Associations Between Ultra-Processed Food Intake and Cardiometabolic Health Among Diverse U.S. Adults 50 or Older

Abstract Asian American (AA) diets are naturally adapted to the NOVA dietary recommendations, favoring minimally processed foods. Yet the relationship between dietary intake and metabolic health, among AAs is largely unknown. We examined the association between ultra-processed foods and cardiometabolic health (obesity, hypertension, high cholesterol, and diabetes), among US adults 50 or older reporting a single ethnicity, using the National Health and Nutrition Examination Survey (2001-2018). From multivariable adjusted logistic regression models, the highest compared to the lowest quartile of ultra-processed food intake was associated with obesity only, among AAs (OR: 2.15, 95% CI: 1.04, 4.45), followed by non-Hispanic blacks (OR: 1.73, 95% CI: 1.40, 2.14), non-Hispanic whites (OR: 1.41, 95% CI: 1.19, 1.68), and Hispanics (OR: 1.34, 95% CI: 1.08, 1.65). AAs are more likely than other ethnic/racial groups to be obese when consuming ultra-processed foods. Cultural adaptation of current North American-focused dietary recommendations should drive AA preventive dietary recommendations.

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Abstract P181: Processed food intake is adversely associated with multiple indicators of cardiometabolic health in US adults: Findings from the National Health and Nutrition Examination Surveys (2005-2008)

Circulation ◽

10.1161/circ.129.suppl_1.p181 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Leah Lipsky ◽

Tonja Nansel ◽

Virginia Quick

Keyword(s):

Waist Circumference ◽

Food Intake ◽

Weight Status ◽

Cardiometabolic Health ◽

Processed Foods ◽

Processed Food ◽

C Reactive Protein ◽

Reactive Protein ◽

Former Smokers ◽

Never Smokers

Introduction: Reducing intake of ingredients characteristic of processed foods is vital to improving ideal cardiovascular dietary behaviors described in the American Heart Association 2020 Strategic Impact Goals. Hypothesis: We sought to develop an indicator of processed food intake and evaluate its hypothesized adverse relationships with biomarkers of cardiometabolic health in a nationally representative sample of US adults. Methods: Data from two 24 hour recalls were examined for US adults (>=18y) in NHANES (2005-2008). An index of processed food intake (PFI) was developed using the mean of the standardized (mean=0, standard deviation=1), energy-adjusted (per 1000 kcal) intakes of refined grains, processed meat, discretionary oils, discretionary solid fat, added sugar and sodium. We evaluated bivariate associations of PFI with demographics (sex, poverty-income ratio, education) and behavioral factors (smoking, nutritional supplement use). Multivariable linear regressions were used to examine associations of PFI with BMI (kg/m2), waist circumference (cm), and biomarkers for cardiometabolic health (total cholesterol, HDL-C, LDL-C, triglycerides, apo-b and c-reactive protein), adjusting for demographic and behavioral covariates. We tested for potential interactions between PFI and weight status, sex, and smoking. Results: PFI was higher in smokers than never smokers (p<.001). PFI was lower for those with at least a college degree than those with less education (p=.004) and for NH White vs. NH Black adults (p=.04). Adjusting for covariates, higher PFI was associated with greater BMI (p<.001) and waist circumference (p<.001), lower HDL-C (p<.001), and higher c-reactive protein (p=.01). Interactions (p<.05) were observed between PFI and sex for predicting BMI, and between PFI and smoking for predicting TC and HDL-C. The magnitude of associations was larger for female vs. male and for current and former smokers vs. non-smokers. No interactions were observed between PFI and weight status. Conclusion: Intake of components characteristic of processed foods is adversely associated with a variety of cardiometabolic biomarkers. Positive associations of PFI with BMI were greater for females vs. males, while associations of PFI with TC and HDL-C were greater for current and former smokers vs. never smokers. The nutritional value of dietary components of PFI is primarily restricted to energy, protein, and sodium, none of which are considered lacking in the diets of US adults. These findings underscore the rationale for encouraging replacing such components with foods that promote cardiovascular health including fruit, vegetables, whole grains, fish, legumes, nuts and seeds. Acknowledgment: This research was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.

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Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus

Cadernos de Saúde Pública ◽

10.1590/0102-311x00049318 ◽

2019 ◽

Vol 35 (4) ◽

Cited By ~ 8

Author(s):

Daniela Saes Sartorelli ◽

Lívia Castro Crivellenti ◽

Daniela Cristina Candelas Zuccolotto ◽

Laércio Joel Franco

Keyword(s):

Diabetes Mellitus ◽

Food Intake ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Food Processing ◽

Processed Foods ◽

Processed Food ◽

Logistic Regression Models ◽

The Relationship

This study aimed to investigate the relationship between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight, obesity, and gestational diabetes mellitus conditions. This is a cross-sectional study conducted among 785 adult women in singleton pregnancies (between 24th and 39th weeks of gestation) in Brazil. Usual food intake was estimated by the Multiple Source Method, using two 24-hour dietary recalls. The food groups of interest in this study were the unprocessed or minimally processed foods and ultra-processed foods. The World Health Organization criteria for the diagnosis of gestational diabetes mellitus and the Atalah criteria for excess weight were used. Adjusted multinomial logistic regression models were used to assess the relationship between energy contribution (%E) from foods with overweight and obesity conditions and, adjusted logistic regression models for gestational diabetes mellitus. In total, 32.1% participants were overweight, 24.6% were obese, and 17.7% of women were diagnosed with gestational diabetes mellitus . After adjustments, an inverse association between the highest tertile of %E from the intake of unprocessed or minimally processed foods and obesity was found [0.49 (0.30-0.79)]. Moreover, a positive association between the highest tertile of %E from ultra-processed food intake [3.06 (1.27-3.37)] and obesity was observed. No association between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight or gestational diabetes mellitus was found. The findings suggest a role of food processing in obesity but not in gestational diabetes mellitus. Further research is warranted to provide robust evidence on the relationship between the role of processed foods in obesity and gestational diabetes mellitus.

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Consumption of ultra-processed foods and the risk of overweight and obesity, and weight trajectories in the French cohort NutriNet-Santé

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003559 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Marie Beslay ◽

Caroline Méjean ◽

Benjamin Allès ◽

Thibault Fiolet ◽

...

Keyword(s):

Food Intake ◽

Confidence Interval ◽

Prospective Study ◽

Food Consumption ◽

Overweight And Obesity ◽

Processed Foods ◽

Processed Food ◽

Weight Trajectories ◽

Incident Cases

AbstractIntroductionPrevious epidemiological studies have found associations between the consumption of ultra-processed foods and the risk of obesity-related outcomes, such as post-menopausal breast cancer, cardiovascular diseases, hypertension and mortality. However, only one Spanish prospective study has explored the associations between the consumption of ultra-processed foods and the risk of overweight and obesity. The aim of this study is to investigate the associations between ultra-processed food consumption and the risk of overweight and obesity, as well as the associations between ultra-processed food consumption and weight trajectories, in middle-aged adults included in the French large scale NutriNet-Santé cohort.MethodsOverall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records, merged with a food composition database of 3300 different products. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risks of overweight and obesity were assessed using multivariable Cox proportional hazard models. Associations between ultra-processed food intake and weight trajectories were assessed using multivariable linear mixed models for repeated measures with random slope and intercept. Models were adjusted for known risk factors (sociodemographic, lifestyle, and nutritional factors).ResultsUltra-processed food intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (95% confidence interval 1.08 to 1.14); P < 0.0001, median follow-up: 4.1y, 260304 person-years) and obesity (n = 3066 incident cases; HR = 1.09 (95% confidence interval 1.05 to 1.13); P < 0.0001, median follow-up: 8.0y 365344 person-years). Higher consumers of ultra-processed foods (4th quartile) were more likely to present an increase in body mass index over time (change of BMI/time-unit in Q4 vs Q1 = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionIn this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

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Contribution of Ultra-processed Food to the Daily Food Intake of HIV-positive and HIV-Negative Women during Pregnancy

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1695738 ◽

2019 ◽

Vol 41 (10) ◽

pp. 588-596 ◽

Cited By ~ 1

Author(s):

Clarissa de Oliveira Agostini ◽

Ester Zoche ◽

Rafaela da Silveira Corrêa ◽

Eunice Beatriz Martin Chaves ◽

Helena von Eye Corleta ◽

...

Keyword(s):

Food Intake ◽

Demographic Data ◽

Caloric Intake ◽

Hiv Positive ◽

Fisher Exact Test ◽

Processed Foods ◽

Processed Food ◽

Trans Fat ◽

Positive Group ◽

Hiv Negative

Objective To assess the daily dietary intake and energy contribution of ultra-processed foods among women who are positive and negative for the human immunodeficiency virus (HIV) during pregnancy. Methods This case–control study included 77 HIV-positive and 79 HIV-negative puerperal women between 2015 and 2016. The socioeconomic and maternal demographic data were assessed, and a food frequency questionnaire (FFQ) adapted for pregnant women was applied. The Fisher exact test and the Mann-Whitney test were applied to detect differences between the groups. Linear regression was used to assess the associations between the intake of ultra-processed food and energy, macro- and micronutrients, with values of p < 0.05 considered significant. Results The HIV-positive group was older (p < 0.001) and had lower income (p = 0.016) and level of schooling (p < 0.001) than the HIV-negative group. Both groups presented similar average food intake: 4,082.99 Kcal/day and 4,369.24 Kcal/day for the HIV-positive and HIV-negative women respectively (p = 0.258).The HIV-positive group consumed less protein (p = 0.048), carbohydrates (p = 0.028) and calcium (p = 0.001), and more total fats (p = 0.003). Ultra-processed foods accounted for 39.80% and 40.10% of the HIV-positive and HIV-negative groups' caloric intake respectively (p = 0.893). The intake of these foods was associated with a higher consumption of carbohydrates (p < 0.001), trans fat (p = 0.013) and sodium (p < 0.001), as well as lower protein (p < 0.001) and fiber intake (p = 0.022). Conclusion These findings demonstrate that the energy consumption and ultra-processed food intake were similar in both groups, which reinforces the trend toward a high intake of ultra-processed food in the general population. The intake of ultra-processed food was positively associated with the consumption of carbohydrates, trans fat and sodium, and negatively associated with the consumption of protein and fiber.

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Current Intake of Ultra-Processed Foods in the U.S. Adult Population According to Education-Level and Income

Current Developments in Nutrition ◽

10.1093/cdn/nzab038_030 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 418-418

Author(s):

Filippa Juul ◽

Niyati Parekh ◽

Euridice Martinez-Steele ◽

Carlos Augusto Monteiro ◽

Virginia Chang

Keyword(s):

High School ◽

Food Intake ◽

Family Income ◽

Adult Population ◽

Processed Foods ◽

Processed Food ◽

High School Degree ◽

Poverty Threshold ◽

Socioeconomic Strata ◽

The U.S

Abstract Objectives Ultra-processed food have been associated with multiple chronic diseases, yet recent data regarding its consumption in the U.S. and potential differences in intake across population groups is lacking. We determined the intake of ultra-processed food across diverse socioeconomic strata in the U.S. adult population. Methods We performed cross-sectional analysis of dietary intake among adults (>20y, N = 9759) in the National Health and Nutrition Examination Survey (NHANES) 2015–2018. Data on dietary intake was collected by 24h dietary recall. Foods were classified as ultra-processed/non ultra-processed according to the NOVA classification. We determined intake of ultra-processed food (%kcal) in the overall sample, and stratified by education (<high school, high school degree, some college, college graduate of above) and family poverty income ratio, (<130%, 130–349% and ≥ 350% of the federal poverty threshold). Multivariable linear regression was used to assess if education and income were independent predictors of ultra-processed food intake, controlling for age, sex and race/ethnicity. Results Ultra-processed foods provided 54% of energy among U.S. adults in 2015–2018. Compared to adults without a high school degree (52%kcal), high school graduates and adults with some college education consumed significantly more ultra-processed foods (57% kcal, P = 0.022 and 57.0% kcal, P = 0.009, resp.), while college graduates consumed significantly less ultra-processed foods (49% kcal, P < 0.001). Adults with a family income of 130–349% of the federal poverty threshold consumed significantly more ultra-processed foods than adults with the lowest family income (56 vs. 54% kcal, P = 0.009). However, intake did not differ significantly between adults with low and high income (52% kcal, P = 0.817). Conclusions This study uniquely describes ultra-processed food consumption across socioeconomic groups in the U.S. population and may inform policies and intervention to reduce intakes of ultra-processed foods and prevent chronic disease outcomes. Although consumption differed across education- and income levels, ultra-processed food intake is high in all socioeconomic strata. Our results highlight the need for public health efforts to reduce ultra-processed food consumption in the U.S. Funding Sources None.

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Ultra-processed Food Consumption and Incident Frailty: A Prospective Cohort Study of Older Adults (P01-012-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz028.p01-012-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Helena Sandoval-Insausti ◽

Ruth Blanco-Rojo ◽

Auxiliadora Graciani ◽

Esther Lopez-Garcia ◽

Belén Moreno-Franco ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Food Intake ◽

Food Consumption ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Dwelling ◽

Alcoholic Beverages ◽

Processed Foods ◽

Processed Food

Abstract Objectives Ultra-processed food intake has been associated with chronic conditions. The aim of this study was to assess the relationship between ultra-processed food intake and incident frailty in community-dwelling older adults. Methods Prospective cohort study with 1822 individuals aged ≥60 who were recruited during 2008–2010 in Spain. At baseline, food consumption was obtained using a validated computerized face-to-face dietary history. Ultra-processed foods were identified according to the nature and extent of their industrial processing (NOVA classification). In 2012, incident frailty was ascertained based on Fried's criteria. Statistical analyses were performed with logistic regression and adjusted for the main potential confounders. Results After a mean follow-up of 3.5 years, 132 cases of frailty were identified. The odds ratios (95% confidence interval) for frailty across increasing quartiles of the percentage of total energy intake from ultra-processed foods were: 1.00, 1.52 (0.78–2.96), 2.98 (1.62–5.50), and 3.67 (2.00–6.73); p for linear trend: <0.001. Results were similar when food consumption was expressed as gram per day/body weight. Regarding ultra-processed food groups, the highest versus the lowest tertiles of consumption of yogurts and fermented milks, cakes and pastries, as well as non-alcoholic beverages (instant coffee and cocoa, packaged juices, and other non-alcoholic drinks, excluding soft drinks) were also significantly related to incident frailty. Conclusions Consumption of ultra-processed foods is strongly associated with frailty risk in older adults. Funding Sources Data collection was funded by the following grants: FIS PI16/1512; PI16/1460; PI16/609; PI17/1709 (State Secretary of R + D and FEDER/FSE), the ATHLOS project (EU H2020-Project ID: 635316), the SALAMANDER project (PCIN-2016-145), and the CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.

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Abstract 039: Insomnia And Short Sleep Uniquely Predict Obesity, Hypertension, And Diabetes

Circulation ◽

10.1161/circ.143.suppl_1.039 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Adam Knowlden ◽

Michael A Grandner

Keyword(s):

Regression Models ◽

Sleep Problems ◽

Population Level ◽

Cardiometabolic Health ◽

Epidemiological Evidence ◽

Logistic Regression Models ◽

Short Sleep ◽

Health And Nutrition ◽

History Of ◽

Obesity Hypertension

Background: Epidemiological evidence of short sleep’s (<6 hours) association with negative cardiometabolic health outcomes continues to mount; yet, the complex relationship between sleep and health is still not well-understood. Sleep problems, such as short sleep (SS) and insomnia (IN), are often analyzed as a singular construct at the population level; however, it has been proposed that, although these two sleep problems likely overlap, they are separate phenomena. The purpose of this study was to: (1) determine if SS and IN were independent constructs; and to (2) evaluate whether SS and IN predicted obesity, hypertension, and diabetes. Methods: Analyses were based on the 2015-2016 National Health and Nutrition Examination Survey (NHANES). NHANES employs a complex, multistage, probability sampling design to survey a representative sample of non-institutionalized U.S. adults (≥18 years). Data related to short (<6), normal (7-8), and long (9+) sleep duration, insomnia (present: mild, moderate, severe), hypertension (present: previous hypertension/hypertension medications/blood pressure in the hypertensive range), and diabetes (present: history of diabetes/fasting blood sugar of 130+) were extracted for analysis. Age, sex, and obesity (body mass index, 30.0+) were entered as covariates into the models. Results: Among the subjects, 0.08% were normal sleepers with IN; 0.21% were SS with insomnia; and, 0.59% had IN with SS. Table 1 summarizes the multivariate and stratified logistic regression models of SS and IN predicting obesity, hypertension, and diabetes. Conclusions: Findings from this study suggested SS and IN are independent constructs, uniquely predicting obesity, hypertension, and diabetes. SS and IN neither mediated nor moderated one another, implying these two sleep outcomes are not additive in nature, but are instead separate health problems. The distinction between SS and IN may have important epidemiological and clinical implications.

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Diet Quality Is Associated with Cardiometabolic Outcomes in Survivors of Childhood Leukemia

Nutrients ◽

10.3390/nu12072137 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2137

Author(s):

Sophie Bérard ◽

Sophia Morel ◽

Emma Teasdale ◽

Nitin Shivappa ◽

James R. Hebert ◽

...

Keyword(s):

Diet Quality ◽

Childhood Leukemia ◽

Lymphoblastic Leukemia ◽

Health Indicators ◽

Poor Adherence ◽

World Health ◽

Cardiometabolic Health ◽

Processed Foods ◽

Quality Indices ◽

Dietary Recommendations

There is little information about how diet influences the health of childhood acute lymphoblastic leukemia (cALL) survivors. This study explores the associations between diet quality indices, cardiometabolic health indicators and inflammatory biomarkers among cALL survivors. Participants were part of the PETALE study (n = 241, median age: 21.7 years). Adherence to 6 dietary scores and caloric intake from ultra-processed foods were calculated. Multivariate logistirac regressions, Student t-tests and Mann-Whitney tests were performed. We found that 88% of adults and 46% of children adhered poorly to the Mediterranean diet, 36.9% had poor adherence to the World Health Organisation (WHO) recommendations and 76.3% had a diet to be improved according to the HEI-2015 score. On average, ultra-processed foods accounted for 51% of total energy intake. Low HDL-C was associated with a more inflammatory diet (E-DIITM score) and higher intake of ultra-processed foods. A greater E-DII score was associated with elevated insulin resistance (HOMA-IR), and consumption of ultra-processed foods was correlated with high triglycerides. Circulating levels of TNF-α, adiponectin and IL-6 were influenced by diet quality indices, while CRP and leptin were not. In conclusion, survivors of cALL have poor adherence to dietary recommendations, adversely affecting their cardiometabolic health.

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Consumption of industrial processed foods and risk of premenopausal breast cancer among Latin American women: the PRECAMA study

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2021-000335 ◽

2022 ◽

pp. e000335

Author(s):

Isabelle Romieu ◽

Neha Khandpur ◽

Aikaterini Katsikari ◽

Carine Biessy ◽

Gabriela Torres-Mejía ◽

...

Keyword(s):

Breast Cancer ◽

Food Intake ◽

Latin American ◽

Oestrogen Receptor ◽

Meat Products ◽

Population Based ◽

Processed Foods ◽

Processed Food ◽

Premenopausal Breast Cancer ◽

Increased Risk

Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. No data are available in the Latin American population although the consumption of ultra-processed foods is increasing rapidly in this region.We evaluated the association of ultra-processed food intake to breast cancer risk in a case–control study including 525 cases (women aged 20–45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification.Overall, the major contributors to ultra-processed food intake were ready-to-eat/heat foods (18.2%), cakes and desserts (16.7%), carbonated and industrial fruit juice beverages (16.7%), breakfast cereals (12.9%), sausages and reconstituted meat products (12.1%), industrial bread (6.1%), dairy products and derivatives (7.6%) and package savoury snacks (6.1%). Ultra-processed food intake was positively associated with the risk of breast cancer in adjusted models (OR T3-T1=1.93; 95% CI=1.11 to 3.35). Specifically, a higher risk was observed with oestrogen receptor positive breast cancer (ORT3-T1=2.44, (95% CI=1.01 to 5.90, P-trend=0.049), while no significant association was observed with oestrogen receptor negative breast cancer (ORT3-T1=1.87, 95% CI=0.43 to 8.13, P-trend=0.36).Our findings suggest that the consumption of ultra-processed foods might increase the risk of breast cancer in young women in Latin America. Further studies should confirm these findings and disentangle specific mechanisms relating ultra-processed food intake and carcinogenic processes in the breast.

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Ultra-Processed Foods, Nutrition and Pregnancy: Characteristics of Food Consumption by HIV-Positive Women during Pregnancy

Reproductive Medicine Gynaecology & Obstetrics ◽

10.24966/rmgo-2574/100072 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1-2

Author(s):

Clarissa De Oliveira Agostini ◽

Keyword(s):

Food Intake ◽

Hiv Positive ◽

Processed Foods ◽

Physiological Changes ◽

Processed Food ◽

Daily Food Intake ◽

Hiv Positive Women ◽

Daily Food ◽

Nutritional Needs ◽

Hiv Negative

This article aims to provide a commentary on the article “Contribution of Ultra-processed Food to the Daily Food Intake of HIV-positive and HIV-Negative Women during Pregnancy”. Pregnancy causes physiological changes in the woman’s body, modifying her nutritional needs, as well as food intake.

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