Examined the combined effects of ultra-processed food (UPF), Dietary Inflammatory Index (DII), Healthy Eating Index-2015 (HEI-2015), and Dietary Antioxidant Index (DAI) on mortality from chronic respiratory diseases (CRDs), chronic obstructive pulmonary disease (COPD), and lung cancer.

A prospective analysis included 96,607 participants (53 % women). Diet intake was measured using food frequency questionnaire. Associations of dietary exposures with CRD, COPD, and lung cancer mortality were examined using Cox regression.

During 1,459,299 person-years of follow-up, there were 30,623 all-cause deaths, including 5218 from CRDs, 1613 from COPD, and 2127 from lung cancer. A 10 % increase in UPF intake (% grams/day) showed a non-linear association with higher CRD and COPD mortality but not lung cancer. Stronger curvature was observed between DII and mortality from all three conditions. However, HEI-2015 was inversely associated with CRD, COPD, and lung cancer mortality, while DAI showed an inverse relationship with CRD and COPD mortality but not lung cancer. Adjusting for DII attenuated UPF-related mortality risks by 39 % (CRD), 11 % (COPD), and 18 % (lung cancer), while HEI-2015 adjustment showed less attenuation. Additionally, the DII-mortality associations were less attenuated after adjusting for UPF intake but were offset after adjusting for HEI-2015. However, the HEI-2015-mortality associations remained unaffected when adjusted for UPF, DII, or DAI.

The findings highlight that the UPF-mortality relationship is potentially explained by DII and, to a lesser extent, by HEI-2015. Adhering to HEI-2015 guidelines can counterbalance the effects of DII on respiratory health but may not offset the effects associated with UPF.

To explore the relationship between ultra-processed food (UPF) intake and knee osteoarthritis (KOA)-related imaging and clinical outcomes in men and women.

Osteoarthritis Initiative participants with sufficient dietary and sociodemographic data (n = 4403) were included in this cross-sectional study. Dietary UPF was assessed by food frequency questionnaire-based NOVA Classification, categorizing diet according to processing level, with NOVA-4 indicating UPF. The exposure variable was standardized UPF proportion/day (%)-the proportion of NOVA-4 servings in the daily diet. The outcomes were Western Ontario and McMaster University OA Index (WOMAC) pain, activities of daily living (ADL), stiffness, total scores, average cartilage thickness (quantified using 3D-dual echo steady state sequences on 3 T magnetic resonance imaging), Chair Stand Test (CST) and gait speed. Mixed effects and linear regression models were used for knee-level and participant-level outcomes, respectively. Models were adjusted for age, race, body mass index, daily calories, physical activity, and medical insurance availability. Sex differences were tested by interactions between UPF and sex.

Sex interactions were significant for WOMAC-pain, ADL, total scores, gait speed, and cartilage thickness (p-interaction-range ≤ 0.001-0.006). Greater UPF was associated with significantly worse pain (β = 0.17 [0.093, 0.242], p < 0.001), ADL (β = 0.59 [0.365, 0.832], p < 0.001), total scores (β = 0.81 [0.483, 1.13], p < 0.001), thinner cartilage (β = -0.013 [-0.02, -0.006], p < 0.001) and slower gait (β = -0.035 [-0.042, -0.027], p < 0.001) in women. Sex interactions were non-significant for CST and WOMAC-stiffness (p-interaction = 0.319, 0.573, respectively). With greater UPF, CST and WOMAC-stiffness showed significant poor outcomes (β = -0.008 [-0.013, -0.004], p < 0.001, β = 0.04 [0.008, 0.064], p = 0.011, respectively). WOMAC-stiffness results were not significant after Bonferroni corrections.

UPF-rich diet is linked to worse KOA outcomes disproportionately more in women.

This meta-analysis systematically evaluated the association between ultra-processed food (UPF) intake and adverse liver outcomes, addressing a critical evidence gap as prior observational studies lacked pooled quantitative synthesis. Researchers conducted a comprehensive search in PubMed, Cochrane Library, Embase, and Web of Science (up to October 17, 2024) using Medical Subject Headings (MeSH) terms and keywords. Statistical analyses in Stata 14.0 employed fixed-effects (P > 0.1, I2 ≤ 50%) or random-effects models (I2 > 50%), with publication bias assessed via funnel plots and Egger's test. The analysis included 17 studies (11 cohort, 3 case-control, 3 cross-sectional; n = 1,092,950 participants). UPF consumption significantly increased risks of adverse liver outcomes (OR = 1.58; 95% CI: 1.34-1.86; I2 = 89.9%), specifically non-alcoholic fatty liver disease (NAFLD) (OR = 1.72; 95%CI: 1.36-2.17), liver fibrosis (OR = 1.31; 95%CI: 1.08-1.59), and liver cancer (OR = 1.35; 95%CI: 1.03-1.76). Subgroup analyses revealed regional variations, with Asian cohorts showing lower NAFLD risk (OR = 1.47 vs. American/European studies). High heterogeneity (I2 = 89.9%) persisted across analyses. Findings confirm UPFs as independent risk factors for liver diseases, mediated through metabolic pathways like fat accumulation and inflammation. This synthesis strengthens evidence for dietary guidelines limiting UPFs to mitigate global liver disease burdens. The study's robust methodology and large sample size underscore the clinical and public health implications of reducing UPF consumption.

There is ongoing debate about the optimal macronutrient and micronutrient proportions for treating type 2 diabetes (T2D) and hypertension. The objective of this study was to evaluate the dietary composition of patients participating in a 12-month interventional study with follow-up. Additionally, it aimed to evaluate the interactions and correlations between diet components and anthropometric markers, laboratory markers, and blood pressure (BP). Finally, perform a qualitative analysis of daily and postmeal satiety.

This experimental, analytical, and correlational study is a quaternary evaluation within a recently published longitudinal research. Eighty-four participants were divided into two groups: intervention: followed a Mediterranean-DASH diet for 12 months with follow-up at 15 months; control: no dietary changes. Parametric variables were compared using two-way ANOVA and Tukey post hoc test. Nonparametric variables were compared using Kruskal-Wallis with Dwass-Steel-Critchlow-Fligner post hoc test and Friedman with Durbin-Conover post hoc test. Parametric data were represented as mean ± standard deviation, nonparametric as median ± interquartile range. Linear regression was used for interaction/relation analysis, and Pearson test for correlation. Significance was P less than 0.05.

Initially, both groups consumed diets high in ultra-processed foods, rich in refined carbohydrates, saturated fats, and sodium. At the 12th visit and follow-up, the intervention group showed substantial improvement in diet quality and dietary requirements (P < 0.05). The control group maintained or worsened their diet quality (P < 0.05). At first, both groups reported high hunger and low satiety. By the 12th month, the intervention group showed significant improvements, with 88.6% reporting postmeal fullness and 75% experiencing daily satiety. Significant positive and negative correlations (P < 0.05) were observed in both groups. In the control group, low-density lipoprotein cholesterol (LDL-C) was correlated with trans fats and proteins; high-density lipoprotein cholesterol (HDL-C) with polyunsaturated fats; total cholesterol (TC) with proteins and monounsaturated fats; and glycated hemoglobin (HbA1c) with fibers. In the intervention group, BMI was correlated with carbohydrates; HbA1c with total fats; LDL-C with carbohydrates; glucose with proteins; TC with total fats and carbohydrates; HDL-C with total fats, polyunsaturated fats, and saturated fats; glucose with monounsaturated fats (P < 0.05). In the intervention group, BP, heart rate, plasma, and urinary sodium levels significantly improved over time (P < 0.05). However, no strong correlations between sodium intake and these markers were observed (P > 0.05). In contrast, the control group showed no significant changes in BP, heart rate, plasma, or urinary sodium levels over time (P > 0.05), nor were there any strong correlations between sodium intake and these markers (P > 0.05). Notably, SBP, plasma, and urinary sodium levels demonstrated a significant difference between groups from the 12th month to the follow-up (P < 0.05). Additionally, DBP differed significantly from baseline, with the intervention group initially presenting higher values, which reversed by the 12th month and persisted until follow-up (P < 0.05).

The Mediterranean-DASH diet improved anthropometric, laboratory parameters, and BP in T2D and hypertension over the 12-month intervention and follow-up, whereas the ultra-processed diet worsened some of these markers. The intervention also improved satiety levels throughout the day. The quality and quantity of the diet are proportionally correlated to the anthropometric and laboratory markers. No significant strong correlations were found between plasma and urinary sodium levels, BP, or heart rate with sodium intake; only trends were observed. Nonetheless, further clinical trials are needed to establish causality, and the findings should be interpreted with caution due to the study's limitations.

Exposure to perfluoroalkyl substances (PFAS) is concerning because some of these chemicals are associated with health effects. Preadolescents eat more food per body weight and may be more affected by substances in food compared to adults.

Estimate how diet quality and nutrients are associated with concurrently measured PFAS concentrations in Canadian preadolescents.

Using data from 157 participants (7-11 years) in a Maternal-Infant Research on Environmental Chemicals follow-up study (2018-2021), we analyzed serum concentrations of 9 PFAS, and derived 2019-Healthy Eating Food Index (HEFI-2019) scores and nutrient intakes from 24-h diet recalls. We used multivariable linear regression to estimate cross-sectional associations between diet and serum PFAS concentrations.

Saturated fat consumption was associated with higher serum perfluorooctanesulfonic acid (PFOS) concentrations. The fruits and vegetables score was associated with higher perfluorodecanoic acid (PFDA), and perfluorononanoic acid (PFNA); similar associations appeared with the HEFI-2019 total score. Percentage of energy intake (%E) from protein was associated with lower perfluorooctanoic acid (PFOA), PFOS, and perfluorohexanesulphonic acid (PFHxS) while %E from fat was associated with higher PFDA and PFOS. Fiber and iron intakes were associated with higher PFHxS. Vitamin D intake was associated with lower PFNA.

We observed some associations between diet and PFAS. Our findings may be partially explained by toxicokinetics and PFAS presence in Canadian food systems. However, our interpretation is hindered by lack of temporality and potential confounding. Additional investigations which integrate food systems information paired with PFAS concentrations from food and biomonitoring are required.

Ultra-processed food (UPF) consumption has been linked to increased risks of negative health outcomes such as type 2 diabetes, obesity, and all-cause mortality. Some studies have shown an increase of UPF consumption with acculturation, whereas the influence of the Western diet on non-US born individuals is an area of increasing interest. The aim of this work was to investigate UPF consumption with an acculturation index and to assess whether there was an interaction of UPF consumption with race/ethnicity in non-US born adults.

Dietary intake of non-US born adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018 was assessed using day one of 24-h dietary recall, and the relative daily energy intake comprised of UPFs was used as the outcome of interest. The effect of acculturation assessed by an acculturation index (AcI) on UPF consumption was investigated after controlling for significant covariates. Complex survey sample regression analyses were used to evaluate the association between UPF consumption and AcI.

Population sample (n = 3,639) was comprised of non-US born adults (50% male) between 19 and 70 (43.1 ± 0.40) years of age. Of the adults assessed, 42.2% had lower AcI scores of 0 to 2, whereas 57.8% were more accultured (AcI scores of 3-5). Overall, dietary energy from UPFs was about 43.3%. When controlling for co-variates, acculturation was significantly associated with UPF consumption (β = 0.03, s.e. = 0.004, p < 0.001), meaning that for every unit increase in AcI score, there was a 3 % increase in mean UPF consumption. When the interaction between AcI and race/ethnicity was assessed, there was no difference in the impact of AcI on UPF consumption among race/ethnicity groups (p = 0.052).

Our findings indicate that greater acculturation is associated with higher UPF consumption. Given the links between high UPF consumption and adverse health outcomes, targeted interventions that promote healthier dietary choices-while preserving culturally relevant eating habits-are essential to support the well-being of non-US born populations.

Ultra-processed food (UPF) intake has been associated with adverse health outcomes; however, research on UPF intake and cardiovascular disease (CVD) prognosis has largely neglected its longitudinal pattern over time. This study investigated trajectories of UPF intake over a decade and their prospective associations with the risk of fatal and non-fatal CVD, as well as all-cause mortality, using data spanning from 16 to 19 years.

This study utilized data from the British Whitehall II cohort study, including 7,138 participants (68.3% male; median baseline age 60.4 years), all free of CVD at baseline. Dietary intake was assessed using a validated 127-item food frequency questionnaire at three time points: phase 3 (1991-1994), phase 5 (1997-1999), and phase 7 (2002-2004). UPF intake was estimated using the Nova classification, and group-based trajectory modelling identified different longitudinal consumption patterns. Phase 7 (2002-2004) was the baseline for subsequent monitoring of cardiovascular events and mortality outcomes until 2019/2021. Multivariate Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for socio-demographics, lifestyle, diet quality, energy intake, and clinical factors.

Three distinct UPF trajectory groups were identified: high (26.2% of participants), moderate (52.9%) and low UPF intake (20.9%). All groups showed a slight increase in UPF intake over time. Over the median follow-up of 16 years for incident cases and 19 years for mortality, we observed 1,128 incident CVD events, 859 CHD cases and 1,314 deaths. The highest vs. lowest UPF intake group had a 23% higher risk of CVD (HR 1.23, 95% CI 1.01 to 1.40), and a 32% higher risk of CHD (HR 1.32, 95% CI 1.06 to 1.65). No significant associations were observed between UPF trajectory groups and CVD mortality, CHD mortality, or all-cause mortality.

Sustained high UPF intake over 10 years was associated with increased risks of non-fatal CVD and CHD but not with CVD-specific, CHD-specific, or all-cause mortality. These findings suggest that sustained high intake of UPF may be a modifiable risk factor for preventing non-fatal cardiovascular risks.

Background: Nutrition can influence the occurrence of Premenstrual Syndrome (PMS) symptoms such as depression and food addiction. However, there is insufficient evidence on how ultra processed foods (UPFs) characterised by high sugar, fat and additive content contribute to PMS symptoms. Aim: This study aimed to examine the relationship between UPF consumption and PMS symptoms including depressed affect, anxiety, fatigue, irritability, and pain severity among female university students. Methods: The study is cross sectional. It was conducted among 432 female students from Bandirma Onyedi Eylul University. The data collection tools included descriptive information form, UPF consumption frequency questionnaire, and the PMS scale. Numbers, percentages, mean, standard deviation and multiple linear regression analysis were used in the analysis of the data. Results: In this study in Model 1 and Model 2 and Model 3 adjusted for confounding variables, an increase in UPF consumption was found to be associated with an increase in PMS scale subscale scores (p < 0.05). Conclusion: This study shows that an increase in UPF consumption exacerbates PMS symptoms such as depression, anxiety, fatigue, irritability, depressive thoughts, pain, appetite changes, and sleep changes, except bloating. Given these results, limiting UPF intake and adopting a balanced diet rich in whole foods, fiber, and essential nutrients may help alleviate PMS symptoms. Future interventions should focus on dietary education and awareness programs to promote healthier eating habits among young women.

Ultra-processed foods (UPF) play a central role in modern diets but pose a serious threat to public health. The aim of this study was to investigate the relationship between UPF consumption and hedonic hunger, food addiction, and mood and to explain the impact of these factors on dietary habits. This cross-sectional study included 3997 adults (2517 female, 1480 male), aged 18-65 years, recruited through snowball sampling in Ankara, Turkey. Data were collected via a web-based survey that included demographic information, self-reported anthropometric measurements, and validated scales: Screening Questionnaire of Highly Processed Food Consumption, The Power of Food Scale, Yale Food Addiction Scale, and Depression Anxiety Stress Scale-21. The mean age of the participants was 31.7 ± 12.82 years. The Screening Questionnaire of Highly Processed Food Consumption was positively correlated with the Yale Food Addiction Scale score and the subdimension scores of the Depression Anxiety Stress Scale-21 (p < 0.05). According to linear regression analysis, it was determined that gender, age, Yale Food Addiction Scale score, and the scores of depression, anxiety, and stress affected the Screening Questionnaire of Highly Processed Food Consumption score (p < 0.05). There was a difference between the groups with low and high levels of UPF consumption in terms of age, gender, marital and working status, Yale Food Addiction Scale score, and the subdimension scores of the Depression Anxiety Stress Scale-21 (p < 0.05). In conclusion, considering the influence of food addiction and mood on UPF consumption, policies and interventions targeting the psychosocial processes of individuals should be developed and further research conducted in this area to limit the UPF consumption and promote healthy eating habits along with conscious eating behaviors.

Humans are widely exposed to synthetic chemicals, especially via food. The types of chemical contaminants in food (including food contact chemicals) are diverse, and many of these are known to be hazardous, with mounting evidence that some contribute to noncommunicable diseases. The increasing consumption of ultra-processed foods, which contain synthetic chemicals, also contributes to adverse health. If the chemical contamination of foods were better characterized, then this issue would likely receive more attention as an important opportunity for disease prevention. In this Review, we discuss types and sources of synthetic food contaminants, focusing on food contact chemicals and their presence in ultra-processed foods. We outline future research needs and highlight possible responses at different food system levels. A sustainable transition of the food system must address the health impacts of synthetic chemicals in food; we discuss existing solutions that do justice to the complexity of the issue while avoiding regrettable substitutions and rebound effects.

This review examines the growing concern regarding the relationship between maternal ultra-processed food (UPF) consumption, preterm birth, and the subsequent development of metabolic disorders in offspring. Ultra-processed foods have become increasingly prevalent in global diets, coinciding with rising rates of metabolic diseases. Concurrently, preterm birth remains a significant public health concern affecting 5-18% of births worldwide. Here, we critically reviewed the current evidence regarding how maternal UPF consumption affects fetal development and how preterm birth disrupts metabolic programming. Furthermore, the information is presented on the potential synergistic effects when both factors are present. The mechanisms underlying these associations, including fetal malnutrition, inflammation, and hormonal dysregulation, are analyzed. Research suggests that maternal UPF consumption and preterm birth independently contribute to altered metabolic health in offspring, with potential compounding effects when both factors are present. This review highlights the public health implications of these findings and identifies areas requiring further research to better understand the complex interplay between maternal diet, preterm birth, and long-term metabolic health outcomes in offspring.

As a consequence of global population growth, rising incomes, urbanisation, and improved household economics, the demand for animal products is expected to increase. This has led to a heightened focus on the challenge of allocating natural resources between the production of human food and livestock feed. The livestock industry, particularly ruminant producers, is seeking cost-effective, human-inedible feed alternatives due to the rising costs of forage production and grains. Former foodstuff products (FFPs), derived from food industry leftovers (material remnants of food processing), represent a promising strategy for reducing feed-food competition, particularly through partial replacement of grains and concentrate feed in ruminant diets. FFPs are rich in simple sugars and fats; however, their excessive intake by ruminants may increase the risk of subacute rumen acidosis and modulate microbial protein synthesis and methane emissions. Furthermore, chemical substances present in FFPs (polyphenols and theobromine), packaging remnants, and microbiological contaminants may alter ruminal ecosystems and fermentation, methane emissions, milk quality, and animal health. This review summarises the nutritional composition of FFPs, with a focus on their potential to replace energy feeds, the risks and benefits of FFPs in ruminant nutrition, and legislation regarding the use of FFPs in livestock diets. It concludes by highlighting further research that could promote sustainable FFP practices.

Although the adverse health effects of consuming ultra-processed foods (UPFs) are well-documented, limited evidence exists on their impact during lactation. This study examined the association between maternal UPF consumption, feeding practices, and malnutrition in breastfed infants. A cross-sectional analysis was conducted with 111 mother-child pairs up to 150 days postpartum. Infant feeding practices were assessed using WHO indicators, and malnutrition was evaluated by length-for-age and BMI-for-age. Maternal dietary intake was estimated using two 24 h recalls, and UPF consumption was classified by the Nova classification. Dyads were grouped based on the highest UPF consumption quartile, and adjusted binary logistic regression was applied. UPFs accounted for 26% of the maternal diet on average. While 71.2% of infants were exclusively breastfed, one-third were overweight, and 11.7% were stunted. High maternal UPF consumption (>32% of energy) was associated with increased odds of malnutrition by BMI-for-age (wasting or overweight) (OR 3.38; 95% CI: 1.29-8.83) and stunting (OR 3.89; 95% CI: 1.04-14.58). Feeding practices showed no association. These findings highlight that maternal UPF consumption is associated with malnutrition odds in breastfed infants in the population assessed, emphasizing the need for dietary guidance during lactation to improve infant health outcomes.

Lunch is an important meal in Brazil, with varying standards among different population groups. This study aims to determine the lunch dietary patterns of Brazilian adults and verify their association with socioeconomic and demographic characteristics. Data from the Brazilian National Dietary Survey were used, comprising 28,901 adults aged 19 to 59 years (excluding pregnant and lactating women). Food consumption was assessed via 24-hour recalls at the interviewee's home. A total of 1,832 food items were recorded, 1,120 of which were mentioned at lunch. Socioeconomic and demographic variables were obtained through a structured questionnaire. Dietary patterns were derived by factor analysis, considering the complexity of the sample. The mean scores and 95% confidence intervals for each dietary pattern were estimated across all levels of socioeconomic and demographic variables. Considering the complexity of the sampling design, all analyses were performed using the statistical package SAS OnDemand for Academics. In total, 3.4% of Brazilian adults reported not having lunch. In total, three patterns explained 30.7% of lunch variability: traditional Brazilian; salads; and protein-based meal with desserts and beverages. Men, individuals with less schooling, those with lower income, and residents of the Central-West and Northeast regions adhered more to the traditional pattern. Fruits did not play an essential role in any pattern. Adherence to dietary patterns varied according to socioeconomic and demographic factors.

Background/Objectives: Plant-based diets are associated with human and planetary health. However, the overall quality of these diets may depend on the proportion of ultra-processed foods (UPFs). This study investigates the association between UPF consumption and plant-based diet quality in Australian adults. Methods: Analysis was conducted on 9111 participants (aged ≥ 19 years) from the National Nutrition and Physical Activity Survey 2011-2012. Food items reported from a 24 h recall were classified using the NOVA system, and the contribution of UPFs to total energy intake was calculated. Plant-based diet quality was examined using the overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI). Multiple linear regression models were used to examine the association between the UPF intake and PDI, hPDI, uPDI, and their score components. Results: The proportion of energy from UPFs was positively associated with the uPDI (β = 0.80; 95% CI 0.72, 0.89) and negatively associated with the PDI (β = -0.13; 95% CI: -0.22, -0.04) and the hPDI (β = -0.65; 95% CI: -0.73, -0.57). All score components of the PDI, hPDI and uPDI, except whole grains, legumes and fruit juices, significantly contributed to these associations. The sugars and syrups group contributed most to the positive association between UPFs and the uPDI (β = 6.47; 95% CI: 6.07, 6.87) and the negative association of UPFs and the hPDI (β = -6.47; 95% CI: -6.07, -6.87). Conclusions: Higher consumption of UPFs was associated with a lower plant-based diet quality. These findings have implications for the design of dietary interventions that encourage the consumption of minimally processed plant-based foods.

Ultra-processed foods (UPFs) are characterized by poor nutritional composition and the generating neo-formed carcinogens during high levels of processing. The current study aimed to investigate the association between UPFs consumption and the odds of prostate cancer (PC).

This case-control study recruited 62 PC cases and 63 hospital-based controls from two major referral hospitals of Shiraz, Iran, in 2015. Eligible men, newly diagnosed with PC through histological confirmation, were included as cases. Along with demographic and anthropometric information data, participant's dietary intake was assessed using a semi-quantitative food frequency questionnaire. The NOVA classification was employed to categorize food items based on their level of industrial processing. The association between UPFs consumption (as a percentage of daily calorie intake) and the odds of developing PC was estimated using logistic regression models. BMI, education, physical activity, age, and fiber intake were considered confounders in the adjusted model.

The study included 60 cases and 60 controls, with mean UPFs intake of 8.3% and 6.4%, respectively. The crude analysis showed no significant association between UPFs intake and PC odds ratio (OR) (OR = 1.96, confidence interval (CI) 95%: 0.94-4.05, P = 0.069). However, after adjusting for potential confounders, the association became significant, with high versus low UPFs intake associated with 2.81 times higher odds of PC (OR = 2.81, CI 95%: 1.18-6.65, P = 0.019).

Our findings highlight UPFs consumption as a factor associated with higher odds of PC in the Iranian male population. The study emphasizes the importance of monitoring industrial food processing practices and implementing measures to reduce UPFs consumption.

Ultra-processed foods (UPFs) are becoming more and more important in daily diets around the world; in some cases, they can account for as much as 60% of daily energy intake. Epidemiological evidence suggests that this shift toward high levels of food processing may be partially responsible for the global obesity epidemic and the rise in the prevalence of chronic diseases.

Few prospective studies have examined the relationship between UPF consumption and cancer outcomes. According to currently available information, UPFs may increase the risk of cancer due to their obesogenic properties and exposure to substances that can cause cancer, such as certain food additives and pollution from product processing. The complex relationship between obesity and cancer involves factors such as immune dysregulation, altered adipokine and sex hormone levels, abnormal fatty acid metabolism, extracellular matrix remodeling, and chronic inflammation. Addressing cancer risk associated with UPF consumption could involve a multifaceted approach, including consumer behavior modification programs and robust public health regulations aimed at enhancing food environments. Improved knowledge of the potential dual negative impacts of UPFs on the environment and cancer risk is one of the priority areas we identify for future research and policy implications. Various approaches could be used to prevent cancers associated with UPF consumption, such as consumer behavior change programs and stricter public health regulations needed to improve the food environment. This review examines for the first time the potential role of UPFs in cancer risk associated with obesity, exploring underlying biological mechanisms and identifying key areas for future research and policy action, including the dual environmental and health impact of UPFs.

Ultra-processed food (UPF) intake is high among adolescent populations worldwide. This study aimed to characterize the UPF intake and assess its contribution to the traditional diet of Costa Rican adolescents. Using cross-sectional data from 3-day food records obtained from 818 adolescents (13-18 years) from San José, Costa Rica, we calculated the daily % of total energy intake (TEI) from Nova-defined UPF, the Traditional Costa Rica Adolescents Diet Score (TCRAD; higher score reflecting higher traditional adherence), other nutrients, and fiber. The multivariable-adjusted mean UPF intakes were compared across participants' characteristics, mealtime, and days of the week, and assessed for association with TCRAD (continuous score and by adherence categories) and dietary components. UPF intake represented 35.9% of the TEI and was higher on weekdays (vs. weekends), among female adolescents (vs males), urban areas (vs. rural), and higher socioeconomic status. UPF were consumed mostly as snacks (43.5%), in the morning: (58.5%) and afternoon (41.5%). Each 10-percentage-point increase in the total UPF energy contribution was associated with -0.44 (SE = 0.04; P < .0001) lower TCRAD score. UPF was inversely associated with fiber and beneficial micronutrients, and directly associated with added sugars and trans fats. The multivariable-adjusted UPF intake was lower at moderate (38.5%, P < .0001) and high (29.9%, P < .0001) adherence to the TCRAD, compared with low adherence (43.9%). Our results support widespread trends of UPF displacing healthy diets. Strategies to reduce UPF consumption, especially during school hours, and encourage healthy traditional diets, are needed for Costa Rican adolescents.

Research on poor eating habits among individuals recovering from substance use disorders (SUD) is limited. This study examines the relationship between poor eating habits, delay discounting (DD), quality of life (QOL), and remission status, in addition to examining DD as a mediator of the relationship between poor eating and QOL.

Participants (n = 257) in recovery from SUD, completed the Health Behaviors Questionnaire (poor eating was measured using the food domain), a DD task, the World Health Organization QOL questionnaire, demographics, and SUD-related questions. Multivariate linear regression was used to test associations between poor eating and DD, as well as each QOL domain. Mediation analyses were conducted to evaluate the role of DD in the relationship between poor eating and QOL. A binary logistic regression was used to test associations between poor eating and remission status, as well as DD and remission status.

Poor eating habits were significantly associated with higher rates of DD (β = 0.08, p < .001) and lower QOL across psychological (β = -0.88, p < .001, only for those in remission), physical (β = -0.58, p < .001), and environmental (β = -0.75, p < .001) domains. Additionally, DD significantly mediated the relationship between poor eating habits and reduced QOL in these domains (ꞵs < -0.08, ps < 0.003). Poor eating (ꞵ = 0.05, p = .014; OR = 1.05, p = .012) and high DD rates (ꞵ = 0.12, p = .049; OR = 1.12, p = .038) were associated with a lower likelihood of remission from SUD.

Our findings highlight the integral role of dietary habits in the recovery trajectory of individuals with SUD. The study supports the need for holistic treatment approaches that consider the impacts of nutrition on both psychological and physiological aspects of recovery.

To present a screener for consumption of ultra-processed foods for children in early childhood, evaluating the ability of the score generated by this screener to reflect the participation of ultra-processed foods in children's diets.

This study was conducted with a convenience subsample of the 2015 Pelotas Birth Cohort (n = 365). The mothers of the participating children answered a food consumption questionnaire the day before the interview (screener) containing 16 subgroups of ultra-processed foods, followed by a traditional 24-hour food recall (24hR). Each participant's ultra-processed food consumption score corresponded to the number of food subgroups consumed and the percentage of energy derived from the participation of ultra-processed foods in the diet on the same day was calculated from the answers in the 24hR. The association between the score and the percentage of energy from ultra-processed foods was tested using linear regression models. The degree of agreement between the classification of participants according to approximate fifths of the percentage of calories from ultra-processed foods and according to the score intervals was assessed using the Pabak index.

The average percentage share of ultra-processed foods in the total caloric value of the diet, calculated using the 24hR, was directly and significantly associated with an increase in the ultra-processed food consumption score. There was substantial agreement between the ranges of the ultra-processed food consumption score obtained by the screener and the approximate fifths of the share of ultra-processed foods in the diet calculated by the 24hR (Pabak index = 0.65).

The ultra-processed food consumption score, obtained from an ultra-processed food consumption screener, a practical and agile instrument, is capable of reflecting the participation of ultra-processed foods in children's diets, with regard to the 2015 Pelotas Birth Cohort.

This article organizes the origin and historical context of the second edition of the Dietary Guidelines for the Brazilian Populationten years after its publication, analyzing its contributions to the science of Nutrition and public food and nutrition policies in Brazil and around the world.

This is a narrative review prepared based on consultation of scientific articles, gray literature and journalistic publications, among others.

The Guide resulted from scientific evidence and subsequently became an object of study. Its being based on the Nova Food Classification brought a new paradigm to nutritional science. Its publication was the basis of a series of public policies that encourage consumption of fresh or minimally processed foods and mitigate consumption of ultra-processed options.

The Guide was able to induce and guide health actions and other public policies to promote adequate and healthy eating. It also boosted scientific research, having national and global influence.

Background/Objectives: This scoping review explores the relationship between ultra-processed food (UPF), bone health, and joint diseases, focusing on its potential impact on bone mineral density (BMD), osteoporosis, osteoarthritis, and inflammatory arthritis, including rheumatoid arthritis (RA), gout, and spondyloarthritis. Methods: A search strategy was developed using key terms such as "ultra-processed food" and related terms like "fast food," alongside various definitions of bone health impairment, chronic degenerative joint diseases, and inflammatory arthritis. Results: A total of 19 studies were included: 12 on bone health, 3 on osteoarthritis, and 4 on inflammatory arthritis. Preclinical studies showed that UPF consumption negatively affects bone structure and strength. In studies on children and adults, four investigations (2013-2017) found no association between fast food intake and BMD. However, more recent large-scale cross-sectional studies linked higher UPF consumption to lower BMD, increased osteoporosis risk, and greater prevalence of osteopenia, particularly in postmenopausal women. UPF intake was associated with knee osteoarthritis risk, with evidence suggesting an interaction with cartilage thickness, though no association was found for hip osteoarthritis. In inflammatory arthritis, UK Biobank data indicated a higher risk of RA and gout in UPF consumers, while a Brazilian study reported worse metabolic profiles in RA patients. No significant differences in UPF intake were found in spondyloarthritis. Conclusions: This review highlights relevant considerations about the deleterious role of UPF on bone health and joint diseases, providing additional evidence to suggest healthier dietary patterns to patients and to the general population.

To describe the development and validation of the Nova FFQ (NovaFFQ) for Brazilian adults.

The NovaFFQ is a self-administered, semi-quantitative questionnaire. The food list includes the most consumed foods and drinks based on 2017-2018 National Food Intake Survey data. We identified and differentiated foods that could be classified into multiple Nova groups. We assessed reproducibility and criterion validity using the percent energy contribution of each Nova group. Reproducibility was assessed by comparing NovaFFQ estimates on two occasions. Criterion validity was assessed by comparing the first NovaFFQ estimate against the mean of two Nova24h recalls. We estimated the intraclass correlation coefficients (ICC) for both analyses and assessed the agreement of classification into quintiles using the prevalence-and-bias-adjusted kappa coefficients for criterion validity analysis.

Nationwide Brazilian study, the NutriNet-Brasil cohort.

There were 243 participants in the reproducibility analysis and 376 in the criterion validity analysis.

Strong reproducibility was observed, with an ICC of 0·91 for all the Nova groups. Criterion validity showed a moderate ICC, ranging from 0·61 for processed and ultra-processed foods (UPF) to 0·65 for unprocessed and minimally processed foods. Substantial agreement in ranking individuals across quintiles was found, as indicated by the prevalence-and-bias-adjusted kappa (PABAK = 0·74, 0·72, 0·70 and 0·73 for unprocessed and minimally processed foods, culinary ingredients and processed and ultra-processed foods, respectively).

The NovaFFQ is a valid instrument for assessing food consumption by processing level, especially for discriminating individuals according to the magnitude of consumption in all Nova groups.

Longitudinal cohort studies across the lifespan suggest an association between ultra-processed food (UPF) and depression. However, the effect of UPF on depression and mental health in older adults has not been determined. Therefore, this study investigated the effect of UPF on depressive symptoms and mental health in community-dwelling older adults.

A pragmatic target trial was designed and emulated using the ASPirin in Reducing Events in the Elderly longitudinal data. Participants were community-dwelling older adults (≥ 70 years) in Australia. We specified and emulated the protocol of a two-arm randomised pragmatic clinical trial using the level of UPF consumption as the intervention. Greater than or equal to 4 servings of UPF per day was considered the intervention, with less than 4 servings per day the control. Dietary consumption was assessed using a mail-based diet screening questionnaire, and the level of food processing was classified based on the NOVA classification. The study outcomes were depressive symptoms, defined as a score of ≥ 8 on the Center for Epidemiological Studies Depression 10-item scale, and general mental health, defined by the mental component summary score of the Short Form-12. We applied inverse probability treatment weighting to balance confounders. Marginal structural models were employed to estimate the population-level average effect of intervention using generalised estimated equations.

A total of 11,192 participants (3415 intervention and 7777 control) were eligible for the emulation. High UPF consumption at time zero was associated with an increased risk of depressive symptoms at follow-ups (RR: 1.10; CI: 1.04-1.18). The finding was consistent with sensitivity analyses; after excluding participants on antidepressants at time zero, the risk of depressive symptoms in the intervention group was increased by 11% compared to the control (RR: 1.11; 95% CI: (1.04-1.20)). Consumption of UPF adversely affected the mental component quality of life (β: - 0.40; CI: - 0.65 to - 0.15).

A higher level of UPF consumption was associated with a higher risk of depressive symptoms and adversely affected mental health among older adults.

Global dietary patterns are increasingly driven by ultra-processed foods-cheap, highly palatable, and ready-to-eat options. Exploring time-related eating patterns and its association with ultra-processed foods could help in intervention efforts, but knowledge on this topic is still limited. This study assessed the association of time-related eating patterns with unprocessed/minimally processed and ultra-processed food consumption across different life stages.

Two 24-hour food recalls from a nationally representative sample in Brazil (Brazilian Household Budget Survey, POF, 2017-2018; n = 46,164) were used to estimate tertiles of first and last intake times, eating midpoint, caloric midpoint time, and night fasting (independent variables). All consumed foods were classified according to the Nova classification system, and the outcomes of interest were consumption of unprocessed/minimally processed and ultra-processed foods. Multiple linear regression models were performed for all individuals and stratified for each age group: adolescents (10-19 years, n = 8,469), adults (20-59 years, n = 29,332), and older individuals (≥ 60 years, n = 8,322).

The later tertile of first food intake time, last food intake time, caloric midpoint, and eating midpoint were positively associated with consumption of ultra-processed foods (β = 3.69, 95%CI = 3.04, 4.34; β = 1.89, 95%CI = 1.32, 2.47; β = 5.20, 95%CI = 4.60, 5.81; β = 3.10, 95%CI = 2.49, 3.71, respectively) and negatively associated with consumption of unprocessed or minimally processed foods (β=-2.79, 95%CI=-3.37; -2.22; β=-1.65, 95%CI=-2.24, -1.05; β=-3.94, 95%CI=-4.44, -3.44; β=- 2.35, 95%CI=-2.93, -1.78, respectively) compared to the first "earlier" tertile (reference). An inverse association was found for night fasting (β=-1.74, 95%CI=-2.28, -1.22 and β = 1.52, 95%CI = 0.98, 2.06 for ultra-processed and unprocessed/minimally processed foods, respectively). These associations were consistent across all age groups.

Chrononutrition patterns characterized by late intake timing and shortened overnight fasting were associated with higher consumption of ultra-processed foods and lower intake of unprocessed/minimally processed foods across all age groups.

The contribution of dietary phosphate (P) in the pathogenesis of CKD-associated mineral bone disease and the management of P intake in patients with CKD are essential to slow down disease progression and improve patient outcomes. In patients with CKD, and most likely in the general population, P retention and overload can affect four critical aspects of the cardiovascular system: increased arterial BP, vascular and valvular calcification, and left ventricular hypertrophy. All of these factors contribute to increased cardiovascular risk and mortality. Intestinal absorption of P from a mixed diet is approximately 60%-70% of the dietary P content, with lower rates for organic P from plant sources and higher rates for inorganic P from processed foods containing additives. The widespread use of phosphate additives in processed foods and the high consumption of animal protein in the Western diet have led to a steady increase in phosphate consumption in recent decades. Although it is unclear whether this high P intake has adverse effects in people with normal kidney function, several studies have found that increased dietary P contributes to the progression of CKD and cardiovascular damage. High P intake may be detrimental, but there is no clear evidence that it should be avoided in the general population. On the contrary, kidney function impairment is the setting in which modulation of P intake is justified and easy to implement by restricting/reducing protein intake. However, it is quite difficult to implement P restriction in patients on dialysis because of the conflicting recommendation of high protein intake. Educational approaches, together with solid motivation and adherence by patients and caregivers, are needed to achieve the goal of successful dietary phosphate management in patients with CKD.

To assess the caloric contribution of ultra-processed foods (UPFs), factors associated with UPFs energy intake and investigate the relationship between UPFs energy intake, diet quality and nutrient intake among adolescents in urban slums, Kenya.

A cross-sectional household study amongst adolescents (10-19 years, N = 621) collected socio-demographic and dietary intake data. Global Diet Quality Score (GDQS); mean and percentage total energy intake (%TEI) from UPFs; and nutrient intakes were computed. Regression analysis assessed the factors associated with UPFs energy intake, and the association between %TEI from UPFs and diet quality.

Mean daily energy intake was 1,604 kcal (±550), 25.2% from UPFs. Higher leisure screen time (≥2 h/day) [OR = 1.9 (1.2-3.1)] was associated with UPFs energy intake. Household wealth index (quintile five vs. one) [OR = 2.6 (1.3-6.0)] was associated with non-UPFs energy intake. UPFs (%TEI) was inversely associated with GDQS score (quartile four vs. one) [β = -2.9 (-3.4 to -2.1)]. Adolescents with higher %TEI from UPFs (quartile four) had highest total energy, total fat and saturated fat; and lowest protein, fibre, iron, calcium and zinc intake.

UPFs contribute substantially to adolescents' energy intake and are linked to poor diet quality and nutrient intake.

There is growing interest in the connection between ultra-processed food (UPF) and cardiovascular diseases. This study explores how UPF intake relates to the severity of coronary artery disease (CAD) in at-risk patients undergoing elective angiography.

Data covering demographic, and clinical details, and dietary intakes (using a validated food frequency questionnaire) were gathered from the Nutrition Heshmat Registry (NUTHER) in Rasht, Iran. UPF consumption was evaluated using the NOVA food classification system, with the exception of core grain foods. The study comprised 1,015 participants, who were classified based on the severity of CAD using the Gensini score (severe-CAD = Gensini score ≥ 60). Logistic regression was used to analyze the odd ratio (OR) and 95%confidence interval (95%CI) for severe-CAD across UPF quartiles (percentage of energy), and for each 10% increase in UPF intake. Restricted cubic spline (RCS) regression was employed to explore nonlinear relationships between UPF and severe-CAD.

Following controlling for potential confounders, normal-weight participants in the highest quartile of UPF exhibited about 5 times greater odds of severe-CAD than those in the lowest category (OR(95%CI): 5.01 (1.89, 13.29); P-for-trend = 0.002). Overweight/obese participants in the higher UPF quartiles had approximately 2-3.5 times greater odds for severe-CAD than those in the 1st quartile (ORs (95%CIs): 3rd quartile 1.91 (1.14, 3.21); and 4th quartile: 3.53 (2.07, 5.99); P-for-trend < 0.001). Each 10% increase in daily energy intake from UPF was associated with about 1.6-2 times increased severe-CAD risk among overweight/obese and normal-weight individuals (ORs (95%CIs) of 1.64 (1.28, 2.11), and 2.24 (1.24, 4.05), respectively). RCS analysis showed an upward trend toward higher UPF intake in relation to increased risk of severe-CAD (P-for-overall-trend < 0.0001; P-for-nonlinearity = 0.005).

The findings obtained underscore a direct association between UPF and the risk of CAD progression among at-risk patients, independent of BMI. However, further prospective studies are essential to confirm these results and better understand this relationship.

Ultra-processed food (UPF) consumption has been steadily increasing globally, yet the associated risk of all-cause mortality remains unclear. We aimed to assess the risk of all-cause mortality of UPFs via an updated systematic review and dose-response meta-analysis.

A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library for studies published until July 2, 2024, in addition to referred studies included in the previous systematic review. Prospective cohort studies assessing the association between NOVA classification-defined UPF consumption and all-cause mortality were included. Dose-response meta-analysis via a random-effect model was used to combine the results with hazard ratio (HR) as an effect measure.

Overall, 18 studies with 1,148,387 participants (173,107 deaths) were identified. Compared to the lowest, participants with the highest UPF consumption had a 15% increased risk of all-cause mortality (HR = 1.15, 95% CI 1.09-1.22; I2 = 83.0%). Furthermore, a 10% higher risk of all-cause mortality was detected with each 10% increment in UPF consumption (HR = 1.10, 95% CI 1.04-1.16; I2 = 91.0%). Dose-response analysis showed a positive linear association (Pdose-response < 0.001). Moreover, subgroups and sensitivity analyses indicated consistent findings, while meta-regression analyses suggested sex distributions partially explained heterogeneity, with a higher risk of all-cause mortality in males.

Our updated meta-analysis, incorporating a greater number of newly published cohort studies using NOVA classification with the largest sample size to date, strengthens the evidence linking higher UPF consumption to increased all-cause mortality risk. Strategies such as dietary guidelines and policies for limiting UPF consumption worldwide should be encouraged.

PROSPERO CRD42023467226.

The incidence of type 2 diabetes has risen globally, in parallel with the obesity epidemic and environments promoting a sedentary lifestyle and low-quality diet. There has been scrutiny of ultra-processed foods (UPFs) as a driver of type 2 diabetes, underscored by their increasing availability and intake worldwide, across countries of all incomes. This narrative review addresses the accumulated evidence from investigations of the trends in UPF consumption and the relationship with type 2 diabetes incidence. Hypotheses for why UPFs may be causally implicated in the initiation and progression of weight gain and suboptimal blood glucose levels are varied. There is also uncertainty and debate about whether detrimental effects of UPFs could be owing to additives and other features of industrial processing, independent of established dietary risk factors, namely added sugar, sodium, saturated fat and low fibre content. However, these current research gaps are addressable with rigorous research and coordinated efforts across nutrition-science domains; for example, the strengths of longitudinal cohort studies can be leveraged to refine the characterisation of key UPF subcategories within the enormous and diverse category of UPFs and ultra-processed beverages, and to identify high-risk patterns of intake that are related to the development of chronic-disease outcomes. The notable advantages of dietary intervention studies are the critical gains in the reliability of dietary assessments, and isolating the effects of individual UPF additives and features through carefully formulated diets. Research improving our understanding of the modifiable food environment, the diet's causal drivers of weight gain and suboptimal cardiometabolic health, and the interactions among them, can be used to meaningfully shift the food supply for large-scale improvements in health. Thus, although the global market share of UPFs seems to outpace the research on its detrimental health effects, leaving the scientific community with the responsibility of generating proof, there may still be promising opportunities to reduce the burden of type 2 diabetes.

With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals' health-related quality of life, a multidimensional concept that comprises an individual's physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life.

A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024.

A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis.

Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases.

The Brazilian Dietary Guidelines provide crucial recommendations for a healthy diet, aiming at promoting health and preventing non-communicable chronic diseases. The core principle is the preference for natural or minimally processed foods and freshly prepared dishes over ultra-processed foods. Despite their growing recognition, healthcare professionals struggle to integrate these guidelines into clinical practice. This article aims to present two innovative strategies for incorporating the Brazilian Dietary Guidelines into healthcare. The Protocols based on the Brazilian Dietary Guidelines for Individual Dietary Advice are standardized clinical tools to support healthcare professionals (nutritionists or not) in giving nutritional advice during individual appointments to various life stages. The Protocols operationalize the assessment of individuals' dietary patterns using the Food Consumption Markers Questionnaire and support the delivery of personalized and priority recommendations through a stepwise flowchart. Conversely, Brazilian Dietary Guidelines-based Meal Plans consist of personalized dietary prescriptions comprising structured daily menus that, unlike conventional plans primarily focusing on nutrient goals, prioritize overall eating patterns guided by the Brazilian Dietary Guidelines. The proposal encourages, in the first place, the selection of a variety of culinary preparations based on natural or minimally processed foods, emphasizing tasteful, accessible, and culturally appropriate choices as the initial step. In a second step, these plans can be customized to individual energy requirements, and adjustments made based on strategic nutrient needs. This article aims to support the enhancement of healthcare professionals' skills in promoting healthy eating practices, thereby contributing to improved health and a reduced disease burden among the Brazilian population.

Modern diets are increasingly dominated by ultra-processed foods, a shift driven by urbanization and lifestyle changes. Among these, ultra-processed meat products (UPMPs) are particularly popular due to their appealing flavor and texture. However, emerging evidence highlights potential health risks associated with UPMPs. Although meat products are rich in high-quality proteins, the processing methods used in UPMPs can affect protein digestibility. Moderate processing techniques, such as sous-vide cooking, fermentation, and enzymatic tenderization, can enhance digestion and nutrient absorption, whereas excessive processing may lead to protein aggregation and cross-linking, reducing protein digestibility. Additionally, the overuse of additives and excessive thermal processing are key concerns in UPMP production, leading to the formation of potentially harmful substances, including acrylamide, heterocyclic amines, polycyclic aromatic hydrocarbons, and advanced glycation end products. This review examines how different processing techniques influence protein digestibility in UPMPs, elucidates the pathways through which harmful substances are generated, and assesses the impact of UPMPs on gut health, with a focus on gut microbiota and the colon. Our synthesis of current research indicates that excessive consumption of UPMPs contributes to gut microbiota dysbiosis, compromises the gut barrier, and increases the risk of colorectal cancer, though the dose-dependent effects require further clarification. Future research should focus on key parameters of moderate processing, explore natural alternatives to harmful additives, examine the dose-response relationship between UPMP consumption and health risks, and evaluate how individual factors, such as genetics and metabolism, influence the health impacts of UPMPs.

The scope of this study was to verify differences in the characteristics of predominantly ultra-processed foods or culinary dishes on sale from the largest food delivery app in Brazil in neighborhoods with differing socioeconomic categories in the city of São Paulo. Twenty neighborhoods were selected, categorized according to quartiles of the Municipal Human Development Index. Data on food on sale, classified as culinary preparations or ultra-processed foods, were collected from the centroid of the neighborhoods. A sample of 350 promotions was analyzed, and their characteristics were compared according to the degree of processing categories and vulnerability of the neighborhood. A higher prevalence of promotions for ultra-processed foods was observed in three out of four socioeconomic categories. Places that offered culinary preparations were closer than places that offered ultra-processed foods. The average price and discount were higher for ultra-processed foods. Given the wide availability of ultra-processed foods, it seems necessary to promote the consumption of culinary preparations and highlight them in digital food environments in order to discourage the choice of ultra-processed foods.

While recent studies suggest a correlation between unhealthy dietary patterns, oxidative stress, inflammation, and male infertility, the potential association between ultra-processed foods (UPFs) and male infertility remains underexplored. Therefore, the aim of the present study was to investigate the association between UPF intake and male infertility by evaluating sperm quality parameters.

The participants (n = 260) of the current cross-sectional study were recruited from an infertility center in Isfahan Province, Iran. Four semen parameters-such as total sperm motility, sperm concentration, sperm volume, and normal sperm morphology-were evaluated. Also, the participants' food intake was assessed using a validated 168-item food frequency questionnaire. Moreover, the NOVA system was employed to calculate the UPF index. The association between UPFs and sperm parameters was analyzed using logistic regression.

In the crude model, no significant associations were observed between the second and last tertiles of UPFs with abnormalities in sperm concentration, total motility, and morphology (p > 0.05 for all). However, after adjusting for age, marriage duration, body mass index, physical activity, depression, anxiety, stress, energy intake, cigarette history, and mineral and vitamin supplements, a significantly higher association was identified between the second tertile of UPFs and abnormalities in sperm concentration (odds ratio (OR) = 3.962, 95% confidence interval (CI): 1.345-11.670, p = 0.013).

In conclusion, although the analysis did not find significant associations between UPF consumption and impaired sperm motility and morphology, it revealed significant trends linking higher UPF intake with lower sperm concentration. If future studies confirm these results, they could aid in designing interventional and preventive programs aimed at addressing infertility in men of reproductive age in the field of public health.

Higher ultra-processed foods (UPF), attributed to more than half of daily intake in the US, have been associated with impaired health outcomes. Documented evidence highlights disparities in UPF consumption due to food insecurity, which is a public health challenge among older adults in the US.

The study examined the link between food insecurity and UPF consumption. The potential of participants' sex, age, and race and Supplemental Nutrition Assistance Program (SNAP) participation in modifying the association were explored.

The analytical sample comprised 6295 US adults, aged 52 - 101 years, enrolled in the longitudinal Health and Retirement Study (HRS), a nationally representative study of aging. Food insecurity was evaluated in the 2013 HRS Health Care and Nutrition Study using the six-item Short Form Food Security Survey Module. Dietary intake was assessed using a food frequency questionnaire, and UPFs, quantified using the NOVA food classification system, were expressed as a percentage of total energy intake. The association between food insecurity and UPFs was examined using linear regression models, adjusted for sociodemographic characteristics.

The prevalence of food insecurity was 15%. Mean UPFs% (95% confidence intervals) were 49.1 (47.8, 50.3), 48.5 (46.6, 50.4), and 52.3 (50.4, 54.3) among adults with food security, low food security, and very low food security, respectively (P-trend = 0.0156). Race modifies the association between food insecurity and UPFs (P-interaction = 0.0033). A positive linear trend was detected among Whites (P-trend = 0.0036), but an inverse linear trend was found among African Americans (P-trend = 0.0007). There was no evidence for heterogeneity by age, sex, or SNAP participation.

Food insecurity was positively correlated with UPF consumption among adults in the US. Race modifies the association with a positive linear trend among Whites and an inverse linear trend among African Americans. Further efforts are needed to promote healthy aging via improving diet quality among food-insecure older adults.

Ultra-processed foods (UPF) are increasingly prevalent in modern diets and are associated with negative health outcomes such as chronic diseases due to their high processing and low nutrient density. Despite the potential impact of UPF intake during pregnancy on maternal and child health, studies in this area are limited. Therefore, this narrative comprehensive review aimed to identify associations between UPF consumption, categorized by the NOVA system, during pregnancy and maternal and child health outcomes over the past five years (2019-2024).

Following PRISMA-ScR criteria (2018), MedLine/PubMed, Scopus, and Embase databases were searched for articles on maternal and child health outcomes associated with UPF consumption categorized by the NOVA system during pregnancy, out of 767 studies identified, 22 were eligible.

Overall, high UPF consumption during pregnancy was positively associated with various adverse maternal-child outcomes, including gestational diabetes mellitus, gestational weight gain, poor glycemic control, negative nutrition biomarkers, inflammatory markers, and hypertensive disorders during pregnancy. It also negatively impacted child growth and development, and was associated with adiposity gain, potential adverse mental disorders, indicators of poor nutrition, and poor overall diet quality.

Despite the limited data, high consumption of UPF during pregnancy adversely affected the health outcomes of both mothers and children, impacting nutrition indicators and diet quality. Further studies on this topic are needed. Promoting healthy eating habits among pregnant women is crucial for achieving optimal health outcomes.

Relationships between ultraprocessed food (UPF) intakes and health have been well described in adults, but evidence of these relationships in older adults is rather limited. Demographic shifts in aging emphasize the importance of understanding the role of diet in maintaining health during later life.

The aim of this systematic review was to identify health outcomes associated with UPF consumption in those aged ≥60 years.

The Medline, Web of Science, Scopus, and Embase databases were searched from inception until June 2023, using search terms representing UPF and any health outcome. Observational studies restricted to individuals aged ≥60 years using the Nova food classification were included. Articles were screened independently by 2 researchers using PECOS inclusion criteria.

Two-thirds of the studies in the present review were prospective cohort studies (n = 4) and the rest were cross-sectional (n = 2). The number of participants ranged from 652 to 2713 across the 6 studies. The mean age of participants ranged between 67 and 73 years.

In the prospective cohort studies, the highest consumption of UPF was associated with incident frailty, incident dyslipidemia, renal function decline, and abdominal obesity. For cross-sectional studies, the highest intake of UPF was associated with negative outcomes similar to young and middle-aged cohorts, with the addition of nutritional frailty and worse cognitive performance.

Currently, the limited understanding of how high UPF intakes could be associated with negative health outcomes for older adults influences the ability to inform policy and practice recommendations. More research is required owing to the very limited number of studies, specifically in older adults.

PROSPERO registration no. CRD42023442783.

Increased ultra-processed food (UPF) is associated with adverse health outcomes. However, with limitations in UPF evidence, and partial overlap between UK front-of-package labelling (FOPL) and degree of food processing, the value of food processing within dietary guidance is unclear. This study compared food and drink from the UK National Diet and Nutrition Survey (NDNS) database based on micronutrient content, Nova classification and FOPL. The aim was to examine the micronutrient contributions of UK food and drink to UK government dietary micronutrient recommendations for adult females and males, aged 19-64 years, based on the degree of food processing and FOPL. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients, processed food (PF) and UPF, and FOPL traffic lights. MPF, PF and UPF provided similar average contributions per 100 g to micronutrient recommendations. Per 100 kcal, MPF provided the greatest average contribution (14·4 % (interquartile range (IQR): 8·2-28·1)), followed by PF (7·7 % (IQR: 4·6-10·9) and then UPF (5·8 % (IQR: 3·1-9·7)). After adjusting for healthy/unhealthy items (presence of 1+ red FOPL), MPF had higher odds of an above-average micronutrient contribution per 100 kcal than UPF (OR: 5·9 (95 % CI 4·9-7·2)) and PF (OR: 3·2 (95 % CI 2·4-4·2)). MPF were more likely to provide greater contributions to micronutrient recommendations than PF or UPF per 100 kcal. These findings suggest that UPF or PF diets are less likely to meet micronutrient recommendations than an energy-matched MPF diet. The results are important for understanding how consumers perceive the healthiness of products based on FOPL.