Abstract
ABSTRACTBackgroundRecent observational data and a controlled in-patient crossover feeding trial show that consumption of “ultra-processed foods” (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A drawback of the NOVA classification is the lack of evidence supporting a causal mechanism for why UPFs lead to overconsumption of energy. In a recent study by Hall the energy intake rate in the UPF condition (48 kcal/min) was >50% higher than in the unprocessed condition (31 kcal/min). Extensive empirical evidence has shown the impact that higher energy density has on increasing ad libitum energy intake and body weight. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Energy density can be combined with eating rate to create a measure of energy intake rate (kcal/min), providing an index of a food's potential to promote increased energy intake.ObjectiveThe current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification.MethodsData were pooled from 5 published studies that measured energy intake rates across a total sample of 327 foods.ResultsWe show that going from unprocessed, to processed, to UPFs that the average energy intake rate increases from 35.5 ± 4.4, to 53.7 ± 4.3, to 69.4 ± 3.1 kcal/min (P < 0.05). However, within each processing category there is wide variability in the energy intake rate.ConclusionsWe conclude that reported relations between UPF consumption and obesity should account for differences in energy intake rates when comparing unprocessed and ultra-processed diets. Future research requires well-controlled human feeding trials to establish the causal mechanisms for why certain UPFs can promote higher energy intake.
Highlights
Recent observational studies suggest a relation between frequently consuming “ultra-processed” foods (UPFs), as defined by the NOVA classification, and the prevalence of obesity and related chronic diseases [1,2,3]
The current comparison highlights that, across a wide sample of foods, those classified as UPFs had, on average, a faster energy intake rate than unprocessed foods, there was significant heterogeneity within each processing category
The current comparison highlights that previously reported relations between UPF consumption and increased energy intake and obesity prevalence may be confounded by underlying differences in the energy intake rates of the foods in these diets [4]
Summary
Recent observational studies suggest a relation between frequently consuming “ultra-processed” foods (UPFs), as defined by the NOVA classification, and the prevalence of obesity and related chronic diseases [1,2,3]. Recent observational data and a controlled in-patient crossover feeding trial show that consumption of “ultra-processed foods” (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Objective: The current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification. Conclusions: We conclude that reported relations between UPF consumption and obesity should account for differences in energy intake rates when comparing unprocessed and ultra-processed diets. Future research requires well-controlled human feeding trials to establish the causal mechanisms for why certain UPFs can promote higher energy intake.
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