Evaluating intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model

Machado, Priscila Pereira; Cediel, Gustavo; Woods, Julie; Baker, Phillip; Dickie, Sarah; Gomes, Fábio da Silva; Scrinis, Gyorgy; Lawrence, Mark

doi:10.1007/s00394-021-02740-8

Cited by 10 publications

(8 citation statements)

References 40 publications

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“…UPF products are typically high in at least one, and often more, of the so-called nutrients-to-limit (added sugars, sodium, saturated and trans-fats and energy density), and are relatively deficient in nutrients-to-promote (such as fibre and micronutrients) 5,6 . For example, 94% of UPF products surveyed in Australia were found to have excessive quantities of one or more critical nutrients based on the Pan-American Health Organization Nutrient Profiling Model 7 .…”

Section: The Nutri-biochemical Levelmentioning

confidence: 99%

From ultra-processed foods to ultra-processed dietary patterns

Scrinis

Monteiro

2022

Nat Food

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Section: The Nutri-biochemical Levelmentioning

confidence: 99%

From ultra-processed foods to ultra-processed dietary patterns

Scrinis

Monteiro

2022

Nat Food

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“…Studies outside of the UK have compared the NOVA classification with nutrient indices such as the Nutrient Rich Food Index (22) , FOPL tools such as Nutri-Score or MTL or nutrient profiling models such as those by the WHO (23)(24)(25)(26)(27)(28) . Such studies find an inverse, partial association between ultra-processed food intake and dietary quality, or typically poorer FOPL profiling in ultra-processed foods compared with minimally processed foods, but also find that not all ultra-processed foods are nutritionally inferior.…”

mentioning

confidence: 99%

Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling

Dicken,

Batterham,

Brown

2024

Br J Nutr

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UK front of package labelling (FOPL) informs consumers on the nutrient content of food. However, FOPL does not consider food processing, and with the UK government being urged to act on ultra-processed food (UPF), whether UPF should be added to FOPL is unclear. This study compared food and drink in the UK National Diet and Nutrition Survey (NDNS) Intake24 database based on FOPL, nutrient content and NOVA classification, to understand whether UPFs are covered by dietary recommendations for foods high in fat, salt, and sugar (HFSS). NDNS items were coded into minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF according to the NOVA classification, and FOPL traffic lights. UPFs contained greater energy, fat, saturated fat (SF), total sugar (TS), and salt than MPF. UPFs had a greater odds of containing red FOPL and an unhealthier overall FOPL score (odds ratio (OR):4.59 [95%CI:3.79,5.57]; OR:7.0 [95%CI:6.1,8.2] respectively) and lower odds of containing green FOPL (OR:0.05 [95%CI:0.03,0.10]), compared with MPFs. For items with no red FOPL, UPFs still contained greater energy, fat, SF, TS and salt than MPFs. However, several UPFs have healthier FOPL scores. UPFs had an unhealthier nutritional profile and FOPL score than MPFs. For items with no red FOPL, UPFs still had an unhealthier profile than MPFs, with a higher energy density. Importantly, not all UPFs were unhealthy according to FOPL. These results indicate partial overlap between FOPLs, nutrient content and NOVA classification of UK food and drink products, with implications for UK food and drink labelling.

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“…These differences include poorer nutrient profiles, the displacement of non-ultra-processed foods from the diet, and alterations to the physical structure of consumables through intensive ultra-processing. More specifically, diets rich in ultra-processed foods are associated with markers of poor diet quality, with higher levels of added sugars, saturated fat, and sodium; higher energy density; and lower fibre, protein, and micronutrients 656. Ultra-processed foods displace more nutritious foods in diets, such as fruits, vegetables, legumes, nuts, and seeds,6 resulting in reduced intakes of beneficial bioactive compounds that are present in these foods, including polyphenols or phytoestrogens such as enterodiol 5758.…”

Section: Discussionmentioning

confidence: 99%

Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses

Lane,

Gamage,

et al. 2024

BMJ

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108

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ObjectiveTo evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.DesignSystematic umbrella review of existing meta-analyses.Data sourcesMEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.Eligibility criteria for selecting studiesSystematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality.ResultsThe search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.ConclusionsGreater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research.Systematic review registrationPROSPERO CRD42023412732.

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Evaluating intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model

Cited by 10 publications

References 40 publications

From ultra-processed foods to ultra-processed dietary patterns

From ultra-processed foods to ultra-processed dietary patterns

Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling

Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses

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