Explore the vast range of titles available.

Evidence on the impact of ultra-processed food (UPF) intake on diet quality among cancer survivors remains limited. This study examined UPF consumption and nutrient intake adequacy among cancer survivors in Lebanon. In this cross-sectional study, adult cancer survivors in remission for at least three months were recruited from two medical centers. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and food items were categorized according to the NOVA classification. Nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated. Participant characteristics, nutrient adequacy, and macronutrient intakes were compared across UPF quartiles using Chi-square tests, and ANOVA. Logistic regression was performed to identify predictors of nutrient inadequacy. The study included 268 participants (mean age: 59 years; 83% female). UPF accounted for 8 ± 7% of total food weight and 17.5 ± 11% of energy intake. Most participants did not meet requirements for potassium (95%), vitamin A (87%), and vitamin D (99%) with mean intakes of 2,527 ± 1236 mg, 350 ± 175 Retinol Activity Equivalents, and 0.8 ± 1.2 µg, respectively. Higher UPF intake was significantly associated with higher energy ( p  < 0.001), carbohydrate ( p  < 0.001), protein ( p  = 0.017), fat ( p  < 0.001), and saturated fat intake ( p  < 0.001), and with lower vitamin C adequacy ( p  = 0.02). In multivariable analysis, higher education predicted lower odds of nutrient inadequacy (AOR = 0.26, 95% CI: 0.1–0.65, p  = 0.004), while UPF intake did not. Despite the relatively low UPF contribution, significant micronutrient inadequacies were observed among cancer survivors. These findings underscore the importance of integrating dietary counseling into cancer care to address nutrient gaps and promote healthier food choices.

PurposeHigh consumption of ultra-processed food (UPF) is associated with an increased risk of developing chronic diseases. Inflammation may be one of the underlying mechanisms behind this association. However, only a limited number of studies have investigated the association between UPF consumption and a few selected inflammation biomarkers, yielding inconsistent results. This study aimed to assess the cross-sectional association between UPF consumption (as a whole and 10 sub-categories), and 78 circulating proteins related to inflammation.MethodsThe present study included 1594 adult participants from the STANISLAS cohort. UPF consumption was estimated using the NOVA classification, and linear regression models were used to assess their association with circulating proteins.ResultsUPFs accounted for 28% of the total energy intake and 5.7 servings on average per day. In the unadjusted model, 15 circulating proteins had a significant association with UPF consumption. After adjustment, only (FGF-19) was significantly associated with UPF consumption (β =  − 0.02[− 0.03; − 0.003]).ConclusionUPF consumption was negatively associated with Fibroblast Growth Factor 19 (FGF-19) serum levels. When considering UPF sub-categories, no circulating proteins were associated with dairy products and dairy desserts. Of note, circulating proteins were differentially associated depending on the sub-category of UPF. Further studies are needed to better understand the link between UPF and inflammation.

Background Food consumed outside of the home is often high in energy and population level interventions that reduce energy intake of people from both lower and higher socioeconomic position (SEP) are needed. There is a lack of evidence on the effectiveness and SEP equity of structural-based (e.g. increasing availability of lower energy options) and information provision (e.g. menu energy labelling) interventions on food choice. Methods Across two online experiments, participants of lower and higher SEP made meal choices in a novel virtual fast-food restaurant. To be eligible to take part, participants were required to be UK residents, aged 18 or above, fluent in English, have access to a computer with an internet connection and have no dietary restrictions. Participants were randomized to one of four conditions in a 2 × 2 between-subjects design: menu energy labelling present vs. absent and increased availability of lower energy options (75% of menu options lower energy) vs. baseline availability (25% of menu options lower energy). Participants also completed measures of executive function and food choice motives. Results The analysis of pooled data from both studies ( n  = 1743) showed that increasing the availability of lower energy options resulted in participants ordering meals with significantly less energy on average (− 71 kcal, p  <  0.001, partial η 2  = 0.024) and this effect was observed irrespective of participant SEP. Menu labelling had no significant effect on energy ordered (− 18 kcal, p  = 0.116, partial η 2  = 0.001) in participants from both higher and lower SEP. Furthermore, we found no evidence that executive function or food choice motives moderated the effect of increasing lower energy menu options or energy labelling on total energy ordered. Conclusions In a virtual fast-food environment, energy labelling was ineffective in reducing total energy ordered for both higher and lower SEP participants. Increasing the availability of lower energy options had an equitable effect, reducing total energy ordered in participants from higher and lower SEP. Trial registration Study protocols and analysis plans were pre-registered on the Open Science Framework ( https://osf.io/ajcr6/ ).

The present study aimed to investigate the relationship between screen time and the frequency of consumption of ultra-processed foods (UPF) in overweight pregnant women. This was a cross-sectional study that used baseline data from a randomized clinical trial conducted in the Primary Health Care (PHC) network of a Brazilian municipality between 2018 and 2021. Data from the Food Consumption Markers form were used. Daily screen time (ST) was measured based on the number of minutes spent watching television and using electronic devices during free time. Logistic regression models, adjusted for variables selected by the Directed Acyclic Graph, were used. The median (P25; P75) maternal age was 27 years (23; 32) and the pre-gestational BMI was 27.2 kg/m² (26.1; 28.3). Among pregnant women, 59.4% had some type of paid work and 62.1% belonged to economic stratum C. Pregnant women with a total ST >240 minutes/day were more likely to consume UPF on three or more days of the week. A direct relationship was observed between longer use of electronic devices and higher frequency of UPF consumption. Pregnant women with higher total ST and ST of electronic devices were more likely to have a high frequency of consumption of UPF.

Background Corporate decisions affecting the composition of processed foods are a potent factor shaping the nutritional quality of the food supply. The addition of large quantities of salt to foods is incompatible with Australian Dietary Guidelines and the reformulation of processed foods to have less salt is a focus of non-governmental organisations (NGOs). There is evidence that advocacy can influence corporate behaviour but there are few data to define the effects of NGOs working in the food space. The aim of this study is to quantify the effects of advocacy delivered by a local NGO on the salt content of food products produced or marketed by companies in Australia. Methods/Design This is a cluster-randomised controlled trial that will be done in Australia from 2013 to 2015 which includes 45 food companies. The 23 companies in the control group will receive no specific intervention whilst the 22 companies in the intervention group will receive an advocacy program based upon an established theory of change model. The primary outcome will be the mean change in sodium content (mg/100 g) of processed foods produced or marketed by intervention compared to control companies assessed at 24 months. Interim outcomes (statements of support, published nutrition policies, level of engagement, knowledge and use of technology to reduce salt, salt reduction plans, and support for national initiatives) will also be assessed and a qualitative evaluation will provide more detailed insight. Discussion This novel study will provide robust randomised evidence about the effects of advocacy on food company behaviour and the quality of the processed food supply. A finding of improved food company behaviour will highlight the potential for greater investment in advocacy whilst the opposite result will reinforce the importance of government-led initiatives for the improvement of the food supply. Trial registration ClinicalTrials.gov: NCT02373423 . 26/02/2015

To examine the energy content of main meals served in major UK restaurant chains and compare the energy content of meals in fast food and \"full service\" restaurant chains. Observational study. Menu and nutritional information provided by major UK restaurant chains. Mean energy content of meals, proportion of meals meeting public health recommendations for energy consumption (≤600 kcal), and proportion of meals with excessive energy content (≥1000 kcal). Main meals from 27 restaurant chains (21 full service; 6 fast food) were sampled. The mean energy content of all eligible restaurant meals (13 396 in total) was 977 (95% confidence interval 973 to 983) kcal. The percentage of all meals that met public health recommendations for energy content was low (9%; n=1226) and smaller than the percentage of meals with an excessive energy content (47%; 6251). Compared with fast food restaurants, full service restaurants offered significantly more excessively calorific main meals, fewer main meals meeting public health recommendations, and on average 268 (103 to 433) kcal more in main meals. The energy content of a large number of main meals in major UK restaurant chains is excessive, and only a minority meet public health recommendations. Although the poor nutritional quality of fast food meals has been well documented, the energy content of full service restaurant meals in the UK tends to be higher and is a cause for concern. Study protocol and analysis strategy pre-registered on Open Science Framework (https://osf.io/w5h8q/).

To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. clinicaltrials.gov Identifier: NCT01133093

PurposeTo assess the dietary share of ultra-processed foods (UPF) among Belgian children, adolescents and adults and associations with diet quality.MethodsData from the national Food Consumption Surveys 2004 (N = 3083; ≥ 15 years) and 2014–2015 (N = 3146; 3–64 years) were used. Two 24-h recalls (dietary records for children) were used for data collection. Foods consumed were classified by the level of processing using the NOVA classification. The usual proportion of daily energy intake from UPF was determined using SPADE (Statistical Program to assess dietary exposure).ResultsIn 2014/2015, 36.4% of foods consumed were ultra-processed, while 42.4% were unprocessed/minimally processed. The usual proportion of daily energy intake from UPF was 33.3% (95% CI 32.1–35.0%) for children, 29.2% (95% CI 27.7–30.3%) for adolescents and 29.6% (95% CI 28.5–30.7%) for adults. There were no differences in UPF consumption between 2004 and 2014/2015. The products contributing most to UPF consumption were processed meat (14.3%), cakes, pies, pastries (8.9%), sweet biscuits (7.7%) and soft drinks (6.7%). The UPF dietary share was significantly lower during consumption days when participants met the WHO salt intake recommendation (≤ 5 g/day) and when saturated fat was ≤ 10% of their total energy intake. The dietary share of unprocessed/minimally processed foods was significantly higher during consumption days when participants met the WHO salt and fruit/vegetable intake (≥ 400 g/day) recommendations and when saturated fat was ≤ 10% of their total energy intake.ConclusionsThe UPF dietary share is substantial and associated with lower diet quality. Internationally recommended policies to limit UPF accessibility and marketing need to be implemented to reduce UPF consumption.

To evaluate the association between ultra-processed food intake and all-cause mortality and CVD mortality in a nationally representative sample of US adults. Prospective analyses of reported frequency of ultra-processed food intake in 1988-1994 and all-cause mortality and CVD mortality through 2011. The Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994).ParticipantsAdults aged ≥20 years (n 11898). Over a median follow-up of 19 years, individuals in the highest quartile of frequency of ultra-processed food intake (e.g. sugar-sweetened or artificially sweetened beverages, sweetened milk, sausage or other reconstructed meats, sweetened cereals, confectionery, desserts) had a 31% higher risk of all-cause mortality, after adjusting for demographic and socio-economic confounders and health behaviours (adjusted hazard ratio=1·31; 95% CI 1·09, 1·58; P-trend = 0·001). No association with CVD mortality was observed (P-trend=0·86). Higher frequency of ultra-processed food intake was associated with higher risk of all-cause mortality in a representative sample of US adults. More longitudinal studies with dietary data reflecting the modern food supply are needed to confirm our results.

To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Brazil. Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35-74 years at baseline (2008-2010). UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF. Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.