Ultra-processed Foods Research Articles

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

Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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

Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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

Background. 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. Methods. 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). Results. 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. Conclusions. 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.

Obesogenicity perception of food environments in adults: A cross-sectional study in urban areas of Santiago, Chile.

In Chile, there is a high prevalence of obesity, and most people have an inadequate quality of food. Food environments can constitute barriers that prevent healthy food choices and lead to overweight and obesity, as well as diet-related non-communicable diseases. There are international instruments that allow the characterization of food environments. In Chile, there are no studies on the perception of food environments. This study aimed to characterize the perception of obesogenicity of food environments in the urban Chilean population using an instrument previously validated in Chile. This is a cross-sectional study with probabilistic sampling. The "Perceived Nutrition Environment Measures Survey", based on the Chilean model of food environments, was applied to 256 participants from two urban communities of the Metropolitan Region. Scores were calculated for the instrument items, which allowed calculating scores by environments included in the Chilean model of Food Environments. Negative scores were related to a higher obesogenic level. The results show that the domestic food environment is perceived as less obesogenic (median of 15.8 points), with more than 90% of households having fruits, vegetables, and legumes, even though the supply food environment was negative (median -0.19 points). However, about 50% of households had ultra-processed foods. The street food environment was perceived as the most obesogenic (median -1.91 points), with more than 60% of the participants indicating difficulty finding healthy options. According to the level of obesogenicity of the environments studied, it is necessary to have public policies that improve them and ensure the availability and physical and economic access to healthy food, particularly in the food supply and public road environments.

Gastrointestinal fate of proteins from commercial plant-based meat analogs: Silent passage through the stomach, oxidative stress in intestine, and gut dysbiosis in Wistar rats.

Plant-based meat analogs (PBMAs) are common ultra-processed foods (UPFs) included in the vegan/vegetarian diets as presumed healthy alternatives to meat and meat products. However, such health claims need to be supported by scientific evidence. To gain further insight into this topic, two commercial UPFs typically sold as meat analogs, namely, seitan (S) and tofu (T), were included in a cereal-based chow and provided to Wistar rats for 10weeks. A group of animals had, simultaneously, an isocaloric and isoprotein experimental diet formulated with cooked beef (B). In all cases, experimental chows (∼4kcal/g feed) had their basal protein concentration increased from 14% to 30% using proteins from S, T, or B. Upon slaughter, in vivo protein digestibility was assessed, and the entire gastrointestinal tract (digests and tissues) was analyzed for markers of oxidative stress and untargeted metabolomics. Metagenomics was also applied to assess the variation of microbiota composition as affected by dietary protein. Diets based on PBMAs showed lower protein digestibility than those containing meat and promoted an intense luminal glycoxidative stress and an inflammatory intestinal response. The fermentation of undigested oxidized proteins from T in the colon of Wistar rats likely led to formation of mutagenic metabolites such as p-cresol. The presence of these compounds in the animal models raises concerns about the potential effects of full replacement of meat by certain PBMAs in the diet. Therefore, future research might target on translational human studies to shed light on these findings.

A review on dietary approaches to enhance calcium intake among adolescents

Adolescence is one of the most important milestones in the life cycle stages, in which each individual undergoes various physiological and psychological changes. This period is considered one of the important stages of nutritional vulnerability. Calcium needs are elevated due to intensive bone and muscular development. Calcium acts as one of the vital minerals for bone mineralization during childhood and adolescence that primarily needs to be driven through adequate dietary sources. Globally, calcium intake in all age groups including adolescents has lowered due to changing food patterns which have highly tilted towards a high intake of ultra-processed foods. This review draws attention to enhanced calcium intake through healthy dietary measures.

Mediterranean Diet, ultra-processed food consumption and semen quality in healthy young men

Abstract Background Diet quality can have beneficial effects on male reproductive health, although studies are still limited, and little is known on the potential impact of ultra-processed foods (UPFs) on semen quality parameters. Methods A cross-sectional analysis was run on 126 participants (mean age 20.0 ± 1.2 y) from the FAST randomized controlled trial in 2018-2019. Food intake was assessed through a FFQ. UPF was defined following the Nova classification and calculated as the ratio (weight ratio) between UPF (g/d) and total food (g/d). Adherence to the Mediterranean Diet (MD) was ascertained by the Mediterranean Diet Score (MDS). The semen analyses were performed using a microscope for optical evaluation with a Makler counting chamber and two automated semen analysers. The primary outcomes were sperm volume, concentration, motility and morphology. A hierarchical mixed model approach was utilized to accommodate the within-subject correlation arising from the triple temporal repetition of measurements. Results Highest UPF consumption (Q4), compared to lowest (Q1), was associated with lower sperm concentration (β=-54.1×106 spz./ml; 95%CI: -92.9 to -15.4; p-trend=0.002 across quarters), and progressive motility (β=-14.2%; 95%CI: -28.2 to -0.09; p-trend=0.036). The percentage of cells with normal morphology tended to be reduced in young men consuming more UPF compared to lowest intake (β=-2.93%; 95%CI: -6.22 to 0.37; p-trend=0.071). The MDS was not associated with any of the parameters under study. Conclusions A larger dietary share of UPF was inversely associated with sperm concentration and progressive motility in young men of reproductive age. MD adherence was not associated with semen quality parameters, and this is possibly due to the low variability of MD adherence in this sample. Dietary recommendations for improving sperm health should prioritize limiting UPF in the diet. Key messages • Ultra-processed food (UPF) intake was unfavourably associated with semen quality parameters amongst young men. • Dietary recommendations for improving sperm health should recommend limiting UPF.

Investigating the diverse role of ultra-processed foods on cardiometabolic multimorbidity: Highlights from the ATTICA prospective study (2002-2022)

Abstract Background/Introduction The role of ultra-processed foods (UPF) on multimorbidity is currently unknown with limited research implying the existence of complex associations among the diverse UPF categories. Purpose The aim of the present work was to investigate the association of total and subgroup intake of UPF with cardiometabolic multimorbidity, after twenty years of observation, in a Mediterranean region. Methods In 2001-2002, n=3,042 free-of-cardiovascular disease (CVD) men and women from Attica, Greece, were recruited. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. The NOVA Food Classification system was used to assign the food products as UPF using a standard methodology. The food products assigned as UPF were further grouped as "bread and cereals", "spreads and sauces", "sweets and desserts", "artificially and sugar-sweetened beverages", "processed meat products" and "savory snacks". Cardiometabolic multimorbidity was defined as the co-occurrence of two cardiometabolic diseases i.e., type 2 diabetes and CVD within a 20-year follow-up period in a sample of n=1,846 participants with available data. Results The median consumption level of UPFs was 26.6 (16.3) servings/week contributing to around 40% of participants total daily energy intake. Over the 20–year follow–up period, n=231 cases of cardiometabolic multimorbidity were recorded. Ranking from 1st tertile (lower intake– 11.8 mean servings/week) to 2nd tertile (23.3 mean servings/week) and 3rd tertile (44.7 mean servings/week) regarding the consumption level of UPF, 20-year cardiometabolic multimorbidity was 9.5%, 13.4% and 14.7% respectively. Multi-adjusted analysis revealed that one standard deviation (SD) increase in UPF intake (servings/week) or in contribution of UPFs to total energy intake (% total energy intake) was associated with 26% [Odds ratio (OR)=1.26, 95% Confidence Interval (95%CI) (1.17–1.85)] and 29% higher risk of cardiometabolic multimorbidity [OR=1.29, 95%CI (1.08–1.69)]. Among UPF subgroups, only in case of artificial and sugar-sweetened beverages [OR=1.06, 95%CI (1.02–1.13)] as well as spreads and sauces [OR=1.06, 95%CI (1.02–1.13)] a positive association was observed. In case of breads and cereals an inverse association was observed [OR=0.95, 95%CI (0.92–0.98)]. In the rest categories even if a positive trend was observed (all ORs&amp;gt;1) significance was not reached (all p-values&amp;lt;0.05). Conclusion A dose-response relationship between UPF consumption and elevated risk of cardiometabolic multimorbidity was emerged. However, the diverse categorization of UPFs accompanied by the contradicting associations revealed herein among the different subcategories of UPFs could imply the need to return to the evaluation of foods more on the basis of their nutritional role and less on the basis of their degree of processing. The nation context accompanied by specific dietary habits should also be taken into consideration.

Ultra-processed food consumption and risk of coronary heart diseases: UK Whitehall II cohort study

Abstract In recent decades, ultra-processed foods (UPFs) intake has increased drastically, sparking concerns about their potential impact on cardiometabolic diseases. However, large-scale cohort studies tracking UPF consumption at multiple time points remain limited. This study explores the prospective association between repeated measures of UPF intake and the risk of coronary heart disease (CHD), along with its secondary endpoints, within the UK Whitehall II study. The analytical sample tracked 7,138 midlife British participants without CHD from baseline. UPF consumption was measured using validated food frequency questionnaire (127 items) and classified by the NOVA system during three phases: 1991/1994 (phase 3), 1997/1999 (phase 5), and 2002/2003 (phase 7). This study assessed the onset of CHD and its secondary endpoints, including CHD and all-cause mortality, through medical exams and hospital records up to 2016 and 2021, respectively. Cox proportional hazards regression models adjusted for socio-demographics, lifestyle factors and total energy intake were used to explore the prospective association between cumulative average UPF intake (in quintiles) and CHD outcomes. During a median follow-up of 13 and 19 years, 589 cases and 1,314 deaths were documented. In multivariable adjusted cox models, the highest UPF consumption quintile versus the lowest quintile was associated with higher CHD incidence [HR:1.26; 95% Confidence Interval (CI): 1.02-1.55; p = 0.03]. Additional adjustment of total energy intake increased the CHD risk by 28% [HR:1.28; 95% CI: 1.03-1.58; p = 0.02]. No significant relationships were found between cumulative average UPF intake and CHD or all-cause mortality. In UK midlife adults, higher UPF intake is prospective associated with increased CHD risk. Although additional research is warranted, these findings emphasize the importance of public awareness and food policy interventions to reduce UPF intake for alleviating the population burden of CVD. Key messages • Our study suggests the need for increased efforts to implement population wide strategies on regulating food processing, such as taxation and front of package warning labelling of UPF. • Our study emphasizes UPF’s role in cardiovascular prevention, highlighting the need for nutrition counseling on UPF consumption for those at risk of CVD.

Factors associated with the consumption of ultra-processed among Brazilian and Portuguese pregnant

Abstract Considering the recent evidence about the negative effect of the consumption of ultra-processed foods (UPF) on current and future generations, and pointing to the development of public food policies adapted to the needs of pregnant women, it is important to identify the factors associated with high consumption of UPF. Cross-sectional comparative study that used data from: 1) a randomized controlled clinical trial conducted with pregnant women treated at Health Units in a city in São Paulo (n = 350), Brazil; and 2) the National Dietary and Physical Activity Survey 2015-2016, Portuguese pregnant women (n = 226). Two 24-hour recall surveys were collected. The UPF were classified according to the Nova. Usual consumption was estimated using the Multiple Source Method software. The percentage of energy coming from UPF was calculated using the mean (±SD) and 95%CI. Adjusted and crude linear regression models were used. The analysis were conducted in SPSS (version 21), considering p &amp;lt; 0.05 as significant. The average age of the total sample was 29.4(±6.3) years and the BMI corresponded to 27.8(±3.4)kg/m². The average daily energy consumption from UPF among Brazilian pregnant women was 449.6(±207.6) kcal, representing 24.2(±8.8)% of the total energy consumed on a usual day; among Portuguese women the average corresponded to 484.2(±242.4)kcal and 22.3(9.3)%, respectively. In crude and adjusted linear regression models, the participation of UPF in total energy was higher among single Brazilian pregnant women compared to married women (3.2[0.8-5.5]p=0.009); Among Portuguese women, an inverse relationship was observed between weekly physical activity (PA) ≥150 minutes and UPF energy consumption (-3.2[-6.0 - -0.3]p= 0, 03). In the studied pregnant women, results showed that being single and practicing less than 150 minutes of PA weekly were factors associated with greater consumption of UPF, characterizing a priority group to receive nutritional interventions during prenatal care. Key messages • Public policies and strategies to reduce the consumption of ultra-processed foods during pregnancy. • Promotion of healthy lifestyle habits and impact on current and future health.

Determinants of the consumption of ultra-processed foods in the Brazilian population.

This article aims to evaluate the sociodemographic determinants of ultra-processed foods (UPF) consumption in the Brazilian population ≥ 10 years of age. The study used data from the personal and resident food consumption module of the Family Budget Surveys, grouping foods according to the NOVA classification of food processing. The classification and regression tree (CART) was used to identify the factors determining the lowest to highest percentage participation of UPF in the Brazilian population. UPF accounted for 37·0 % of energy content in 2017-2018. In the end, eight nodes of UPF consumption were identified, with household situation, education in years, age in years and per capita family income being the determining factors identified in the CART. The lowest consumption of UPF occurred among individuals living in rural areas with less than 4 years of education (23·78 %), while the highest consumption occurred among individuals living in urban areas, < 30 years of age and with per capita income ≥ US$257 (46·27 %). The determining factors identified in CART expose the diverse pattern of UPF consumption in the Brazilian population, especially conditions directly associated with access to these products, such as penetration in urban/rural regions. Through the results of this study, it may be possible to identify focal points for action in policies and actions to mitigate UPF consumption.

Ultra-processed food intake and type 2 diabetes: A dose-response meta-analyses of prospective studies

Abstract Studies suggested a positive association between ultra-processed food (UPF) intake and risk of type 2 diabetes (T2DM). However, the magnitude of association varies across studies due to differences in population characteristics and methodological issues. It is also unclear about the exact shape of the association and whether the association is independent of diet quality and adiposity. We conducted a dose-response meta-analysis of prospective studies to summarize the association between UPF intake and T2DM risk. PubMed/MEDLINE, Web of Science, and Embase were searched through Jan. 2024 to identify relevant studies. Using random-effects models, summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated for each of the following unit increment in UPF intake: 10% (of total g/d), 100-g/d, and 1-serving/d. A non-linear dose-response meta-analysis was conducted using restricted cubic spline analysis. After screening 569 publications, 12 prospective cohort studies were included in this study. The summary RRs associated with every 10%, 100-g, and 1-serving increment in UPF intake were 1.13 (95% CI = 1.10-1.16), 1.05 (95% CI = 1.03-1.06), and 1.04 (95% CI = 1.03-1.05), respectively. The positive associations remained statistically significant after additional adjustment for diet quality, BMI, and total energy intake. The dose-response curve for g/d of UPF intake suggested evidence of nonlinearity (p-nonlinearity=0.0005), showing a steeper increase in risk at UPF intake &amp;gt;300 g/d. However, evidence for non-linearity was not observed with % and serving/d of UPF intake. The association did not significantly vary by method and timing of UPF assessment. Higher summary RRs were observed among studies from Europe and North America compared with those from other countries (p-heterogeneity=0.048). Our data suggest that higher UPF intake may increase T2DM risk, independent of diet quality and adiposity. Key messages • Higher intake of ultra-processed food is positively associated with the risk of type 2 diabetes. • Public health strategies should encourage healthier dietary choices by emphasizing reduction of UPF intake in dietary guidelines and implementing regulations on manufacturing and labeling of UPF.

Changing the environment: Removing HFSS items in prominent areas of stores in Nottinghamshire

Abstract This study examines the change in exposure to high-fat, salt, or sugar products (HFSS) after the implementation of a policy restricting the placement of HFSS items in prime locations in England that came into legislation in October 2022. 132 observations were conducted in 2022 and 2023, using a food environment survey. Supermarkets (SM), chain convenience stores (CSS), and independent convenience stores (ICS) were observed in the highest and lowest socioeconomic districts (SED) in Nottinghamshire. Descriptive statistics were used to analyse changes in exposures in prime locations by product category, the policy’s inclusion criteria, the Food Standard Agency’s Nutrient Profile Score (NPS), and the Nova classification. Exposure defined as is the presence of a product at a prime location in stores. A decrease in exposure to restricted products in both SED in SM and CCS was observed. No notable changes were observed in the ICS due to their exemption from the policy. In all SM, the observed exposure to products restricted by the policy was reduced from 39% to 14%. The study found that the policy was successful in reducing exposure to high-sugar products such as biscuits and chocolate. NPS and NOVA showed that exposure rates were notably higher in less healthy and ultra-processed food (UPF) categories compared to the exposure to products restricted due to the policy’s exemption criteria. Exposure to alcohol products increased after the policy’s implementation, with a 20-percentage point increase in alcohol exposure in all SM checkout areas. The study suggests that the policy may have narrowed the differences in environments between the SEDs, highlighted by the findings in the ICS, whereby exposure to less healthy products was higher in the lower SED. The policy also created an opportunity for the alcohol industry to increase its exposure. Shortfalls in the policy’s design were identified through the use of the NPS and Nova classification system. Key messages • Despite the equitable outcomes in socioeconomic districts, loopholes in policy design allow the alcohol industry to exploit prime locations and undermine health objectives. • Policy success is evident in HFSS reduction; however, continued exposure to HFSS items exempt from the policy, and UPF products highlight policy design flaws that undermine health objectives.

The Food industry barrier to achieving the SDGs

Abstract The presentation will use the food industry and the model of the commercial determinants of health to illustrate how commercial actors are a major barrier to progress towards the SDGs. Ultra-processed foods, whose consumption is linked to ill-health, are indeed aggressively marketed - thus directly posing a barrier to progress towards SDG 3 (health and well-being). The industry also uses its corporate political activity to prevent the introduction of measures that limit the consumption of such harmful products and halt harmful practices. SDG 17, which promotes partnerships for the goals, is in direct contradiction with these realities. The presentation will also discuss why the current political-economic system needs to be reformed. The presentation will end with a discussion on solutions, including pitfalls if we are to address the commercial determinants of health for a better food system.