Assessment of the contribution of industrially processed foods to salt and iodine intake in Thailand

Iodization of food grade salt has been mandated in Thailand since 1994. Currently, processed food consumption is increasing, triggered by higher income, urbanization, and lifestyle changes, which affects the source of salt and potentially iodized salt among the population. However, adequate information about the use of iodized salt in processed foods in Thailand is still lacking. Therefore, this study aimed to assess iodine intake through salt-containing processed foods and condiments which were identified using national survey data. Potential iodine intake from iodized salt in food products was modelled using consumption data and product salt content from food labelling and laboratory analysis. Fish sauce, soy sauce and seasoning sauces (salty condiments) have alternative regulation allowing for direct iodization of the final product, therefore modelling was conducted including and excluding these products. Daily salt intake from household salt and food industry salt (including salty condiments) was estimated to be 2.4 g for children 0–5 years of age, 4.6 g for children 6–12 years of age, and 11.5 g for adults. The use of iodized salt in processed foods (excluding salty condiments) met approximately 100% of the estimated average requirement (EAR) for iodine for non-pregnant adults and for children 6 to 12 years of age, and 50% of the EAR for iodine for children aged 0 to 5 years of age. In all cases, iodine intake from processed food consumption was greater than from estimated household iodized salt consumption. Findings suggest that iodized salt from processed foods is an important source of iodine intake, especially in adults. The use of iodized salt by the food industry should be enforced along with population monitoring to ensure sustainability of optimal iodine intake. Currently, the addition of iodine into fish sauce, soy sauce and seasoning sauces has an important role in achieving and sustaining optimal iodine intake.

Download Full-text

Iodine Intake through Processed Food: Case studies from Egypt, Indonesia, the Philippines, the Russian Federation and Ukraine, 2010-2015

10.20944/preprints201707.0056.v1 ◽

2017 ◽

Author(s):

Jacky Knowles ◽

Frits van der Haar ◽

Magdy Shehata ◽

Gregory Gerasimov ◽

Bimo ◽

...

Keyword(s):

Case Studies ◽

Russian Federation ◽

Food Industry ◽

Daily Intake ◽

Iodine Intake ◽

The Philippines ◽

Iodized Salt ◽

Potential Contribution ◽

Processed Food ◽

The Russian Federation

The current performance indicator for universal salt iodization (USI) is the percent of households using adequately iodized salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the GAIN-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodized salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodized salt in selected food products was modelled according to the formula: Quantity of salt per unit of food product x minimum regulated iodine level of salt at production x average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodized salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodized salt use in the food industry in order to achieve optimal population iodine status.

Download Full-text

Processed Foods as an Integral Part of Universal Salt Iodization Programs: A Review of Global Experience and Analyses of Bangladesh and Pakistan

Food and Nutrition Bulletin ◽

10.1177/15648265120334s303 ◽

2012 ◽

Vol 33 (4_suppl3) ◽

pp. S272-S280 ◽

Cited By ~ 12

Author(s):

Rebecca Spohrer ◽

Greg S. Garrett ◽

Arnold Timmer ◽

Rajan Sankar ◽

Basanta Kar ◽

...

Keyword(s):

Developing Countries ◽

Food Industry ◽

Developed Countries ◽

Iodized Salt ◽

Processed Foods ◽

Processed Food ◽

Face To Face ◽

Salt Iodization ◽

Original Definition ◽

The Impact

Background Despite the reference to salt for food processing in the original definition of universal salt iodization (USI), national USI programs often do not explicitly address food industry salt. This may affect program impact and sustainability, given the increasing consumption of processed foods in developing countries. Objective To review experience of the use of iodized salt in the food industry globally, and analyze the market context in Bangladesh and Pakistan to test whether this experience may be applicable to inform improved national USI programming in developing countries. Methods A review of relevant international experience was undertaken. In Bangladesh and Pakistan, local rural market surveys were carried out. In Bangladesh, structured face-to-face interviews with bakers and indepth interviews with processed food wholesalers and retailers were conducted. In Pakistan, face-to-face structured interviews were conducted with food retailers and food labels were checked. Results Experience from industrialized countries reveals impact resulting from the use of iodized salt in the food industry. In Bangladesh and Pakistan, bread, biscuits, and snacks containing salt are increasingly available in rural areas. In Bangladesh, the majority of bakers surveyed claimed to use iodized salt. In Pakistan, 6 of 362 unique product labels listed iodized salt. Conclusions Successful experience from developed countries needs to be adapted to the developing country context. The increasing availability of processed foods in rural Bangladesh and Pakistan provides an opportunity to increase iodine intake. However, the impact of this intervention remains to be quantified. To develop better national USI programs, further data are required on processed food consumption across population groups, iodine contents of food products, and the contribution of processed foods to iodine nutrition.

Download Full-text

Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study

Nutrients ◽

10.3390/nu12082289 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2289 ◽

Cited By ~ 5

Author(s):

María Belén Ruíz-Roso ◽

Patricia de Carvalho Padilha ◽

Diana C. Matilla-Escalante ◽

Paola Brun ◽

Natalia Ulloa ◽

...

Keyword(s):

Physical Activity ◽

Latin America ◽

Food Consumption ◽

Healthy Lifestyle ◽

Cross Sectional Study ◽

Processed Foods ◽

Processed Food ◽

Cross Sectional ◽

Consumption Data ◽

Food Consumption Data

Aim: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. Methods: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. Results: Sample of 726 adolescents, mostly females (59.6%) aged 16–19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80–4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20–0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. Conclusion: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation.

Download Full-text

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.

Download Full-text

A Survey on Salt Content Labeling of the Processed Food Available in Malaysia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072469 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2469

Author(s):

Hasnah Haron ◽

Ivy Hiew ◽

Suzana Shahar ◽

Viola Michael ◽

Rashidah Ambak

Keyword(s):

Salt Intake ◽

Salt Content ◽

Reference Value ◽

Food Products ◽

Food Group ◽

Modern World ◽

Processed Foods ◽

Processed Food ◽

Breakfast Cereal ◽

High Salt Intake

Salt content in processed foods is high, and it is usually used as preservatives, stabilizers, and color enhancers in the products. Increased consumption of processed foods in the modern world has contributed to a high salt intake and thus increased the prevalence of hypertension among Malaysian populations. Therefore, this study aimed to identify and compare salt content in processed food products available in supermarkets and determine the percentage of processed food products exceeding the reference value stated in International Product Criteria (2016). The percentage of processed food products without salt and sodium labeling was determined in this study, in which 76.5% of unlabeled processed food products were made in Malaysia, while 23.5% were imported products. The food group with the highest average salt content was gravy and sauce (3.97 g/100 g), followed by soup (2.95 g/100 g), cheese (2.14 g/100 g), meat (1.37 g/100 g), fish (1.25 g/100 g), chicken (1.20 g/100 g), vegetables (1.18 g/100 g), butter and margarine (1.13 g/100 g), breakfast cereal (0.94 g/100 g), savory snacks (0.90 g/100 g), flatbread (0.86 g/100 g), sweet snacks (0.30 g/100 g), and potato (0.29 g/100 g). In addition, 79.5% of butter and margarine products had an average salt content above the reference value stated in the International Product Criteria, followed by gravy and sauce (79.3%), vegetables (72%), soup (50%), fish (49.2%), breakfast cereal (41%), cheese (36.6%), potato (36%), savory and sweet snacks (29.1), meat (12.5%) and chicken products (2.3%). Most processed food products available in local supermarkets were high in salt content.

Download Full-text

Ultra-processed foods and early childhood caries in 0–3‐year‐olds enrolled at Primary Healthcare Centers in Southern Brazil

Public Health Nutrition ◽

10.1017/s1368980020002839 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Maurício Santos de Souza ◽

Juliana dos Santos Vaz ◽

Thais Martins-Silva ◽

Rafael Aiello Bomfim ◽

Andreia Morales Cascaes

Keyword(s):

Early Childhood ◽

Food Consumption ◽

Primary Healthcare ◽

Early Childhood Caries ◽

Controlled Study ◽

Processed Foods ◽

Processed Food ◽

Southern Brazil ◽

Primary Healthcare Centers ◽

Childhood Caries

Abstract Objective: To investigate the relationship between ultra-processed food consumption and early childhood caries. Design: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. Setting: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. Participants: Children aged 0–3 years (n 309). Results: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. Conclusions: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children’s oral health.

Download Full-text

Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study

10.21203/rs.3.rs-47440/v2 ◽

2020 ◽

Author(s):

Guo-Chao Zhong ◽

Hai-Tao Gu ◽

Yang Peng ◽

Kang Wang ◽

You-Qi-Le Wu ◽

...

Keyword(s):

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Long Term Results ◽

Processed Foods ◽

Processed Food ◽

Disease Mortality ◽

The Us ◽

Subgroup Analyses

Abstract Background: Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods: A population-based cohort of 91891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results: After an average follow-up of 13.5 years (1236049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36–1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50–1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76–1.17). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity<0.05), with a threshold effect observed at ultra-processed food consumption of 2.4 servings/day and 2.3 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction<0.05). Conclusions: High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.

Download Full-text

Association of Ultra-processed Food Consumption With Cardiovascular Mortality in the US Population: Long-term Results From a Large Prospective Multicenter Study

10.21203/rs.3.rs-47440/v1 ◽

2020 ◽

Author(s):

Guo-Chao Zhong ◽

Hai-Tao Gu ◽

Yang Peng ◽

Kang Wang ◽

You-Qi-Le Wu ◽

...

Keyword(s):

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Long Term Results ◽

Processed Foods ◽

Processed Food ◽

Disease Mortality ◽

The Us ◽

Subgroup Analyses

Abstract Background Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods A population-based cohort of 91891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results After an average follow-up of 13.5 years (1236049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.52; 95% CI, 1.39–1.67) and heart disease (HRquintile 5 vs. 1, 1.70; 95% CI, 1.52–1.89) but not cerebrovascular disease (HRquintile 5 vs. 1, 1.00; 95% CI, 0.80–1.23). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity<0.05), with a threshold effect observed at ultra-processed food consumption of 2.5 servings/day and 2.4 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction<0.05). Conclusions High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings are needed to be confirmed in other populations and settings.

Download Full-text

Il cibo per la vita

Giornale di Techniche Nefrologiche e Dialitiche ◽

10.1177/0394936219863950 ◽

2019 ◽

Vol 31 (3) ◽

pp. 207-209

Author(s):

David Mariani ◽

Alessandro Capitanini

Keyword(s):

Food Industry ◽

Food Reward ◽

Well Being ◽

Processed Foods ◽

Processed Food ◽

Nutritional Content ◽

Good Nutrition ◽

Blood Hormones ◽

Mental Well Being ◽

Bone Marrow Blood

We are what we eat Our physical and mental well-being are directly linked to what we eat and drink. The nutritional content of what we eat determines the composition of our cell membranes, bone marrow, blood, hormones, tissues, organs, skin, and hair. Lifestyle and nutrition of the humankind has undergone substantial changes during the last century. Additives and processed food have become the basis of our nutrition. Ingredients such as salt, sugar and fat are sometimes added to processed foods to make their flavour more appealing and to extend their shelf life. When the processed food industry discovered that these ingredients could be formulated to produce a state of satiety, pleasure, and sensory hedonia in those who consumed them, it extended their use to the “bliss point”, the point where the levels of saltiness, sweetness, and richness were perceived by the consumer as just right. Such modified foods can dysregulate the brain’s food reward system by increasing dopamine production, thus making the foods addictive. It is not easy to avoid these foods: the only way is to eat mainly fresh or only lightly processed foods (such as canned tomatoes and frozen vegetables). It is helpful to know which foods are healthy and what you can do to ensure you eat the healthiest diet you can. Combining a variety of foods, eating regular meals, including wholegrains, fibres, fruit, vegetables and “healthy fats”, and limiting the amount of sugar, salt and fat you eat are all recommended for good nutrition.

Download Full-text

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.

Download Full-text