Ultra-processed Foods Research Articles

Jerked beef as an ultraprocessed convenience food: Desalting strategies to minimize the impact on lipid and protein oxidation

AbstractJerked beef (JB) is a high‐protein convenience food but shows high degree of oxidation owing to its severe ultraprocessing. This study aimed to investigate the effect of desalting processes on oxidative stability of JB. JB were submitted to five desalting procedures: immersion in water at room temperature for 12 h without changing the water (AT12); immersion in water at room temperature for 12 h followed by boiling for 30 min and changing the water between the two procedures (AT12 + C30); immersion in boiled water for 10, 20, and 30 min (C10, C20, and C30, respectively). The desalted JB samples were refrigerated (vacuum packed and stored at 1 ± 1°C) and analyzed at 0 and 60 days. The samples without desalting were used as a control group. AT12 samples had the lowest lipid oxidation (0.05 and 0.07 mg of MDA kg−1, at T60 and T0, respectively). AT12 + C30 had the lowest NaCl content (2.8 and 3.3 g 100 g−1, at T0 and T60, respectively). C10, C20, and C30 showed a lower level of total carbonyls (p < 0.05) (0.04–0.13 nmol mg−1 protein), compared to control (0.53–0.93 nmol mg−1 protein in T0 and T60, respectively). Only boiled, desalted meats showed the volatile compound benzaldehyde. Higher concentration of monounsaturated, polyunsaturated, and total unsaturated fatty acids in JB desalted only in boiling water (C10, C20, and C30), compared to control (p < 0.05). AT12 is the best process to use, with regards to lipid oxidative stability, hardness, and NaCl content. Therefore, we conclude that it is possible to offer commercially desalted JB, as a convenience ultraprocessed product.Practical ApplicationLipid oxidation is accelerated when desalting jerked beef (JB) with boiling water. Desalted JB in boiling water had detectable concentrations of benzaldehyde. •Desalting in water at 25°C/12 h resulted in JB with better oxidative stability.

The Development of a Food Frequency Questionnaire for the Assessment of Ultra-Processed Food Consumption in the Italian Adult Population: Protocol for a Validity and Reproducibility Study

Background: Over the last decade, while studies on the detrimental effects of ultra-processed food (UPF) consumption have increased, methodological limitations on the quality of available evidence have emerged. Starting from a critical reassessment of the NOVA classification, this project will aim to develop and validate a food frequency questionnaire (FFQ), which is based on the processing of consumed foods and specifically designed to estimate the UPF consumption and total dietary intake of macro- and micronutrients in the Italian adult population. Methods: This study will take place in selected workplaces and include healthy males and females aged ≥18 years, residing in Italy and with Italian citizenship. The FFQ will be online, voluntary, self-administered, semi-quantitative, and designed to assess food intake over the past year and distinguish between industrial, artisanal, and home-made products. This project will consist of two phases. First, a pilot study will be conducted to obtain the final version of the FFQ. The current food consumption of the target population will be investigated, through a 24 h dietary recall, and the face validity of the new tool will be tested. The second phase will involve at least 436 participants. To assess reproducibility, the FFQ will be administered twice (at an interval of 3–10 months), and the test–retest method will be used. A 7-day weighed dietary record (WDR) will also be completed after each FFQ administration. To evaluate criterion validity, data from the two WDRs will be compared against those from the first FFQ administration. Conclusions: The results will provide a new valid tool focused on food processing, potentially useful for future studies.

The nutritional composition and in-store marketing of processed and packaged snack foods available at supermarkets in South Africa.

Over recent decades, the commercial ultra-processed food industry has grown, making snacks high in energy, added sugar, saturated fat and sodium affordable and accessible to consumers. Dietary patterns high in ultra-processed snacks are concerning as this can result in negative health outcomes. This study aims to provide insight on available snack products in South African supermarkets, and the marketing thereof, which can be used to support policy development aimed at improving the healthfulness of the food supply and consumption patterns. This was an observational cross-sectional, mixed-method study. Secondary data from six major supermarket chains (eight stores) in three different suburbs in Cape Town, South Africa was analysed to evaluate the nutritional composition of snack products (n=3837). The same eight supermarkets were revisited to obtain information on marketing via an observational checklist. Qualitative interviews were also conducted with store managers. Majority (89%) of the products assessed either contained non-sugar sweeteners or were high in sugar, saturated fat, or sodium. These snack items that are high in nutrients of concern to limit were available at checkout areas in all stores, were found in high traffic areas and several in-store promotional strategies such as branded displays, special offers and combo-deals were commonly found. The current South African supermarket environment encourages consumers to purchase unhealthy snacks. Most snacks assessed in this study cannot be recommended for regular consumption due to the nutritional composition being high in nutrients linked to poor health outcomes. There is a need for regulation of the in-store marketing of unhealthy snacks in South Africa. Retail settings are potential intervention points for limiting exposure to these unhealthy products.

Hard stop: reestablishing the significance of abstinence in the treatment of late stage ultra-processed food addiction

Addiction is a complex neurobiological disorder characterized by compulsive drug-seeking and use despite harmful consequences. While abstinence-based approaches have long been the cornerstone of addiction treatment, recent years have seen legitimate challenges from harm reduction clinicians, and within the food addiction realm, the eating disorder treatment practitioners. This perspective emphasizes the role of abstinence in food addiction recovery using the Koob model and its concept of hyperkatifeia despite these reservations. However, further research is essential before abstinence can be recommended. We need to 1) identify what qualifies as abstinence in relation to ultra-processed food, 2) clarify suitable situations and disease progression for optimal implementation of this approach, 3) provide clear guidelines when it is harmful, and 4) conduct clinical studies to confirm the effectiveness of this strategy for long-term recovery from late-stage food addiction.

Screen Exposure in 4-Year-Old Children: Association with Development, Daily Habits, and Ultra-Processed Food Consumption

This study aimed to investigate the association between child development, daily habits, and ultra-processed food consumption with screen exposure in 4-year-old children. A cross-sectional study was conducted using a questionnaire that included sociodemographic data, the child’s daily habits, and screenings for child development and eating habits. The daily screen exposure time (cell phone, computer, television, and/or tablet) was measured in minutes and classified as inadequate if >60 min. We conducted bivariate analyses and a generalized linear model. Overall, 362 caregivers–children pairs were investigated. The average screen time per child was 120 min (IQR: 120), and most of the children (71%) showed inadequate screen time for the age group. The longest screen time was associated with the lowest score in child development (β = −0.03; p = 0.01), an increased habit of eating in front of screens (β = 0.34; p < 0.001), and the highest score of ultra-processed foods (UPFs) (β = 0.05; p = 0.001). The sample showed a high prevalence of inadequate screen time, and this has been associated with the lowest score in child development, an increased habit of eating in front of screens, and the highest score of UPFs.

Abstract 4124518: Recent Trends in Cardiovascular Risk Factors in Latin America and the Caribbean: The Rising Threat of a Cardiometabolic Epidemics

Introduction: The sociodemographic context of population growth and ageing, social disparities and the high level of urbanisation in Latin America and the Caribbean (LAC) provide a unique entry point to reflect on the impact of cardiovascular diseases (CVD) on populations. Our objective was to evaluate recent trends in cardiovascular risk factors (CVRF) in LAC to inform the development of potential solutions to address CVD in LAC. Methods: Using data from the “NCD Risk Factor Collaboration (NCD-Risc)” available for public consultation, we evaluated trends in the main CVRFs in LAC from 1990 to 2016-2020, namely: systolic blood pressure (SBP) in mmHg, total cholesterol (TC) in mmol/ml, body mass index (BMI) in average kg/m2 and prevalence of diabetes. NCD Risc compiles and harmonises data from studies representative of populations from various countries around the world. Data on the estimated prevalence of smoking in the region come from the “Global Burden of Diseases” study. Data are presented standardised by age to allow comparison of different periods, given that the age distribution of the population varied. Results: The CVRFs that showed favourable trends in LAC in recent decades were: smoking, mean SBP and TC. The prevalence of smoking fell from 69% to 17% for men and 67.6% to 7.6% for women, reducing the CVD risk attributable to tobacco by 34%. Mean SBP fell from 130 mmHg to 129 mmHg for men and 127 mmHg to 122 mmHg for women. The mean CT reduced from 4.7 mmol/L to 4.6 mmol/L for men and 4.8 mmol/L to 4.7 mmol/L for women. Obesity and diabetes showed unfavourable trends. The average BMI increased from 23.0 kg/m2 to 26.8 kg/m2 for men and from 23.0 kg/m2 to 27.5 kg/m2 for women, with the prevalence of obesity increasing from 3% to 11% in men and from 6% to 15% in women. The prevalence of diabetes followed this pattern and increased from 5.4% to 8.8% for men and from 5.8% to 9.6% for women. Conclusion: CVRF trends are heterogeneous and demonstrate success for policies aimed at CVRF, such as high blood pressure and smoking. However, the trends reveal that the problem in the coming decades will be the rise in obesity and its consequences, which may reverse favourable trends in CVD mortality risk in LAC. Population and individual strategies, considering the social determinants of health, need to be planned, such as taxation of ultra-processed foods and campaigns to encourage physical activity.

Minimally Processed Foods Have a Higher Total Antioxidant Content Compared to Processed and Ultra-processed Foods: Results from an Analysis of 1,946 Food Items.

Ultra-processed foods (UPF), per the NOVA Classification, provide a major source of calories within modern food systems and are associated with poor health outcomes related to chronic inflammation. Dietary antioxidants play a key role in preventing disease, however, the relationship between the NOVA Classification and the total antioxidant content (TAC) of foods is not well-characterized. We hypothesized that TAC would be highest in Minimally Processed (MPF), lower in Processed (PRF), and lowest in UPF. TAC data for 3,137 animal-based, mixed, and plant-based food items were obtained from a published data set. After data cleaning, 1,946 food items and their TAC values were analyzed using two hierarchal linear models (alpha: p<0.05). MPF had the highest mean TAC (10.79 ± 0.87 mmol/100g) and were 11.31-fold and 10.72-fold higher than PRF and UPF, respectively (p=0.023). Plant-based and Mixed foods had a higher mean TAC (8.55 ± 0.68 and 1.12 ± 0.11 mmol/100g, respectively) and were 22.67-fold and 2.98-fold higher compared to animal-based foods (p<0.001). Food processing did not change mean TAC in Mixed and Animal-based foods; however, plant-based MPF had a higher mean TAC (11.49 ± 0.93 mmol/100g) and were 9.88-fold and 15.12-fold higher compared to plant-based PRF and UPF, respectively (p<0.001). Mean TAC differed between NOVA processing groups for three categories of food: Vegetables, Beverages, and Beans, Nuts & Seeds (p<0.001). Across all food items, and especially plant-based foods, mean TAC decreased with food processing. The lower TAC of UPFs may at least partially explain why their consumption promotes inflammatory chronic disease.

Prospective association between the Cardiovascular Health Diet Index and subclinical atherosclerosis: the ELSA-Brasil cohort study.

The Cardiovascular Health Diet Index (CHDI) is a diet quality score based on the dietary guidelines of the American Heart Association for cardiovascular health, but with some adaptations, such as red meat, dairy, beans, and ultra-processed foods in its components. The CHDI has shown good relative validity parameters, however, its association with health outcomes is still unclear. Thus, our aim was to investigate the association between the CHDI score with subclinical atherosclerosis. Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort were used. Subclinical atherosclerosis was assessed by measuring coronary artery calcification (CAC) at baseline (2008-2010) and second wave (2012-2014) and carotid intima-media thickness (cIMT) at baseline and at the third wave (2017-2019). The CHDI score (ranges from 0 to 110 points) was applied to dietary data obtained from a food frequency questionnaire at baseline. Poisson regression with robust variance, linear regression and linear mixed-effects models were used to evaluate the association of the CHDI score with CAC incidence (n 2,224), CAC progression (n 725), and changes in cIMT (n 7,341) over time, respectively. After a median 8-year follow-up period, a 10-point increase in the CHDI score was associated with a decrease in cIMT of 0.002 mm (95% CI -0.005; -0.001). No association was observed between the CHDI score and CAC incidence and progression after a 4-year follow-up period. Higher scores in the CHDI were prospectively associated with decreased subclinical atherosclerosis after an 8-year follow-up period.

Alleviating the public health burden of hypertension: debating precision prevention as a possible solution

ABSTRACT Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10–20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors – genetic, environmental, and social determinants – offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

Ultra-processed food consumption is related to screen time among Brazilian adolescents, adults, and older adults.

The aim of this study was to investigate the association between screen time and ultra-processed food consumption (UPF) across the lifespan. Data from the 2019 Brazilian National Health Survey, a cross-sectional and population-based study, was used. UPF consumption was evaluated using a score, calculated by summing the positive answers to questions about the consumption of 10 UPF subgroups on previous day. Scores ≥5 represented high UPF consumption. Daily time spent engaging with television or other screens was self-reported. Crude and adjusted models were obtained through Poisson regression and results were expressed in prevalence ratios by age group. The sample included 2,315 adolescents, 65,803 adults, and 22,728 older adults. Prevalence of UPF scores ≥5 was higher according to increased screen time, with dose-response across all age groups and types of screen time. Adolescents, adults, and older adults watching TV for ≥6 hours/day presented prevalence of UPF scores ≥5 1.8 (95% CI 1.2-2.9), 1.9 (95% CI 1.6-2.3) and 2.2 (95% CI 1.4-3.6) times higher, respectively, compared to those who did not watch TV. For other screens, prevalence of UPF scores ≥5 was 2.4 (95% CI 1.3-4.1) and 1.6 (95% CI 1.4-1.9) times higher for adolescents and adults using screens for ≥6 hours/day, respectively, while for older adults only screen times of 2-<3 and 3-<6 hours were significantly associated with UPF scores ≥5. Screen time was associated with high consumption of UPF in all age groups. Considering these associations when planning and implementing interventions would be beneficial for public health across the lifespan.

Ultra-Processed Food Consumption and Its Association with Risk of Obesity, Sedentary Behaviors, and Well-Being in Adolescents

Background/Objectives: The literature on consumption of ultra-processed food (UPF) using the NOVA classification is still limited. Therefore, the aim of the present study was twofold: (i) to compare the UPF consumption, sedentary behaviors, and well-being perception between boys and girls; and (ii) to investigate the association between the UPF consumption and risk of overweight, sedentary behaviors, and well-being in adolescents. Methods: The present cross-sectional study comprised a sample of 245 adolescents (131 boys) aged 12–17 years-old (M = 14.20; SD = 1.09). Height and weight were assessed, and subsequently, the BMI was computed; furthermore, total body fat percentage was measured with bioelectrical impedance. Daily consumption of UPF was assessed by the NOVA screener and time spent sedentary was assessed by the Midlands Behavior Health 2024 questionnaire. The Mental Health Continuum-Short Form (MHC-SF) was used to measure adolescents’ psychosocial well-being. Pearson’s correlations and logistic regression analysis were used, controlling for biological, behavioral, and socio-economic confounders. Results: No sex differences were observed for the different UPF NOVA subscales. Boys reported higher computer use levels than girls on the weekend (p = 0.025), and they spent more time playing electronic games during the week (p = 0.005) and on the weekend than their female counterparts (p &lt; 0.001). Moreover, boys reported higher scores in all well-being dimensions (p &lt; 0.001) than girls. Conclusions: The findings revealed, after controlling for sex, sedentary time, and active behaviors, adolescents who consumed UPF on the previous day tended to be associated with a higher risk of being overweight, but also marginally without statistical significance (OR = 0.91, 95% CI: 0.83–1.01, p = 0.06). Of relevance, the present study revealed that both boys and girls of mothers with high educational levels were less likely to be classified as overweight or obese youth.

ATIVIDADE FÍSICA E OBESIDADE NA PANDEMIA, CAUSAS E CONSEQUÊNCIAS PARA O PÚBLICO MASCULINO ADULTO NO BRASIL

Introduction: This study investigates the relationships between obesity and physical activity in the context of the COVID-19 pandemic, with an emphasis on the adult male population in Brazil. During the pandemic, obesity was intensified by an increase in sedentary lifestyle, changes in eating habits and stress. The performance of social isolation plays a crucial role in reducing the practice of physical activities, as well as increasing the consumption of ultra-processed foods. Objective: To investigate the relationships between physical activity and obesity in the context of the COVID-19 pandemic, focusing on adult males in Brazil. Methodology: In this context, through a bibliographic review with a qualitative and quantitative approach. Articles that dealt with the topic and which were published in Portuguese and English in the period from 2020 to 2024 were recruited from SciELO and PubMed. Results and Discussion: The impact of a sedentary lifestyle and diet is reflected in the psychological and physical complications faced by this population, including the worsening of chronic diseases such as diabetes and hypertension, in addition to the emergence of disorders such as depression and anxiety. Furthermore, the vulnerability of the male public to complications from COVID-19 highlighted the urgent need for external public policies. Conclusion: It is concluded that the COVID-19 pandemic has worsened obesity among adults due to factors such as an increase in sedentary lifestyle, changes in eating habits and stress. Causes include increased consumption of ultra-processed foods and decreased physical activity.

Association between sleep timing and meal and snack patterns in schoolchildren in southern Brazil.

This study aimed to identify meal and snack patterns and assess their association with sleep timing in schoolchildren. This is a cross-sectional study carried out in 2018/2019 with 1333 schoolchildren aged 7-14 years from public and private schools in Florianópolis, Brazil. Previous-day dietary intake data for breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner, and evening snack were collected using a validated online questionnaire. Sleep timing was measured by the midpoint of sleep and classified as quartiles (very early, early, late and very late). Latent Class Analysis was performed to identify meal and snack patterns, and multinomial logistic regression was used to assess associations. Students with very late sleep timing were less likely to consume the "Coffee with milk, bread and cheese" breakfast pattern compared with very early group (35.4%, 95%CI 27.2-43.6 vs. 56.0%, 95%CI 48.5-63.4). Also, the former were more likely to consume the "Mixed" breakfast pattern (healthy and unhealthy foods) compared with very early students (40.0%, 95%CI 32.4- 46.7 vs. 28.0%, 95%CI 23.8- 32.0). The latter were more likely to eat the "Brazilian traditional, processed meat, egg and fish" lunch pattern to the late students (35.4%, 95%CI 30.3- 40.5 vs. 21.5%, 95%CI 15.2- 27.8) and less likely to consume the "Pasta and cheese" lunch pattern compared to the students with later sleep timing (10.1%, 95%CI 8.4- 11.9 vs. 17.1%, 95%CI 13.0- 21.1). Students with later sleep timing were more likely to eat ultra-processed food at mid-afternoon snacks compared with early group (56.3%, 95%CI 52.4- 60.2 vs. 47.2%, 95%CI 43.5- 50.8). The study findings suggest that morning preference appears to promote healthier breakfast, lunch, and afternoon snack patterns, whereas later sleep timing may pose challenges in maintaining healthy patterns at these meals/snacks.

Ultra-processed food consumption is associated with the acceleration of biological aging in the Moli-sani Study

BackgroundHealthy diets have been inversely associated with biological aging. However, the nutritional content is only one aspect of the overall food health potential, and more recently, increasing attention has been paid to nonnutrient food characteristics, such as food processing. ObjectivesTo examine the association of ultra-processed food (UPF) consumption with biological aging measured by circulating blood biomarkers. MethodsCross-sectional analyses were conducted on 22,495 participants enrolled in the Moli-sani Study (2005–2010, Italy). Food intake was assessed by a 188-item food frequency questionnaire. UPF was defined according to the Nova classification and calculated as the ratio (weight ratio; %) between UPF (g/d) and total food eaten (g/d). Diet quality was assessed by the Mediterranean Diet Score (MDS; ranging 0–9). A deep neural network approach based on 36 circulating biomarkers was used to compute biological age (BA), and the resulting difference (Δage = BA − chronological age)—an index of biological aging—was tested as dependent variable in multivariable linear regression analyses including known risk factors. ResultsThe mean Δage in this population was −0.70 (standard deviation ±7.70) years. In multivariable-adjusted analyses, higher intake of UPF was associated with accelerated Δage [β = 0.34 years; 95% confidence interval (CI): 0.08, 0.61 for the last fifth compared with the first). This association was not linear (P value for overall association <0.001; P value for nonlinearity = 0.049). Inclusion of the MDS into the model slightly attenuated this association by 9.1% (β = 0.31 years; 95% CI: 0.04, 0.59). ConclusionsA diet rich in UPF was associated with an acceleration of biological aging in a large sample of Italian adults. The poor nutritional composition of highly processed foods weakly accounted for this association, suggesting that biological aging could be adversely influenced by nonnutrient characteristics of these foods.

Contribution of ultra-processed food and animal-plant protein intake ratio to the environmental impact of Belgian diets

There is growing concern about the various impacts of food consumption, both on human and planetary health. Given the context-specific nature of consumption patterns, evaluating their national-level impacts is crucial for proactive policy development. This research aims to evaluate the environmental impact of current Belgian diets, with particular attention to the contribution of food groups, ultra-processed foods (UPF), and the animal-to-plant protein ratio. The methodology consists of three key stages. Firstly, the Belgian diet was summarised, based on data from the Belgian National Food Consumption Survey 2014/2015. Secondly, the origin of the most frequently consumed foods was traced using trade databases. Finally, a cradle-to-grave life cycle assessment was conducted to determine the impact of Belgian diets on climate change, water use, land use, and fossil resource scarcity. In this third step, an iterative procedure for selecting the food items to be included in the study was performed. The iterative approach resulted in the inclusion of 227 food items in the analysis. The results indicate greenhouse gas (GHG) emissions of 4.4 [4.27–4.54] kg CO2-equivalent per person per day. Red meat (35 %), beverages (16 %), dairy products (16 %) and snacks (10 %) are identified as primary contributors to climate change. Similar results were observed for land use impacts. Water use and fossil resource scarcity exhibited different trends, with beverages being the most impactful food group. Moreover, UPF account for 50 % of the total climate change and land use impacts, with a linear relationship observed between increased UPF consumption and GHG emissions and land use. A similar linear trend is observed between the ratio of animal-to-plant protein intake and both climate change and land use impact categories. A shift from the current protein ratio to a ratio of 40/60, as suggested in the Flemish Green Deal Protein Shift has been shown to result in a reduction in GHG emissions of the diet by 31 %. This study emphasises the need to target the consumption of high-impact foods such as UPF and animal-based products. Future research will investigate the relationship between environmental and health impacts.

Evaluating the impact of the universal infant free school meal policy on the ultra-processed food content of children’s lunches in England and Scotland: a natural experiment

BackgroundThe Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren.MethodsData from the UK National Diet and Nutrition Survey (2008–2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4–7 years, n = 835) was compared to the change in an unexposed control group (8–11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups.ResultsBefore UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions.ConclusionsThis study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children’s diet.

Unhealthy Dietary Pattern Associated with Common Mental Disorders in Adults and Older Adults: A Population-based Study

Background:: Mental and behavioral disorders are influenced by biological, psychological and social factors, especially income, gender, age and family environment, indicating that physical health is directly associated with mental health. In this perspective, food consumption is highlighted as a risk factor for mental health, as healthy behaviors, along with a good quality diet, can reduce symptoms of anxiety and depression. Objective:: The objective of this a study is to investigate the association between CMD and dietary patterns, among other lifestyle and socioeconomic factors. Method:: Cross-sectional population-based and household study conducted with 1574 individuals aged over 20 years, of both sexes, residing in Teresina and Picos, Piaui, Brazil. Sociodemographic, lifestyle and food consumption data were collected. The instrument used to identify the presence of CMDs was the Self Reporting Questionnaire 20 (SRQ-20). Dietary patterns were obtained using the Principal Component Analysis method. Results:: Individuals of female sex, separated, with low education, smokers and lower level of physical activity had a higher prevalence of common mental disorders. As for the eating pattern, after adjustments, individuals who adhered to the unhealthy eating pattern had a 9% higher prevalence of CMD. Furthermore, adherence to the white meat standard represented 12% higher prevalence of CMD. Conclusion:: The results showed that, regardless of other socioeconomic and lifestyle factors, adherence to a more monotonous eating pattern in foods, characterized by the mainly consumption of animal protein and the lack consumption of foods like fruits and vegetables, as well as a less healthy one, characterized by the consumption of ultra-processed foods, increases the risk of developing CMD.

Food Insecurity Is Common in Patients with Inflammatory Bowel Disease and Is Associated with Increased Ultra-Processed Food Intake.

Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population. This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System. Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least "sometimes" in the last 12 months and 10% reporting decreased food access "often" in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, p = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, p = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support. The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality.

Food Consumption According to the NOVA Food Classification and Its Relationship with Symptoms of Depression, Anxiety, and Stress in Women.

Depression, anxiety, and stress are highly prevalent mental disorders worldwide, and food consumption can change in individuals with these conditions. We aimed to assess the food consumption of women with depressive symptoms and compare it to a control without symptoms. A cross-sectional study was conducted with 96 women, aged 18-59, allocated into two groups: control (n = 62) or depressive symptoms (n = 34). The participants underwent an anthropometric assessment, and food consumption was evaluated using a 24 h food recall and the NOVA classification. Depressive symptoms, anxiety, and stress were measured using the DASS-21 questionnaire. Anthropometric parameters did not differ between the groups. Women with depressive symptoms consumed fewer calories (p = 0.006), carbohydrates (p = 0.014), proteins (p = 0.036), and lipids (0.011) from unprocessed and minimally processed foods (UMPF) compared to the control women. A negative correlation was found between the dietary consumption energy of UMPF and symptoms of depression (r = -0.337; p = 0.001), anxiety (r = -0.262; p = 0.014), and stress (r = -0.260; p = 0.014), as well as a positive correlation between energy intake from ultra-processed foods (UPF) and symptoms of depression (r = 0.218; p = 0.042) and stress (r = 0.227; p = 0.034). Regression analysis showed that depressive symptoms accounted for 7.6% of the lower energy consumption from UMPF. Women with depressive symptoms displayed lower UMPF consumption, and this was negatively correlated with symptoms of depression, anxiety, and stress. Professional dietary advice can improve health status in these patients.

Exploring the Relationship Between Dietary Habits and Perceptions of Mental and Physical Disorders, or a Sense of Accomplishment in Japan.

Japanese dietary patterns have traditionally focused on vegetables, legumes, and fish; however, in the last few quarters of the century, the consumption of meat, processed food, and ultra-processed food has become popular. It is anticipated that these changes in the Japanese dietary environment will increase the risk of developing psychosomatic disorders. In this study, we examined the relationship between dietary habits, psychosomatic disorders, and a sense of achievement. For men and women aged 20-80 years (n = 851) living in and around Ebetsu City, Hokkaido, Japan, a questionnaire on dietary habits over the past year, including mental and physical stress and a sense of achievement, was administered. The associations between dietary habits and psychosomatic disorders or a sense of achievement were analyzed using logistic regression (n = 654). The associations between dietary habits and psychosomatic disorders differ depending on sex and age. We found that subjects who consumed more processed meat and ultra-processed food reported more psychosomatic disorders. On the other hand, those who perceived a sense of achievement consumed higher amounts of vegetables, albeit with a lower fish intake. In this study, we demonstrated that dietary habits and food ingredients are associated with mental and physical stress and a sense of achievement. Fish, which is considered to be good for the body, was mostly consumed by subjects who experienced mental and physical stress. These data indicate that highly stressful conditions may encourage fish consumption, as the body needs to mitigate psychosomatic disorders.