants were categorized as OBEs only, SBEs only, both OBEs and SBEs, and no binge eating. Controlling for group differences, results showed middle-aged women who experienced SBEs only reported greater levels of anorexia nervosa attitudes and behaviors compared to all other groups, and greater dietary restraint compared to those who experienced only OBEs and those with no binge eating. Middle-aged women who experienced any type of binge eating reported greater levels of body image concerns and depressive symptoms compared to those who reported no binge eating. Findings suggest that loss of control is more clinically relevant in terms of associations with eating disorder and depressive symptoms in middle-aged women. Level V based on descriptive studies.

BackgroundHigh consumption of UPFs has been proposed as a key driver in the global rise of non-communicable diseases. UK adolescents consume 66% of their daily energy (kcal/d) from UPFs. However,...

The Unique and Moderating Role of Social and Self-Evaluative Factors on Perinatal Eating Disorder and Depression Symptoms