Adherence to Mediterranean diet is inversely associated with the consumption of ultra-processed foods among Spanish children: the SENDO project

Abstract

Objective: To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake. Design: Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index. Setting: Spain. Participants: Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis. Results: 74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption. Conclusions: Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

“…Overall, we found a large variability in the percent of TEI obtained from UPF in the different countries, with the United States and United Kingdom being the countries with the highest percent of TEI from UPF, and Mediterranean countries such as Italy showing the lowest level (~10% of TEI). These results are in line with previous evidence suggesting that adherence to the Mediterranean diet is inversely associated with UPF consumption [ 20 ]. This is further confirmed by findings showing that the highest tertiles or quartiles of UPF intake are associated with the lowest adherence to the Mediterranean diet [ 44 , 55 ].…”

“…On average, the age of participants was 38.9 years, although half of the studies did not report this information. Fifteen studies focused only on children [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], seven on adolescents [31][32][33][34][35][36][37], five on pregnant women [38][39][40][41][42], and three on older subjects [43][44][45], whereas others focused on an adult population or on 2 target groups. Overall, 58.8% of participants were women.…”

Influence of Ultra-Processed Foods Consumption on Redox Status and Inflammatory Signaling in Young Celiac Patients

“…In our study, the adherence to the MD was inversely related to the intake of UPF, in a similar way to that described previously [54]. Notwithstanding, small differences were found regarding dietary habits between CD children according to UPF intake.…”

In This Issue: Ultra-processed food and health

“…For each two-point increment in the KIDMED score (range −4 to þ12), children consumed 3•1% (95 % CI 2•1, 4•0) less energy from ultraprocessed foods. Maintaining a traditional diet was identified as a way to avoid ultra-processed foods (7) . In southern Brazil, the daily frequency of consuming ultra-processed foods was associated with the risk of dental caries.…”

“…The remaining five studies were in children (7)(8)(9)(10)(11) or related to foods targeted to children (12) . In Spanish children with a mean age of 5•3 (SD 1•0) years, dietary intakes were collected using FFQ, foods classified according to the NOVA system and adherence to a Mediterranean style diet assessed by the KIDMED index.…”