Ultra-processed Food Products Research Articles

Balancing the right to health and commercial speech: the approach of Argentina's Supreme Court.

Noncommunicable diseases (NCDs) cause significant human and economic costs globally. Each year, 17 million people die from an NCD before age 70. The burden of NCDs is associated with socioenvironmental, cultural factors and social behavior, including modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and alcohol consumption. NCDs can be prevented if healthy environments are guaranteed by the promotion of effective public policies that control the behavior of the tobacco, food and alcohol industries. The regulation of marketing strategies of unhealthy products, and even its ban, has been demonstrated as an effective measure to protect the right to health and promote human rights. However, companies that produce and commercialize these ultra-processed food products argue that protecting measures restricting marketing violate their constitutional right to freedom of speech, among others. Regarding tobacco product marketing activities, the Supreme Court of Justice of Argentina has ruled that it is afforded less constitutional protection than political speech and could be restricted to protect public health and human rights. This article examines the tobacco marketing case and, using an analytical framework argues that the proportionality test used by the Supreme Court could indeed be applied to ultra-processed food products. It is concluded that a complete ban on ultra-processed food product marketing would be constitutionally valid.

Examining the consumer behaviour of ultra-processed food products: evidence from the Spanish market

PurposeUltra-processed food products are omnipresent in our homes and in grocery stores, and everybody consumes these food products once in a while. In this context, the present study aims to analyse what factors influence the consumption behaviour of ultra-processed food products and, more precisely, what factors drive consumer satisfaction and purchase intention of these food products in one specific market – Spain-.Design/methodology/approachA model of consumer behaviour of ultra-processed food products is proposed and analysed through structural equation modelling on a sample of 608 consumers.FindingsFindings indicate that the effortlessness of ultra-processed food products, as well as their affordability, are the factors that exert the higher influence on consumer satisfaction and purchase intention of ultra-processed food products. On the other hand, the product quality and the ability to save time show a negative influence on both consumer satisfaction and intention to purchase. Contrary to the initial expectations, product convenience and the hedonistic nature of ultra-processed food products do not influence consumer behaviour.Practical implicationsFood policymakers and public health interventions may consider possible actions to reduce the consumption of ultra-processed food products, the reduction of their affordability through taxation or the compulsory inclusion of nutritional warnings in the front of the package to confront marketing actions developed by food companies.Originality/valueThis study examines the factors that drive the purchase and consumption of ultra-processed food products in one European mature market: Spain.

Explaining socioeconomic inequality in food consumption patterns among households with women of childbearing age in South Africa.

The changing food environment shifts peoples' eating behaviour toward unhealthy food, including ultra-processed food (UPF), leading to detrimental health outcomes like obesity. This study examines changes in socioeconomic inequalities in food consumption spending between 2005/06 and 2010/11 in South African households with women of childbearing age (15 to 49) (WCBA). Data come from the 2005/06 and 2010/11 Income and Expenditure Surveys. The distribution of spending according to the NOVA food classification system groupings (unprocessed or minimally processed foods, processed culinary ingredients, processed and UPF products) was analysed using standard methodologies. Changes in spending inequalities between 2005/06 and 2010/11 were assessed using the concentration index (C), while the factors explaining the changes in spending inequalities were identified using the Oaxaca decomposition approach. The Kakwani index (K) was used to assess progressivity. Results show that average real spending on all food categories, including UPF, increased between 2005/06 and 2010/11. Socioeconomic inequality in UPF consumption spending decreased (C = 0.498 in 2005/06 and C = 0.432 in 2010/11), and spending on processed foods (C = 0.248 in 2005/06 and C = 0.209 in 2010/11). Socioeconomic status, race, and urban residence contributed to overall socioeconomic inequality and changes in UPF consumption inequality between 2005/06 and 2010/11. Spending on all food categories was regressive in 2005/06 (K = -0.173 for UPF and -0.425 for processed foods) and 2010/11 (K = -0.192 for UPF and -0.418 for processed foods) because such spending comprises a larger share of poorer household's income than their wealthier counterparts. The government should address these contributors to inequality to mitigate the risks associated with UPF consumption, especially among less affluent households.

Crime and Nourishment: A Narrative Review Examining Ultra-Processed Foods, Brain, and Behavior

Recently, there has been increased scientific and clinical interest in the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. Research spanning epidemiology, mechanistic pre-clinical work, addiction science, microbiome and exposome science, and human intervention trials has underscored that nutrition is of relevance along the criminal justice continuum. As such, the emerging dietetics research is salient to the thousands of international psychologists and allied mental health professionals that are engaged in justice work, including forensics, prevention, and intervention. In addition, relationships between nutrition and behavior relate to “food crime”, an emergent area unifying criminal justice researchers with psychology, public health, and other interdisciplinary sectors. Food crime scrutinizes the vast harms, including non-communicable diseases and adverse behavioral outcomes, as influenced by the distribution of addictive ultra-processed food products. Here, we examine the emergent research, including biophysiological mechanisms, and evidence indicating that dietary patterns/components intersect with psychosocial vulnerabilities linked with risks of antisocial behavior and justice involvement. Viewed through a prevention lens, the study of nutrition and aggressive behavior should be prioritized, especially if the outcomes emerge as externalities of the global consumption of ultra-processed food. In the context of criminal justice and behavior, there is a need for forensic examination of how industry influence and power structures can undermine matters of food justice.

Effects of marketing claims on toddler food products on parents' product preferences, perceptions and purchasing intentions: an online experiment.

The retail market for toddler-specific packaged foods is growing. Many of these products are ultra-processed and high in nutrients of concern for health, yet marketed in ways that may make them appear wholesome. This study aims to assess parents' responses to claims on unhealthy, ultra-processed toddler food products and test whether removing such claims promotes more accurate product perceptions and healthier product preferences. Parents of toddlers aged 12 to < 36months (N = 838) were recruited for an online experiment testing four on-pack claim conditions: control (no claim); 'contains "good" ingredient'; 'free from "bad" ingredient'; and unregulated'child-related' claim. Participants were randomly assigned to one condition, then viewed images of toddler food products that varied in nutrition content and the claims displayed. Participants completed tasks assessing product preferences (unhealthy product displaying claim vs. a healthier option with no claim, across four food categories (banana bars, strawberry snacks, blueberry yogurt snacks and veggie snacks)), purchase intentions and product perceptions. Poisson regression (count variable) and linear regression (continuous outcomes) analyses were employed to test for mean differences by marketing claim conditions. For the overall sample, brief exposure to 'free from "bad" ingredient' claims increased participant's intentions to purchase unhealthy food products for their toddlers, but there was no clear evidence that 'contains "good" ingredient' claims and 'child-related' claims significantly impacted parent's preferences, purchase intentions and perceptions of toddler foods. However, certain claims influenced particular parent subgroups. Notably, parents with three or more children chose more unhealthy products when these products displayed 'contains "good" ingredient' or 'free from "bad" ingredient' claims; the latter claims also promoted stronger purchase intentions and enhanced product perceptions among this subgroup. Findings indicate that 'free from "bad" ingredient' claims on unhealthy toddler foods are of most concern, as they boost the appeal of these products to parents. 'Contains "good" ingredient' claims and 'child-related' claims showed limited effects in this study. Considering available evidence, we recommend claims should not be permitted on child-oriented foods, as they may promote inaccurate product perceptions and unhealthy product choices by parents, that can detract from their children's diets and health.

Proposal and Validation of a Measurement Scale of the Acceptance of Ultra-Processed Food Products.

Today, there is an increasing consumption of ultra-processed food products (UPFs), while more healthy options are available; however, there is no scale available that can adequately measure this phenomenon. In this context, the present study aims to develop and validate a measurement scale of the consumers' acceptance of ultra-processed food products. Research data (n = 478) were analyzed using Exploratory Factor Analysis (EFA), followed by a Confirmatory Factor Analysis (CFA). The results confirm the validity of the proposed measurement scale comprising nine factors: the quality of ultra-processed food products, ability to save time, low affordable price, effortless preparation, convenience, hedonic nature, marketing strategies, satisfaction and purchase intention. The present study makes a noticeable contribution to food marketing, and food companies could consider these factors to design and commercialize ultra-processed foods.

Neurolaw: Revisiting Huberty v. McDonald’s through the Lens of Nutritional Criminology and Food Crime

Recent studies have illuminated the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. At the same time, the human gut microbiome has emerged as an important contributor to cognition and behavior, disrupting concepts of the biopsychosocial ‘self’ and raising questions related to free will. Since the microbiome is undeniably connected to dietary patterns and components, the topics of nutrition and microbes are of heightened interest to neuroscience and psychiatry. Research spanning epidemiology, mechanistic bench science, and human intervention trials has brought legitimacy to nutritional criminology and the idea that nutrition is of relevance to the criminal justice system. The individual and community-level relationships between nutrition and behavior are also salient to torts and the relatively new field of food crime—that which examines the vast harms, including grand-scale non-communicable diseases and behavioral outcomes, caused by the manufacturers, distributors, and marketers of ultra-processed food products. Here in this essay, we will synthesize various strands of research, reflecting this emergent science, using a notable case that straddled both neurolaw and food crime, Huberty v. McDonald’s (1987). It is our contention that the legalome—microbiome and omics science applied in neurolaw and forensics—will play an increasing role in 21st-century courtroom discourse, policy, and decision-making.

Cardiovascular Diseases Risk Reduction And Lifestyle Modification:Cross Sectional Ansalysis Of Patient Responses.

A decrease in cardiovascular event risk with a decrease in total and LDL – cholesterol level is termed as “cholesterol paradox” or “risk factor reversal”. Cardiovascular risk does not have a linear relationship between LDL – cholesterol levels, and other substantial risk factors of cardiovascular events are being disregarded.The aim of this study is, to identify modifiable risk factors of cardiovascular events other than those well proved to cause dyslipidemia. A cross-sectional study was conducted with 652 participants in a tertiary care hospital. Patients were grouped into two, based on the history of cardiovascular events. Demographics and patient responses captured using pre-validated questionnaires were analyzed. 5mL blood samples were collected by venipuncture and lipid profile was estimated. Association between cardiovascular events and explanatory variables. was determined using Chi square test and Odds ratio at 95% confidence intervals. Higher risk of CV events was found among smokers 0.232 [0.144 – 0.373]. Consumption of white sugar, refined oil, processed cold beverages and fast food products increased CV risk respectively. Moreover, total cholesterol, LDL-C and triglycerides were found to decrease after one year of counselling the patients. The classical hypothesis of dyslipidemia induced atherosclerosis may not be the predominant cause of CV events. Herein, we report no association between high fat diet and CV risk while we observed higher risk in consumers of refined and ultra processed food products. However, significant control of cholesterol was observed in patients who shifted to Unrefined food products.

The increasing trend in the consumption of ultra-processed food products is associated with a diet related to chronic diseases in Colombia-Evidence from national nutrition surveys 2005 and 2015.

Ultra-processed food products (UPF) have been related to chronic diseases (CD). Public health politics has been establishing strategies to decrease the consumption of these products in the country. i) To assess the trend of the consumption of UPF between 2005 and 2015. (ii) its association with sociodemographic factors and the overall dietary content of nutrients related to CD in 2015. (iii) to estimate the Population Attributable Fraction of unhealthy nutrient intake in Colombia in 2015 due to ultra-processed food consumption. We used data from the first (2005) and the last (2015) National Surveys of the Nutritional Status in Colombia. Food consumption was assessed using a 24-hour food recall. The NOVA classification classified the food items according to the extent and purpose of industrial processing. The consumption of processed and UPF increased in Colombia between 2005 and 2015. In 2015, no significant differences were found in the consumption of UPF between men and women but significant differences by age, wealth index, area of residence, and ethnicity (p<0.001). A significant positive association was found between the dietary share of UPF and the content of CD-related nutrients such as free sugars, total fats, saturated fats, trans-fats, and sodium. The prevalence of excessive intake of all CD-related nutrients (according to WHO recommendations) increased across quintiles of the dietary share of UPF. With the reduction of UPF consumption to the level seen among the 20% lowest consumers [1.0% (0-4.5%) of the total energy from UPF], the prevalence of excessive nutrient intake was almost three-fourths lower for trans fats; around one third lower for free sugar and saturated fats, 26% lower for sodium and 15% lower for total fat. In Colombia, the increasing trend in the consumption of UPF is associated with increasing intake of CD-related nutrients. Thus, reducing the consumption of UPF is a potentially effective way to achieve the nutritional goals of the WHO for the prevention of CD.

Why there is a Need to Priortise Regulation of Ultra-processed Foods and HFSS Foods in India?

Abstract Incidence of non-communicable diseases (NCDs) such as diabetes and obesity is on the rise worldwide. Rising consumption of ultra-processed food (UPF) products or those high in fats, sugars or salt also called junk foods contributes to this grave situation. Increasing consumption of UPFs is associated with obesity, type-2 diabetes, cardiovascular disease, cancers, cerebral vascular disease and all-cause mortality. Aggressive and pervasive marketing of UPFs targeting children and adolescents leads to the development of preference for such junk foods, and turns diets to be unhealthy. India made progress in 2017 to document and recommend through national multisectoral plan of action to prevent and control NCDs using legal measures to have front-of-the-pack labels and ban on the advertisements. However, it remains to be implemented. This review article delves into scientific evidence on why there is need to prioritise regulating UPFs and high fat, salt and sugar (HFSS) foods in India, while there is need for mass awareness of citizens on the risks of UPFs and how to read labels of pre-packaged foods.

Dietary dicarbonyl compounds exacerbated immune dysfunction and hepatic oxidative stress under high-fat diets in vivo.

High-fat diets (HFDs) predispose to obesity and liver dysfunctions, and α-dicarbonyl compounds (α-DCs) present in highly processed foods are also implicated in relevant pathological processes. However, the synergistic harmful effects of α-DCs co-administered with HFDs remain to be elucidated. In this study, 6-week-old C57BL/6 mice were fed with a HFD co-administered with 0.5% methylglyoxal (MGO)/glyoxal (GO) in water for 8 weeks, and multi-omics approaches were employed to investigate the underlying toxicity mechanisms. The results demonstrated that the MGO intervention with a HFD led to an increased body weight and blood glucose level, accompanied by the biological accumulation of α-DCs and carboxymethyl-lysine, as well as elevated serum levels of inflammatory markers including IL-1β, IL-6, and MIP-1α. Notably, hepatic lesions were observed in the MGO group under HFD conditions, concomitant with elevated levels of malondialdehyde. Transcriptomic analysis revealed enrichment of pathways and differentially expressed genes (DEGs) associated with inflammation and oxidative stress in the liver. Furthermore, α-DC intervention exacerbated gut microbial dysbiosis in the context of a HFD, and through Spearman correlation analysis, the dominant genera such as Fusobacterium and Bacteroides in the MGO group and Colidextribacter and Parabacteroides in the GO group were significantly correlated with a set of DEGs involved in inflammatory and oxidative stress pathways in the liver. This study provides novel insights into the healthy implications of dietary ultra-processed food products in the context of obesity-associated disorders.

Consumption of Ultra-Processed Food and Drink Products in a Greek Christian Orthodox Church Fasting Population

Consumption of Ultra-Processed Food and Drink Products in a Greek Christian Orthodox Church Fasting Population

The Challenges of Tobacco Fiscal Policy Implementation in Mexico From the Perspective of Key Actors.

Raising tobacco taxes is considered the most effective strategy to avoid smoking initiation and discourage its use, especially among vulnerable groups. However, few low- and middle-income countries have adopted high tobacco taxes. Raising taxes is, therefore, an opportunity to strengthen and accelerate tobacco control. The objective of this study is to analyze the barriers and facilitators to the tobacco tax increase in Mexico. Based on the Governance Analytical Framework, data were generated through 17 in-depth interviews with key intersectoral actors for fiscal policy. The interviews were transcribed and coded according to Hufty's theory of governance. Robust scientific evidence, intersectoral coordination, and the presence of "champions" boosted progress in tobacco control (facilitators). The main barriers were the incomplete implementation of the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) and MPOWER package and lack of commitment ("political will") by government decision makers and legislators, misinformation about the effects of tobacco taxes, and strong tobacco industry interference. Robust evidence is necessary but not sufficient to advance the implementation of the MPOWER (WHO-FCTC) actions. To achieve tobacco tax increases and public policies that protect people from unhealthy products in general, the implementation of policies or legal frameworks against industry interference in the development of public policies is imperative. By analyzing the barriers and facilitators to increasing the tobacco tax in Mexico, this study identifies two key messages: (1) The need to sensitize legislators and the general population to the problem of smoking not only through epidemiological data but also through testimonies that highlight the life experiences and adversities faced by people who smoke. (2) The need for a regulatory framework to prevent industry interference in public affairs and conflicts of interest. The same framework could be very useful for public health policies to control the consumption of ultra-processed food products or alcohol.

“Soy Boy vs. Holy Cow”—Understanding the Key Factors Determining U.S. Consumers’ Preferences and Commitment to Plant-Based Milk Alternatives

Plant-based milk products are ultra-processed food products that enjoy a positive reputation as being safe, healthy, ethical, and sustainable. The present study is focused on these products and addresses the product and brand managers of US food retailers. A consumer survey explores the factors explaining US consumers’ preferences for and commitment to plant-based milk and other plant-based milk products. Environmental concerns, food safety, health, and sustainability concerns are identified as relevant predictors for both consumer behaviors. In addition, animal welfare concerns are relevant, but only for product commitment.

Food additives and PAHO’s nutrient profile model as contributors’ elements to the identification of ultra-processed food products

The NOVA classification system categorizes foods according to the extent and purpose of industrial processing. Ultra-processed food products (UPF) are frequently composed of excessive amounts of sugars, salt, oils, and fats, and cosmetic additives designed to make them palatable and/or appealing. We aimed to describe the presence of critical nutrients in excess and cosmetic additives in packaged foods and beverages and to evaluate the proportion of UPF that can be correctly identified through the presence of critical nutrients in excess or the presence of cosmetic additives in food products. A total of 9851 items available in Brazilian supermarkets containing lists of ingredients and nutrition facts panels were analyzed. Cosmetic additives and critical nutrients in excess, according to Pan American Health Organization (PAHO)’s nutrient profile model, were assessed. All food items were categorized into the four NOVA classification groups. Relative frequencies of items with at least one critical nutrient in excess and one type of cosmetic additive were estimated. For UPF, 82.1% had some cosmetic additive, and 98.8% had some cosmetic additive or a nutrient in excess. This combined criterion allowed the identification of 100.0% of sweet cookies, salted biscuits, margarine, cakes and sweet pies, chocolate, dairy beverages, and ice cream. Combining the presence of cosmetic additives and the PAHO’s nutrient profile model contributes to the identification of UPF.

Food-grade titanium dioxide (E171) differentially affects satiation in mice fed a regular or a high fat diet.

Food-grade titanium dioxide (E171) is a widely used food additive and the toxicity after oral consumption is still under research, although it has been already banned in some countries. The consumption of this additive occurs mainly through ultra-processed food products which also contain high amounts of fat. High fat diets (HFD) impair the physiological system controlling satiation and satiety, which are responsible for control of food intake and energy status. The impact of E171 on animal behavior has been poorly explored and here we hypothesize that E171 could worsen the effects on feeding behavior induced by HFD. Therefore, we aimed to evaluate the effects of E171 on the feeding pattern and the behavioral satiety sequence (BSS) of mice fed with a regular diet (RD) or a HFD after 1 and 16 weeks of exposure. The results showed that RD+E171 increased food intake and feeding time, but the prototypical structure of the BSS pattern (feeding→ grooming-activity → resting), was preserved. Conversely, food consumption was not altered in HFD+E171, but the BSS pattern was disrupted as the animals prolonged resting time and spent less time being active. Our findings suggest that E171 delayed the onset of satiation in mice fed with RD but induced the opposite effect in mice fed with HFD.

Meeting the nutrition and physical activity needs of young people in residential out-of-home care

Summary Health outcomes for young people living in residential out-of-home care are poor. There has been increased emphasis on the need to prioritize preventative support and upskill residential care workers to better meet young people's health needs. The aim of this study was to examine the food quality and physical activity environment in residential care houses in Victoria, Australia prior to staff undertaking Healthy Eating, Active Living Matters (HEAL) training; 102 residential care houses participated. House representatives completed an online survey exploring: (1) physical activity equipment and engagement and (2) weekly food budget and expenditure. Findings The average weekly food expenditure per household was $318.98 (SD = $106.51), with variation between different sized households. The majority (61%) of houses’ weekly food expenditure was spent on ultra-processed food products that are ready to eat with no/little preparation, in comparison to 36% spent on unprocessed foods (fresh fruit and vegetables). The majority of houses reported having two types of equipment. Young people were not often engaged in physical and/or recreational activities in their community. Application Residential care houses in Victoria require additional supports to ensure that young people are supported to eat well and be active at home and in the community. HEALing Matters aims to provide this, by offering professional development for residential carers to better facilitate engagement in physical activity and healthy eating among the young people in their care. If successful, HEALing Matters may provide an effective pathway to improved health and wellbeing outcomes for young people in residential care.

The impact of cash transfer participation on unhealthy consumption in Brazil

We assess the impact of the Brazilian government’s conditional cash transfer program Bolsa Família on unhealthy consumption by households, proxied by expenses with ultra-processed food, alcohol, and tobacco products. Using machine learning techniques to improve the propensity score estimation, we analyze the intensive and extensive margin effects of participating in the program on the household purchase of unhealthy products. Our results reveal that program participants spend more on food in general, but not necessarily more on unhealthy options. While we find evidence that participants increase their probability of spending more on food away from home, they do not significantly alter their expenditures on packaged food, alcohol, or tobacco products.

Impact of textual warnings on emotional brain responses to ultra-processed food products.

Ultra-processed food products (UPF) have been associated with numerous non-communicable diseases. Despite this, the addictive nature of UPF, and the aggressive marketing strategies used to promote them, has created a strong emotional connection between UPF and consumers, and supports their increasing UPF global consumption. In view of the emotional link that consumers often have with UPF, modulating emotional reactions to UPF (by using strategies such as textual warnings) is important in changing consumers' behavior. Since emotions are better understood by assessing individuals' implicit reactions, we conducted an electroencephalographic study applying the event-related potential technique to investigate whether textual warnings were able to modulate the brain responses to UPF stimuli. Twenty-six participants (19 women) viewed pictures of UPF preceded by a warning sentence about the health risks of consuming UPF or a control sentence while the electroencephalogram was recorded. In addition, the participants rated the picture in respect of pleasantness, arousal, and intention to consume. As emotions are associated with motivational circuits in the brain, we focused on a well-known event-related potential brain marker of the motivational relevance associated with emotional stimuli, namely late positive potential (LPP). The late positive potential amplitude was larger for pictures depicting UPF under the warning condition compared to the control condition, a result that was accompanied by lower pleasantness ratings during the warning condition (compared to the control). Textual warnings about the negative health consequences of consuming UPF changed the emotional responses toward UPF, possibly increasing the motivation to avoid UPF. These results shed new light on the impact of textual warnings on UPF-evoked emotions.

Assessment of the impact of the Belgian and French food industry on obesity and population nutrition

Abstract Major food industry players make commitments to improve food environments, but it remains unclear how well these commitments translate into practice. This study set out to quantitatively assess the nutrition-related commitments and practices, as well as the correlation between both, of major food companies in Belgium and France. The ‘Business Impact Assessment’ (BIA-Obesity) was applied to evaluate nutrition-related commitments and practices regarding product formulation, labelling, promotion and accessibility. Publicly available commitments were collected and companies given the opportunity to complete the information (2019-2020). Practices were evaluated applying following performance metrics: the proportion of products with Nutri-Score A or B, the percentage of products not-permitted to be marketed to children (World Health Organisation) and the proportion of ultra-processed food products (NOVA). Correlations between commitments and practices were calculated applying the Spearman's rank correlation coefficient. Overall BIA-Obesity scores for commitments were lower in France (median: 28%) than in Belgium (35%). Response rates in France (39%) were lower than in Belgium (56%). Median product portfolios in France contained less ultra-processed products (63%) and contained a higher proportion of products with a Nutri-Score A or B (38%) compared to Belgium (75% and 29%, respectively). In both countries a similar proportion of products was not-permitted to be marketed to children (81% in Belgium and 84% in France). Stronger company commitments did not translate into better performance metrics. Belgian food companies obtained a higher score for their nutrition-related commitments. French companies performed slightly better according to the performance metrics. In both countries there was ample room to improve commitments and practices. To improve food environments it is crucial to ensure that commitments are strengthened and translate into improved company practices. Key messages