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Carlos Augusto Monteiro - One of the best experts on this subject based on the ideXlab platform.
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ultra Processed Foods what they are and how to identify them
Public Health Nutrition, 2019Co-Authors: Carlos Augusto Monteiro, Maria Laura Da Costa Louzada, Jeanclaude Moubarac, Renata Bertazzi Levy, Geoffrey Cannon, Gustavo Cediel, Fernanda Rauber, Neha Khandpur, Daniela Neri, Euridice MartinezsteeleAbstract:The present commentary contains a clear and simple guide designed to identify ultra-Processed Foods. It responds to the growing interest in ultra-Processed Foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-Processed Foods are defined within the NOVA classification system, which groups Foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-Processed Foods include the fractioning of whole Foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-Processed Foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unProcessed or minimally Processed Foods. A practical way to identify an ultra-Processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-Processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).
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consumption of ultra Processed Foods and obesity in canada
Canadian Journal of Public Health-revue Canadienne De Sante Publique, 2019Co-Authors: Milena Nardocci, Maria Laura Da Costa Louzada, Malek Batal, Carlos Augusto Monteiro, Bernardsimon Leclerc, Jeanclaude MoubaracAbstract:To assess the association between consumption of ultra-Processed Foods and obesity in the Canadian population. Cross-sectional study including 19,363 adults aged 18 years or more from the 2004 Canadian Community Health Survey, cycle 2.2. Ultra-Processed food intake was estimated using daily relative energy intake of ultra-Processed food (% of total energy intake) from data obtained by 24-h food recalls. Obesity was assessed using body mass index (BMI ≥ 30 kg/m2). Univariate and multivariate linear regressions were performed to describe ultra-Processed food consumption according to socio-economic and demographic variables, and multivariate logistic regression was performed to verify the association between ultra-Processed food consumption and obesity, adjusting for potential confounders, including socio-demographic factors, physical activity, smoking, immigrant status, residential location, and measured vs self-reported weight and height. Ultra-Processed Foods make up almost half (45%) of the daily calories consumed by Canadian adults. Consumption of these Foods is higher among men, younger adults, those with fewer years of formal education, smokers, those physically inactive, and Canadian-born individuals. Ultra-Processed food consumption is positively associated with obesity. After adjusting for confounding factors, individuals in the highest quintile of ultra-Processed food consumption were 32% more likely of having obesity compared to individuals in the first quintile (predicted OR = e0.005 × 56 = 1.32; 95% CI = 1.05–1.57). Canadians would benefit from reducing consumption of ultra-Processed Foods and beverages and increasing consumption of freshly prepared dishes made from unProcessed or minimally Processed Foods.
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added sugars and ultra Processed Foods in spanish households 1990 2010
European Journal of Clinical Nutrition, 2018Co-Authors: P. Latasa, Maria Laura Da Costa Louzada, Martinez E Steele, Carlos Augusto MonteiroAbstract:To study the association between ultra-Processed Foods acquisitions and added sugar content of total food purchases in Spanish households in 2010. Changes over time (1990–2000–2010) in ultra-Processed food purchases and added sugars content of total food purchases are also compared. We used data from three nationally representative Household Budget Surveys (HBS) conducted in 1990, 2000 and 2010. Number of studied households was 21,012, 33,730 and 22,116, respectively. Purchased Foods and drinks were classified according to NOVA food groups as ultra-Processed Foods, Processed Foods, unProcessed or minimally Processed Foods, or Processed culinary ingredients. Linear and Poisson regressions were used to estimate the association between quintiles of energy contribution of ultra-Processed Foods and added sugars contents of total food purchases in 2010. Changes over time were assessed using tests of linear trend and Student’s t test. In 2010, ultra-Processed Foods represented 31.7% of daily energy acquisitions and 80.4% of all added sugars. Added sugars content of food purchases raised from 7.3% in the lowest to 18.2% in the highest quintiles of energy contribution of ultra-Processed Foods. The risk of exceeding 10% energy from added sugars quadrupled between the lowest and highest quintiles. The percentage of ultra-Processed Foods on all food purchases almost tripled between 1990 and 2010 (from 11.0 to 31.7%), paralleling the increase of added sugars content (from 8.4 to 13.0%). Cutting down exceeding added sugars availability in Spain may require a reduction in ultra-Processed food purchasing.
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consumption of ultra Processed Foods and associated sociodemographic factors in the usa between 2007 and 2012 evidence from a nationally representative cross sectional study
BMJ Open, 2018Co-Authors: Larissa Galastri Baraldi, Daniela Silva Canella, Euridice Martinez Steele, Carlos Augusto MonteiroAbstract:Objectives To compare ultra-Processed food consumption across sociodemographic groups and over time (2007–2008, 2009–2010, 2011–2012) in the USA. Design Cross-sectional study. Setting National Health and Nutrition Examination Survey (NHANES) 2007–2012. Participants All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847). Main outcome measures Average dietary contribution of ultra-Processed Foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification. Data analysis Linear regression was used to evaluate the association between sociodemographic characteristics or NHANES cycles and dietary contribution of ultra-Processed Foods. Results Almost 60% of calories consumed in the period 2007–2012 came from ultra-Processed Foods. Consumption of ultra-Processed Foods decreased with age and income level, was higher for non-Hispanic whites or non-Hispanic blacks than for other race/ethnicity groups and lower for people with college than for lower levels of education, all differences being statistically significant. Overall contribution of ultra-Processed Foods increased significantly between NHANES cycles (nearly 1% point per cycle), the same being observed among males, adolescents and high school education-level individuals. Conclusions Ultra-Processed food consumption in the USA in the period 2007–2012 was overall high, greater among non-Hispanic whites or non-Hispanic blacks, less educated, younger, lower-income strata and increased across time.
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household availability of ultra Processed Foods and obesity in nineteen european countries
Public Health Nutrition, 2018Co-Authors: Carlos Augusto Monteiro, Jeanclaude Moubarac, Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Daniela Silva Canella, Geoffrey CannonAbstract:Objective To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-Processed Foods and prevalence of obesity. Design Ecological, cross-sectional study. Setting Europe. Subjects Estimates of ultra-Processed Foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Results Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unProcessed or minimally Processed Foods, 20·3 % for Processed culinary ingredients, 19·6 % for Processed Foods and 26·4 % for ultra-Processed Foods. The average household availability of ultra-Processed Foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-Processed Foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-Processed Foods resulted in an increase of 0·25 percentage points in obesity prevalence. Conclusions The study contributes to a growing literature showing that the consumption of ultra-Processed Foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unProcessed or minimally Processed Foods and make ultra-Processed Foods less available and affordable.
Maria Laura Da Costa Louzada - One of the best experts on this subject based on the ideXlab platform.
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The consumption of ultra-Processed Foods according to eating out occasions.
Public Health Nutrition, 2019Co-Authors: Giovanna Calixto Andrade, Maria Laura Da Costa Louzada, Maria Fernanda Gombi-vaca, Catarina Machado Azeredo, Renata Bertazzi LevyAbstract:Objective: To describe out-of-home consumption according to the purpose and extent of industrial processing and also evaluate the association between eating out and ultra-Processed food consumption, taking account of variance within and between individuals. Design: Cross-sectional study. Setting: Brazil. Participants: The study was based on the Individual Food Intake of the Brazilian Household Budget Survey, carried out with 34 003 individuals aged 10 years or more, between May 2008 and May 2009. All food items were classified according to food processing level. The habit of eating out was evaluated through the frequency of days each individual reported eating out, described according to sociodemographic characteristics. The contribution of food energy per group and subgroup was estimated according to the frequency of eating out. In addition, multilevel modelling was employed to evaluate the association between eating out and ultra-Processed food consumption. Results: In Brazil, culinary preparations accounted for most of the energy eaten out. However, it was possible to observe a higher contribution of ultra-Processed Foods, especially sugary beverages and ready-to-eat meals, as the frequency of out-of-home consumption increased. Compared with food consumption exclusively at home, eating out increased the consumption of ultra-Processed Foods by 0·41 percentage points within and between individuals. Conclusion: In Brazil, the same individual and different individuals had greater consumption of ultra-Processed Foods when they ate out of home compared with when they ate at home. So, it is necessary to implement public policies which discourage the out-of-home consumption of ultra-Processed Foods and that provide affordable and accessible less-Processed food options.
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added sugars and ultra Processed Foods in spanish households 1990 2010
European Journal of Clinical Nutrition, 2018Co-Authors: P. Latasa, Maria Laura Da Costa Louzada, Martinez E Steele, Carlos Augusto MonteiroAbstract:To study the association between ultra-Processed Foods acquisitions and added sugar content of total food purchases in Spanish households in 2010. Changes over time (1990–2000–2010) in ultra-Processed food purchases and added sugars content of total food purchases are also compared. We used data from three nationally representative Household Budget Surveys (HBS) conducted in 1990, 2000 and 2010. Number of studied households was 21,012, 33,730 and 22,116, respectively. Purchased Foods and drinks were classified according to NOVA food groups as ultra-Processed Foods, Processed Foods, unProcessed or minimally Processed Foods, or Processed culinary ingredients. Linear and Poisson regressions were used to estimate the association between quintiles of energy contribution of ultra-Processed Foods and added sugars contents of total food purchases in 2010. Changes over time were assessed using tests of linear trend and Student’s t test. In 2010, ultra-Processed Foods represented 31.7% of daily energy acquisitions and 80.4% of all added sugars. Added sugars content of food purchases raised from 7.3% in the lowest to 18.2% in the highest quintiles of energy contribution of ultra-Processed Foods. The risk of exceeding 10% energy from added sugars quadrupled between the lowest and highest quintiles. The percentage of ultra-Processed Foods on all food purchases almost tripled between 1990 and 2010 (from 11.0 to 31.7%), paralleling the increase of added sugars content (from 8.4 to 13.0%). Cutting down exceeding added sugars availability in Spain may require a reduction in ultra-Processed food purchasing.
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Consumption of vegetables and their relation with ultra-Processed Foods in Brazil
Revista De Saude Publica, 2018Co-Authors: Daniela Silva Canella, Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Rafael Moreira Claro, Janaína Calu Costa, Daniel Henrique Bandoni, Ana Paula Bortoletto MartinsAbstract:ABSTRACT OBJECTIVE To characterize the household purchase and the individual consumption of vegetables in Brazil and to analyze their relation with the consumption of ultra-Processed Foods. METHODS We have used data on the purchase of food for household consumption and individual consumption from the 2008–2009 Brazilian Household Budget Survey. The Brazilian Household Budget Survey studied the purchase of food of 55,970 households and the food consumption of 34,003 individuals aged 10 years and over. The Foods of interest in this study were vegetables (excluding roots and tubers) and ultra-Processed Foods. We have described the amount of vegetables (grams) purchased and consumed by all Brazilians and according to the quintiles of caloric intake of ultra-Processed food. To this end, we have calculated the crude and predicted values obtained by regression models adjusted for sociodemographic variables. We have analyzed the most commonly purchased types of vegetables (% in the total amount) and, in relation to individual food consumption, the variety of vegetables consumed (absolute number), the participation (%) of the types of culinary preparations based on vegetables, and the time of consumption. RESULTS The adjusted mean household purchase of vegetables was 42.9 g/per capita/day. The adjusted mean individual consumption was 46.1 g. There was an inverse relation between household purchase and individual consumption of vegetables and ultra-Processed Foods. Ten types of vegetables account for more than 80% of the total amount usually purchased. The variety consumed was, on average, 1.08 type/per capita/day. Approximately 60% of the vegetables were eaten raw, and the amount consumed at lunch was twice that consumed at dinner; individuals with higher consumption of ultra-Processed Foods tended to consume even less vegetables at dinner. CONCLUSIONS The consumption of vegetables in Brazil is insufficient, and this is worse among individuals with higher consumption of ultra-Processed Foods. The most frequent habit was to consume raw vegetables at lunch and with limited variety.
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household availability of ultra Processed Foods and obesity in nineteen european countries
Public Health Nutrition, 2018Co-Authors: Carlos Augusto Monteiro, Jeanclaude Moubarac, Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Daniela Silva Canella, Geoffrey CannonAbstract:Objective To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-Processed Foods and prevalence of obesity. Design Ecological, cross-sectional study. Setting Europe. Subjects Estimates of ultra-Processed Foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Results Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unProcessed or minimally Processed Foods, 20·3 % for Processed culinary ingredients, 19·6 % for Processed Foods and 26·4 % for ultra-Processed Foods. The average household availability of ultra-Processed Foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-Processed Foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-Processed Foods resulted in an increase of 0·25 percentage points in obesity prevalence. Conclusions The study contributes to a growing literature showing that the consumption of ultra-Processed Foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unProcessed or minimally Processed Foods and make ultra-Processed Foods less available and affordable.
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ultra Processed Foods and added sugars in the chilean diet 2010
Public Health Nutrition, 2018Co-Authors: Gustavo Cediel, Maria Laura Da Costa Louzada, Carlos Augusto Monteiro, Marcela Reyes, Euridice Martinez Steele, Camila Corvalan, Ricardo UauyAbstract:Objective To assess the consumption of ultra-Processed Foods and analyse its association with the content of added sugars in the Chilean diet. Design Cross-sectional study of national dietary data obtained through 24 h recalls and classified into food groups according to the extent and purpose of food processing (NOVA classification). Setting Chile. Subjects A probabilistic sample of 4920 individuals (aged 2 years or above) studied in 2010 by a national dietary survey (Encuesta Nacional de Consumo Alimentario). Results Ultra-Processed Foods represented 28·6 ( se 0·5) % of total energy intake and 58·6 ( se 0·9) % of added sugars intake. The mean percentage of energy from added sugars increased from 7·7 ( se 0·3) to 19·7 ( se 0·5) % across quintiles of the dietary share of ultra-Processed Foods. After adjusting for several potential sociodemographic confounders, a 5 percentage point increase in the dietary share of ultra-Processed Foods determined a 1 percentage point increase in the dietary content of added sugars. Individuals in the highest quintile were three times more likely (OR=2·9; 95 % CI 2·4, 3·4) to exceed the 10 % upper limit for added sugars recommended by the WHO compared with those in the lowest quintile, after adjusting for sociodemographic variables. This association was strongest among individuals aged 2–19 years (OR=3·9; 95 % CI 2·7, 5·9). Conclusions In Chile, ultra-Processed Foods are important contributors to total energy intake and to the consumption of added sugars. Actions aimed at limiting consumption of ultra-Processed Foods are being implemented as effective ways to achieve WHO dietary recommendations to limit added sugars and Processed Foods, especially for children and adolescents.
Euridice Martinez Steele - One of the best experts on this subject based on the ideXlab platform.
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consumption of ultra Processed Foods and associated sociodemographic factors in the usa between 2007 and 2012 evidence from a nationally representative cross sectional study
BMJ Open, 2018Co-Authors: Larissa Galastri Baraldi, Daniela Silva Canella, Euridice Martinez Steele, Carlos Augusto MonteiroAbstract:Objectives To compare ultra-Processed food consumption across sociodemographic groups and over time (2007–2008, 2009–2010, 2011–2012) in the USA. Design Cross-sectional study. Setting National Health and Nutrition Examination Survey (NHANES) 2007–2012. Participants All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847). Main outcome measures Average dietary contribution of ultra-Processed Foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification. Data analysis Linear regression was used to evaluate the association between sociodemographic characteristics or NHANES cycles and dietary contribution of ultra-Processed Foods. Results Almost 60% of calories consumed in the period 2007–2012 came from ultra-Processed Foods. Consumption of ultra-Processed Foods decreased with age and income level, was higher for non-Hispanic whites or non-Hispanic blacks than for other race/ethnicity groups and lower for people with college than for lower levels of education, all differences being statistically significant. Overall contribution of ultra-Processed Foods increased significantly between NHANES cycles (nearly 1% point per cycle), the same being observed among males, adolescents and high school education-level individuals. Conclusions Ultra-Processed food consumption in the USA in the period 2007–2012 was overall high, greater among non-Hispanic whites or non-Hispanic blacks, less educated, younger, lower-income strata and increased across time.
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ultra Processed Foods and added sugars in the chilean diet 2010
Public Health Nutrition, 2018Co-Authors: Gustavo Cediel, Maria Laura Da Costa Louzada, Carlos Augusto Monteiro, Marcela Reyes, Euridice Martinez Steele, Camila Corvalan, Ricardo UauyAbstract:Objective To assess the consumption of ultra-Processed Foods and analyse its association with the content of added sugars in the Chilean diet. Design Cross-sectional study of national dietary data obtained through 24 h recalls and classified into food groups according to the extent and purpose of food processing (NOVA classification). Setting Chile. Subjects A probabilistic sample of 4920 individuals (aged 2 years or above) studied in 2010 by a national dietary survey (Encuesta Nacional de Consumo Alimentario). Results Ultra-Processed Foods represented 28·6 ( se 0·5) % of total energy intake and 58·6 ( se 0·9) % of added sugars intake. The mean percentage of energy from added sugars increased from 7·7 ( se 0·3) to 19·7 ( se 0·5) % across quintiles of the dietary share of ultra-Processed Foods. After adjusting for several potential sociodemographic confounders, a 5 percentage point increase in the dietary share of ultra-Processed Foods determined a 1 percentage point increase in the dietary content of added sugars. Individuals in the highest quintile were three times more likely (OR=2·9; 95 % CI 2·4, 3·4) to exceed the 10 % upper limit for added sugars recommended by the WHO compared with those in the lowest quintile, after adjusting for sociodemographic variables. This association was strongest among individuals aged 2–19 years (OR=3·9; 95 % CI 2·7, 5·9). Conclusions In Chile, ultra-Processed Foods are important contributors to total energy intake and to the consumption of added sugars. Actions aimed at limiting consumption of ultra-Processed Foods are being implemented as effective ways to achieve WHO dietary recommendations to limit added sugars and Processed Foods, especially for children and adolescents.
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the share of ultra Processed Foods determines the overall nutritional quality of diets in brazil
Public Health Nutrition, 2018Co-Authors: Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Geoffrey Cannon, Euridice Martinez Steele, Camila Zancheta Ricardo, Carlos Augusto MonteiroAbstract:Objective To estimate the dietary share of ultra-Processed Foods and to determine its association with the overall nutritional quality of diets in Brazil. Design Cross-sectional. Setting Brazil. Subjects A representative sample of 32 898 Brazilians aged ≥10 years was studied. Food intake data were collected. We calculated the average dietary content of individual nutrients and compared them across quintiles of energy share of ultra-Processed Foods. Then we identified nutrient-based dietary patterns, and evaluated the association between quintiles of dietary share of ultra-Processed Foods and the patterns’ scores. Results The mean per capita daily dietary energy intake was 7933 kJ (1896 kcal), with 58·1 % from unProcessed or minimally Processed Foods, 10·9 % from Processed culinary ingredients, 10·6 % from Processed Foods and 20·4 % from ultra-Processed Foods. Consumption of ultra-Processed Foods was directly associated with high consumption of free sugars and total, saturated and trans fats, and with low consumption of protein, dietary fibre, and most of the assessed vitamins and minerals. Four nutrient-based dietary patterns were identified. ‘Healthy pattern 1’ carried more protein and micronutrients, and less free sugars. ‘Healthy pattern 2’ carried more vitamins. ‘Healthy pattern 3’ carried more dietary fibre and minerals and less free sugars. ‘Unhealthy pattern’ carried more total, saturated and trans fats, and less dietary fibre. The dietary share of ultra-Processed Foods was inversely associated with ‘healthy pattern 1’ (−0·16; 95 % CI −0·17, −0·15) and ‘healthy pattern 3’ (−0·18; 95 % CI −0·19, −0·17), and directly associated with ‘unhealthy pattern’ (0·17; 95 % CI 0·15, 0·18). Conclusions Dietary share of ultra-Processed Foods determines the overall nutritional quality of diets in Brazil.
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validating the usage of household food acquisition surveys to assess the consumption of ultra Processed Foods evidence from brazil
Food Policy, 2017Co-Authors: Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Ana Paula Bortoletto Martins, Rafael Moreira Claro, Euridice Martinez Steele, Eliseu Verly, Carlo Cafiero, Carlos Augusto MonteiroAbstract:Our ability to research dietary changes over time and their effects on health is limited by challenges in accurately measuring food consumption. In countries where dietary surveys are scarce and rarely nationally representative, household budget surveys may serve asa useful alternative for assessing food consumption. The objective of this study was to evaluate how well household acquisition data reflects the actual intake of ultra-Processed Foods, using data from the 2008 to 2009 Brazilian Household Budget Survey. The food acquisition module was conducted for all households selected for the survey (n=55,970) and a subsample corresponding to 25% of the households (n=13,569) was randomly selected for the individual food intake module, which was conducted for all individuals aged 10years or older (n=34,003). Ultra-Processed Foods were defined as formulations made by the food industry mostly or entirely from substances extracted from Foods or obtained with the further processing of constituents of Foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, chips, sugar-sweetened beverages, and ready-to-eat dishes. Our results showed an important agreement between the estimates of ultra-Processed food consumption obtained from household acquisition data and individual intake inside-the-home data, particularly for the relative (% of total energy) consumption of these Foods. Our study thus indicates that household budget surveys are quite promising for tracking population-level changes in the consumption of ultra-Processed Foods. The trend toward increased consumption of food away from home in other low- and middle-income countries indicates that future household budget surveys should include the collection of these data.
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the share of ultra Processed Foods and the overall nutritional quality of diets in the us evidence from a nationally representative cross sectional study
Population Health Metrics, 2017Co-Authors: Euridice Martinez Steele, Barry M Popkin, Boyd Swinburn, Carlos Augusto MonteiroAbstract:Recent population dietary studies indicate that diets rich in ultra-Processed Foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these Foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-Processed Foods in the US diet and its content of critical nutrients, individually and overall. We evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unProcessed or minimally Processed Foods, Processed culinary ingredients, Processed Foods, and ultra-Processed Foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-Processed Foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-Processed Foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-Processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment. The average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-Processed Foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose–response association was found between ultra-Processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars. This study suggests that decreasing the dietary share of ultra-Processed Foods is a rational and effective way to improve the nutritional quality of US diets.
Jeanclaude Moubarac - One of the best experts on this subject based on the ideXlab platform.
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ultra Processed Foods what they are and how to identify them
Public Health Nutrition, 2019Co-Authors: Carlos Augusto Monteiro, Maria Laura Da Costa Louzada, Jeanclaude Moubarac, Renata Bertazzi Levy, Geoffrey Cannon, Gustavo Cediel, Fernanda Rauber, Neha Khandpur, Daniela Neri, Euridice MartinezsteeleAbstract:The present commentary contains a clear and simple guide designed to identify ultra-Processed Foods. It responds to the growing interest in ultra-Processed Foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-Processed Foods are defined within the NOVA classification system, which groups Foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-Processed Foods include the fractioning of whole Foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-Processed Foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unProcessed or minimally Processed Foods. A practical way to identify an ultra-Processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-Processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).
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consumption of ultra Processed Foods and obesity in canada
Canadian Journal of Public Health-revue Canadienne De Sante Publique, 2019Co-Authors: Milena Nardocci, Maria Laura Da Costa Louzada, Malek Batal, Carlos Augusto Monteiro, Bernardsimon Leclerc, Jeanclaude MoubaracAbstract:To assess the association between consumption of ultra-Processed Foods and obesity in the Canadian population. Cross-sectional study including 19,363 adults aged 18 years or more from the 2004 Canadian Community Health Survey, cycle 2.2. Ultra-Processed food intake was estimated using daily relative energy intake of ultra-Processed food (% of total energy intake) from data obtained by 24-h food recalls. Obesity was assessed using body mass index (BMI ≥ 30 kg/m2). Univariate and multivariate linear regressions were performed to describe ultra-Processed food consumption according to socio-economic and demographic variables, and multivariate logistic regression was performed to verify the association between ultra-Processed food consumption and obesity, adjusting for potential confounders, including socio-demographic factors, physical activity, smoking, immigrant status, residential location, and measured vs self-reported weight and height. Ultra-Processed Foods make up almost half (45%) of the daily calories consumed by Canadian adults. Consumption of these Foods is higher among men, younger adults, those with fewer years of formal education, smokers, those physically inactive, and Canadian-born individuals. Ultra-Processed food consumption is positively associated with obesity. After adjusting for confounding factors, individuals in the highest quintile of ultra-Processed food consumption were 32% more likely of having obesity compared to individuals in the first quintile (predicted OR = e0.005 × 56 = 1.32; 95% CI = 1.05–1.57). Canadians would benefit from reducing consumption of ultra-Processed Foods and beverages and increasing consumption of freshly prepared dishes made from unProcessed or minimally Processed Foods.
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household availability of ultra Processed Foods and obesity in nineteen european countries
Public Health Nutrition, 2018Co-Authors: Carlos Augusto Monteiro, Jeanclaude Moubarac, Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Daniela Silva Canella, Geoffrey CannonAbstract:Objective To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-Processed Foods and prevalence of obesity. Design Ecological, cross-sectional study. Setting Europe. Subjects Estimates of ultra-Processed Foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Results Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unProcessed or minimally Processed Foods, 20·3 % for Processed culinary ingredients, 19·6 % for Processed Foods and 26·4 % for ultra-Processed Foods. The average household availability of ultra-Processed Foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-Processed Foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-Processed Foods resulted in an increase of 0·25 percentage points in obesity prevalence. Conclusions The study contributes to a growing literature showing that the consumption of ultra-Processed Foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unProcessed or minimally Processed Foods and make ultra-Processed Foods less available and affordable.
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consumption of ultra Processed Foods predicts diet quality in canada
Appetite, 2017Co-Authors: Jeanclaude Moubarac, Malek Batal, Maria Laura Da Costa Louzada, Martinez E Steele, Carlos Augusto MonteiroAbstract:Abstract This study describes food consumption patterns in Canada according to the types of food processing using the Nova classification and investigates the association between consumption of ultra-Processed Foods and the nutrient profile of the diet. Dietary intakes of 33,694 individuals from the 2004 Canadian Community Health Survey aged 2 years and above were analyzed. Food and drinks were classified using Nova into unProcessed or minimally Processed Foods, Processed culinary ingredients, Processed Foods and ultra-Processed Foods. Average consumption (total daily energy intake) and relative consumption (% of total energy intake) provided by each of the food groups were calculated. Consumption of ultra-Processed Foods according to sex, age, education, residential location and relative family revenue was assessed. Mean nutrient content of ultra-Processed Foods and non-ultra-Processed Foods were compared, and the average nutrient content of the overall diet across quintiles of dietary share of ultra-Processed Foods was measured. In 2004, 48% of calories consumed by Canadians came from ultra-Processed Foods. Consumption of such Foods was high amongst all socioeconomic groups, and particularly in children and adolescents. As a group, ultra-Processed Foods were grossly nutritionally inferior to non-ultra-Processed Foods. After adjusting for covariates, a significant and positive relationship was found between the dietary share of ultra-Processed Foods and the content in carbohydrates, free sugars, total and saturated fats and energy density, while an inverse relationship was observed with the dietary content in protein, fiber, vitamins A, C, D, B6 and B12, niacin, thiamine, riboflavin, as well as zinc, iron, magnesium, calcium, phosphorus and potassium. Lowering the dietary share of ultra-Processed Foods and raising consumption of hand-made meals from unProcessed or minimally Processed Foods would substantially improve the diet quality of Canadian.
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ultra Processed Foods and added sugars in the us diet evidence from a nationally representative cross sectional study
BMJ Open, 2016Co-Authors: Euridice Martinez Steele, Jeanclaude Moubarac, Maria Laura Da Costa Louzada, Larissa Galastri Baraldi, Dariush Mozaffarian, Carlos Augusto MonteiroAbstract:Objectives To investigate the contribution of ultra-Processed Foods to the intake of added sugars in the USA. Ultra-Processed Foods were defined as industrial formulations which, besides salt, sugar, oils and fats, include substances not used in culinary preparations, in particular additives used to imitate sensorial qualities of minimally Processed Foods and their culinary preparations. Design Cross-sectional study. Setting National Health and Nutrition Examination Survey 2009–2010. Participants We evaluated 9317 participants aged 1+ years with at least one 24 h dietary recall. Main outcome measures Average dietary content of added sugars and proportion of individuals consuming more than 10% of total energy from added sugars. Data analysis Gaussian and Poisson regressions estimated the association between consumption of ultra-Processed Foods and intake of added sugars. All models incorporated survey sample weights and adjusted for age, sex, race/ethnicity, family income and educational attainment. Results Ultra-Processed Foods comprised 57.9% of energy intake, and contributed 89.7% of the energy intake from added sugars. The content of added sugars in ultra-Processed Foods (21.1% of calories) was eightfold higher than in Processed Foods (2.4%) and fivefold higher than in unProcessed or minimally Processed Foods and Processed culinary ingredients grouped together (3.7%). Both in unadjusted and adjusted models, each increase of 5 percentage points in proportional energy intake from ultra-Processed Foods increased the proportional energy intake from added sugars by 1 percentage point. Consumption of added sugars increased linearly across quintiles of ultra-Processed food consumption: from 7.5% of total energy in the lowest quintile to 19.5% in the highest. A total of 82.1% of Americans in the highest quintile exceeded the recommended limit of 10% energy from added sugars, compared with 26.4% in the lowest. Conclusions Decreasing the consumption of ultra-Processed Foods could be an effective way of reducing the excessive intake of added sugars in the USA.
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ultra Processed Foods what they are and how to identify them
Public Health Nutrition, 2019Co-Authors: Carlos Augusto Monteiro, Maria Laura Da Costa Louzada, Jeanclaude Moubarac, Renata Bertazzi Levy, Geoffrey Cannon, Gustavo Cediel, Fernanda Rauber, Neha Khandpur, Daniela Neri, Euridice MartinezsteeleAbstract:The present commentary contains a clear and simple guide designed to identify ultra-Processed Foods. It responds to the growing interest in ultra-Processed Foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-Processed Foods are defined within the NOVA classification system, which groups Foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-Processed Foods include the fractioning of whole Foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-Processed Foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unProcessed or minimally Processed Foods. A practical way to identify an ultra-Processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-Processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).
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household availability of ultra Processed Foods and obesity in nineteen european countries
Public Health Nutrition, 2018Co-Authors: Carlos Augusto Monteiro, Jeanclaude Moubarac, Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Daniela Silva Canella, Geoffrey CannonAbstract:Objective To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-Processed Foods and prevalence of obesity. Design Ecological, cross-sectional study. Setting Europe. Subjects Estimates of ultra-Processed Foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Results Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unProcessed or minimally Processed Foods, 20·3 % for Processed culinary ingredients, 19·6 % for Processed Foods and 26·4 % for ultra-Processed Foods. The average household availability of ultra-Processed Foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-Processed Foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-Processed Foods resulted in an increase of 0·25 percentage points in obesity prevalence. Conclusions The study contributes to a growing literature showing that the consumption of ultra-Processed Foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unProcessed or minimally Processed Foods and make ultra-Processed Foods less available and affordable.
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the share of ultra Processed Foods determines the overall nutritional quality of diets in brazil
Public Health Nutrition, 2018Co-Authors: Maria Laura Da Costa Louzada, Renata Bertazzi Levy, Geoffrey Cannon, Euridice Martinez Steele, Camila Zancheta Ricardo, Carlos Augusto MonteiroAbstract:Objective To estimate the dietary share of ultra-Processed Foods and to determine its association with the overall nutritional quality of diets in Brazil. Design Cross-sectional. Setting Brazil. Subjects A representative sample of 32 898 Brazilians aged ≥10 years was studied. Food intake data were collected. We calculated the average dietary content of individual nutrients and compared them across quintiles of energy share of ultra-Processed Foods. Then we identified nutrient-based dietary patterns, and evaluated the association between quintiles of dietary share of ultra-Processed Foods and the patterns’ scores. Results The mean per capita daily dietary energy intake was 7933 kJ (1896 kcal), with 58·1 % from unProcessed or minimally Processed Foods, 10·9 % from Processed culinary ingredients, 10·6 % from Processed Foods and 20·4 % from ultra-Processed Foods. Consumption of ultra-Processed Foods was directly associated with high consumption of free sugars and total, saturated and trans fats, and with low consumption of protein, dietary fibre, and most of the assessed vitamins and minerals. Four nutrient-based dietary patterns were identified. ‘Healthy pattern 1’ carried more protein and micronutrients, and less free sugars. ‘Healthy pattern 2’ carried more vitamins. ‘Healthy pattern 3’ carried more dietary fibre and minerals and less free sugars. ‘Unhealthy pattern’ carried more total, saturated and trans fats, and less dietary fibre. The dietary share of ultra-Processed Foods was inversely associated with ‘healthy pattern 1’ (−0·16; 95 % CI −0·17, −0·15) and ‘healthy pattern 3’ (−0·18; 95 % CI −0·19, −0·17), and directly associated with ‘unhealthy pattern’ (0·17; 95 % CI 0·15, 0·18). Conclusions Dietary share of ultra-Processed Foods determines the overall nutritional quality of diets in Brazil.
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consumption of ultra Processed Foods and obesity in brazilian adolescents and adults
Preventive Medicine, 2015Co-Authors: Maria Laura Da Costa Louzada, Jeanclaude Moubarac, Renata Bertazzi Levy, Daniela Silva Canella, Geoffrey Cannon, Ana Paula Bortoletto Martins, Larissa Galastri Baraldi, Euridice Martinez Steele, Ashkan Afshin, Fumiaki ImamuraAbstract:Abstract Objectives The aim of this study was to evaluate the relationship between the consumption of ultra-Processed Foods and obesity indicators among Brazilian adults and adolescents. Methods We used cross-sectional data on 30,243 individuals aged ≥ 10 years from the 2008–2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-Processed Foods were defined as formulations made by the food industry mostly from substances extracted from Foods or obtained with the further processing of constituents of Foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-Processed Foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. Results Ultra-Processed Foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-Processed Foods had significantly higher body-mass-index (0.94 kg/m 2 ; 95% CI: 0.42,1.47) and higher odds of being obese (OR = 1.98; 95% CI: 1.26,3.12) and excess weight (OR = 1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. Conclusion Our findings support the role of ultra-Processed Foods in the obesity epidemic in Brazil.
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impact of ultra Processed Foods on micronutrient content in the brazilian diet
Revista De Saude Publica, 2015Co-Authors: Maria Laura Da Costa Louzada, Jeanclaude Moubarac, Renata Bertazzi Levy, Daniela Silva Canella, Ana Paula Bortoletto Martins, Larissa Galastri Baraldi, Rafael Moreira Claro, Geoffrey CannonAbstract:OBJECTIVE To evaluate the impact of consuming ultra-Processed Foods on the micronutrient content of the Brazilian population’s diet.METHODS This cross-sectional study was performed using data on individual food consumption from a module of the 2008-2009 Brazilian Household Budget Survey. A representative sample of the Brazilian population aged 10 years or over was assessed (n = 32,898). Food consumption data were collected through two 24-hour food records. Linear regression models were used to assess the association between the nutrient content of the diet and the quintiles of ultra-Processed food consumption – crude and adjusted for family incomeper capita.RESULTS Mean daily energy intake per capita was 1,866 kcal, with 69.5% coming from natural or minimally Processed Foods, 9.0% from Processed Foods and 21.5% from ultra-Processed Foods. For sixteen out of the seventeen evaluated micronutrients, their content was lower in the fraction of the diet composed of ultra-Processed Foods compared with the fraction of the diet composed of natural or minimally Processed Foods. The content of 10 micronutrients in ultra-Processed Foods did not reach half the content level observed in the natural or minimally Processed Foods. The higher consumption of ultra-Processed Foods was inversely and significantly associated with the content of vitamins B12, vitamin D, vitamin E, niacin, pyridoxine, copper, iron, phosphorus, magnesium, selenium and zinc. The reverse situation was only observed for calcium, thiamin and riboflavin.CONCLUSIONS The findings of this study highlight that reducing the consumption of ultra-Processed Foods is a natural way to promote healthy eating in Brazil and, therefore, is in line with the recommendations made by the Guia Alimentar para a Populacao Brasileira (Dietary Guidelines for the Brazilian Population) to avoid these Foods.
