No abstract

Ultra-processed food (UPF) consumption have increased in the world during the last decades since they are hyper-palatable, cheap and ready-to-consume products. However, uncertainty exists on their impact on health. We conducted a systematic review and meta-analysis evaluating the association of UPF consumption with the all-cause mortality risk. Five bibliographic databases were searched for relevant studies. Random effects models were used to calculate pooled relative risks (RR) and 95% confidence intervals (CI). Of 6,951 unique citations, 40 unique prospective cohort studies comprising 5,750,133 individuals were included. Publication date of the included studies ranged from 1984 to2021. Compared to low consumption, highest consumption of UPF (RR=1.29, 95% CI 1.17-1.42), sugar-sweetened beverages (SSB) (RR=1.11, 95% CI, 1.04-1.18), artificially sweetened beverages (ASB) (RR=1.14, 95% CI, 1.05-1.22) and processed meat/red meat (RR=1.15, 95% CI, 1.10-1.21) were significantly associated with increased risk of mortality. On the contrary, breakfast cereals were associated with a lower mortality risk (RR=0.85, 95% CI, 0.79-0.92). Conclusion: This meta-analysis suggests that high consumption of UPF, SSB, ASB, processed meat and processed red meat might increase all-cause mortality, while breakfast cereals might decrease it. Future studies are needed to address lack of standardized methods in UPF categorization.

The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I2 statistics and the chi-squared test. Study quality was assessed using the Newcastle–Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03–14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD −3.0 kg, 95% CI −5.9, −0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm2 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD −0.9 kg/mg2, 95% CI −1.4, −0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.