Ultra-processed food consumption and associations with biomarkers of nutrition and inflammation in pregnancy: The Norwegian Environmental Biobank

Abstract

BackgroundA high consumption of ultra-processed foods (UPFs) is often associated with low nutritional quality, but data on associations with biomarkers are scarce. We aimed to explore associations between UPF intake, diet quality, and concentrations of biomarkers of nutrition and inflammation measured in mid-pregnancy.MethodsThis cross-sectional study included n = 2,984 pregnant women recruited during 2002–2008 in the Norwegian Mother, Father, and Child Cohort Study (MoBa). Concentrations of C-reactive protein (CRP) and 21 nutritional biomarkers including carotenes (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamins [α-tocopherol, γ-tocopherol, 25-hydroxyvitamin D (25-OH-D), retinol], creatinine, elements (K, Na, Co, Cu, Mn, Mo, Se, Zn), and ferritin (Fe) were measured in blood and urine collected in mid-pregnancy. Habitual diet in pregnancy was assessed using a validated semi-quantitative food frequency questionnaire. We calculated the relative (%) energy contribution of UPF to overall intake according to the NOVA classification. We also applied a diet quality index (DQI) adapted to assess adherence to Norwegian dietary guidelines (DQI; min–max: 0–110, higher score meaning higher adherence). We present summary statistics for biomarker concentrations and explored associations between UPF intake or the DQI and measured biomarkers using adjusted linear, logistic, and generalized additive regression models.ResultsUltra-processed food intake was positively associated with biomarker concentrations of vitamin E (γ-tocopherol), creatinine, K, and Na [βs: 5.6 to 17% increase in biomarker concentration per interquartile range (IQR) increase in UPF intake] and negatively associated with carotenoids (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamin A, Mo, and Se (βs: −2.1 to −18%). Inversely, high diet quality (i.e., the DQI) was positively associated with concentrations of carotenoids, vitamins [vitamin A (retinol) and D (25-OH-D)], and Se (β: 1.5 to 25%) and negatively associated with vitamin E (γ-tocopherol), creatinine, and Na (β: −4.8 to −8.3%). A weak, positive association was found between UPF and CRP (β: 5.4%, 95% CI 0.12–11%).ConclusionHigh UPF intake was associated with reduced concentrations of nutrition biomarkers in mid-pregnancy. Associations in the opposite direction were found with high adherence to the Norwegian dietary guidelines, suggesting that the two dietary scoring systems capture diet quality in a mirrored manner in this population.

Ultra-processed food consumption and risk of chronic respiratory diseases mortality among adults: evidence from a prospective cohort study

“…The current the current study also revealed notable differences in UPF consumption patterns among participants with lower family income, younger adults, overweight and people with obesity, as well as non-smokers and ex-smokers. This study aligns with previous research [41,43,44] by demonstrating that UPF consumption is inversely an inverse related to dietary quality as measured by HEI-2015, lower intake of fruits and vegetables, and positively related to total fat, cholesterol, saturated fat, and trans-fatty acid intake.…”

“…Firstly, consumption of UPF is the predominant dietary pattern, displacing healthier foods in the American diet and globally. UPF are nutritionally inferior, poor sources of essential nutrients such as antioxidants and rich in energy, sugary drinks, saturated and hydrogenated fats [43,44]. These products all cause systemic oxidative stress and breach immunological response [50], which could be the prime mechanism for the development of many non-communicable diseases [56,57], including CRDs and cancer.…”

Differential dietary intake and contribution of ultra-processed foods during pregnancy according to nutritional status

“…Our findings indicate that UPFs (NOVA 4) contribute 27, 29, 26.5, and 31% of total calories, total sugar, saturated fat, and sodium, respectively. Previous studies involving American, Norwegian, Brazilian, and Mexican pregnant women have estimated the proportion of UPF in total energy intake, revealing a wide range: over 50% in American women (16, 36), nearly twice the amount found in our study; 46% in Norwegian women; 27.9% in Mexican women; and 20.9% in Brazilian women (34,37,38). Furthermore, our analysis highlights the contribution of sodium, saturated fat, and sugar from UPF to the overall nutrient intake during pregnancy.…”

Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review

“…As to the E-DII score, a cross-sectional study in Brazil found a direct relationship between a higher dietary energy intake from UPF and a higher rate of dietary inflammation in pregnant women [ 58 ]. Similar findings were obtained in the Italian cohort Moli-Sani, where a higher consumption of UPF was related to a higher pro-inflammatory potential of the adults’ diet [ 59 ].…”