Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies

Askari, Mohammadreza; Heshmati, Javad; Shahinfar, Hossein; Tripathi, Nishant; Daneshzad, Elnaz

doi:10.1038/s41366-020-00650-z

Cited by 306 publications

(257 citation statements)

References 50 publications

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“…Although, food processing is integral to feeding the worlds growing population, the consumption of ultraprocessed foods has been associated with a deterioration in diet quality and non-communicable disease risk. [3][4][5][6][7][8][9][10] Several classification systems have been proposed to classify foods according to their degree of processing [11][12][13] of which What this paper adds ► WHO has recently highlighted that the processing of foods is often coupled with a decline in the nutritional profile of the diet. ► Classification systems have been created to aid categorisation of foods according to the grade at which they are processed.…”

Section: Introductionmentioning

confidence: 99%

Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

Griffin

AlBaloul

Kopytek

et al. 2021

BMJNPH

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ObjectiveTo examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort.DesignCross-sectional.SettingOccupational cohort.Participants53 163 British police force employees enrolled (2004–2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study.Main outcome measuresA CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake.ResultsIn this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=−0.32, p<0.001), fibre (r=−0.20, p<0.001) and protein (r = −0.40, p<0.001) and positively correlated with fat (r=0.18, p<0.001), saturated fat (r=0.14, p<0.001) and nmes (r=0.10, p<0.001) intake . Multivariable analysis suggests a positive association between ultraprocessed food (NOVA 4) consumption and CMR. However, this main effect was no longer observed after adjustment for diet quality (p=0.209). Findings from mediation analysis indicate that the effect of ultraprocessed food (NOVA 4) intake on CMR is mediated by diet quality (p<0.001).ConclusionsUltraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.

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Section: Introductionmentioning

confidence: 99%

Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

Griffin

AlBaloul

Kopytek

et al. 2021

BMJNPH

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“…27 A significant association between consumption of ultra-processed foods and overweight (pooled effect size: 1.33; 95% confidence interval [CI]: 1.18, 1.49, p < 0.001) and obesity (pooled effect size: 1.73; 95% CI: 1.36, 2.20, p < 0.001) was reported. 27 This result is consistent with a similar systematic review which reported a significant association between the highest ultra-processed food consumption and increased risk of overweight and obesity in 73,169 adults (odds ratio: 1.39, 95% CI: 1.29, 1.50; p < 0.0001, I 2 ¼ 0%, p ¼ 0.47). 28 This review also reported statistically significant associations between highest ultra-processed food consumption and an increased risk of high waist circumference or abdominal obesity, an increased risk of the metabolic syndrome and reduced highdensity lipoprotein cholesterol levels in adults.…”

Section: Global Energy Imbalance: a Dietary Perspectivementioning

confidence: 97%

Diet Quality and Its Effect on Weight Gain Prevention in Young Adults: A Narrative Review

2020

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Global environmental and societal changes have resulted in an increased consumption of energy-dense foods contributing to escalating obesity prevalence, with most rapid weight gain occurring in young adults. Diet is one major modifiable factor contributing to escalating obesity prevalence. Understanding overall diet quality of populations at high risk for weight gain and obesity development, including young adults, provides evidence of dietary intakes, dietary patterns, and associated behaviors, to inform the development of targeted interventions aimed at the prevention of weight gain. This narrative review synthesizes the current evidence of the association between diet quality and weight gain in young adults. Overall, there is a consistent direction of association between improved diet quality and reduced weight gain in adults. This demonstrates the potential of small improvements in diet quality over time as a probable contributor to minimizing weight gain in young adults. Future research evaluating environmental nutrition policies with associated change in diet quality and prospective weight change in population-based studies is warranted to determine their longer-term impact in improving overall diet quality as one strategy to halt escalating obesity prevalence rates.

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“…This is an instrument that was innovated by using NOVA as a technical framework, since this classification also guides the recommendations of the Dietary Guidelines for the Brazilian Population. Additionally, there is growing evidence associating the consumption of ultra-processed foods, one of NOVA’s groups, with negative health outcomes, such as chronic noncommunicable diseases, overweight, and obesity [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Consumer Food Environment Healthiness Score: Development, Validation, and Testing between Different Types of Food Retailers

Borges

Gabe

Jaime

2021

IJERPH

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The aim of this study was to develop and validate a scoring system, based on AUDITNOVA, to assess the healthiness of the consumer food environment, considering food availability, price, advertising, and placement strategies. Audited data of 650 food retailers were used to develop, validate, and test the consumer food environment healthiness score. To compose the score, the reference was the Dietary Guidelines for the Brazilian Population. The total and subscores were standardized for a scale from 0 to 100. Construct validity was assessed using the Kruskal–Wallis Dunn tests. Cronbach’s alpha coefficients were calculated to determine the consistency of the scores. The median score was 33.7 (p25 = 26.9; p75 = 42.1). The public and private specialized indoor fresh food markets showed the highest medians; otherwise, bakeries and food retailers with the predominant sale of ultra-processed foods showed the lowest. The score was able to satisfactorily classify the extreme food retailer groups by the predominant sale of fresh or minimally processed foods and the predominant sale of ultra-processed foods. The results of Cronbach’s alpha showed excellent internal consistency (α = 0.91). The score helped to provide an overall assessment of consumer food environment healthiness and was able to classify food retailer groups as healthy and unhealthy according to the degree of processing of the available foods.

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Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies

Cited by 306 publications

References 50 publications

Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

Diet Quality and Its Effect on Weight Gain Prevention in Young Adults: A Narrative Review

Consumer Food Environment Healthiness Score: Development, Validation, and Testing between Different Types of Food Retailers

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