The objective of the study was to estimate the contribution of ultra-processedfoods to total caloric intake and investigate whether it differs according to socioeconomic position. We analyzed baseline data from the Brazilian Lon- gitudinal Study of Adult Health (ELSA-Brasil 2008-2010; N = 14.378) and data on dietary intake using a food frequency questionnaire, assigning it into three categories: unprocessed or minimally processedfoods and processed culinary ingredients, processedfoods, and ultra-processedfoods. We measured the associations between socioeconomic position (education, per capita house- hold income, and occupational social class) and the percentage of caloric con- tribution of ultra-processedfoods, using generalized linear regression models adjusted for age and sex. Unprocessed or minimally processedfoods and pro- cessed culinary ingredients contributed to 65.7% of the total caloric intake, followed by ultra-processedfoods (22.7%). After adjustments, the percentage of caloric contribution of ultra-processedfoods was 20% lower among par- ticipants with incomplete elementary school when compared to postgraduates. Compared to individuals from upper income classes, the caloric contribution of ultra-processedfoods was 10%, 15% and 20% lower among the ones from the three lowest income, respectively. The caloric contribution of ultra-pro- cessed foods was also 7%, 12%, 12%, and 17% lower among participants in the lowest occupational social class compared to those from high social classes. Results suggest that the caloric contribution of ultra-processedfoods is higher among individuals from high socioeconomic positions with a dose-response relationship for the associations.
prevalence disease, should control the intake of food with lactose to avoid gastrointestinal symp- toms. Since tolerance depends on the amount of lactose ingested, it is essential to discuss the avail- ability of the amount of lactose information in processedfoods, which is currently not mandato- ry. The study measured the availability of infor- mation on the amount of lactose on the labels of processed food that contained milk or lactose in the ingredient list. Then, we contacted the food industry to request this information. We evalu- ated 1,209 processedfoods, of which 1,092 were traditional and 117 were diet/light/zero. Only 3,1% of the analyzed foods provided information on the amount of lactose in the labeled nutrition table. This information was more available in the diet/light/zero food group. Furthermore, of the 156 contacted companies, only 14 reported the amount of lactose contained in foods, 93 answered the request, but have not provided the amounts and 49 did not answer the request. We conclud- ed that there is a low availability of information about the amount of lactose in processedfoods. Key words Lactose, Lactose intolerance, Con- sumer rights, Nutrition labeling
In view of the above facts, it is still a major challenge for public health to reduce the consumption of ultra-processedfoods in food additives. Even when dealing with university students in the area of nutrition, they follow the trend of the general population, in which the consumption of ultra- processedprocessedfoods is growing every year. Measures are needed most encouraging healthy eating habits and physical activity among university students, they are the ones who will provide information to the public about healthy eating habits.
Prevalence rates (PR) and 95% confidence intervals (95%CI) for daily consumption of each group of ultra-processedfoods (UPF) according to daily time spent in sedentary behavior (≤ 2 hours versus > 2 hours) among Brazilian adolescents, adjusted for gender, age, skin color, maternal schooling, household assets index, major geographic region, and school’s administrative jurisdiction. Brazilian National School Health Survey (PeNSE), Brazil, 2015 (N = 102,072).
The aim of this cross-sectional study was to inves- tigate the association between sedentary behavior and consumption of ultra-processedfoods (UPF) among Brazilian adolescents. The study used data from the 2015 edition of the Brazilian National School Health Survey (PeNSE). Daily consump- tion of at least one group of UPF was the outcome, and the principal exposure was daily time spent in sedentary behavior (hours spent sitting, except for time sitting at school). We calculated prevalence rates, prevalence ratios, and 95% confidence inter- vals (95%CI). The analyses were adjusted for gen- der, age, skin color, maternal schooling, household assets index, major geographic region, and school’s administrative jurisdiction (public versus private). Forty percent of the schoolchildren reported daily consumption of at least one group of UPF (39.7%; 95%CI: 39.2-40.3), while 68.1% (95%CI: 67.7- 68.7) reported > 2 hours/day of sedentary behavior. Among schoolchildren with sedentary behavior > 2 hours/day, prevalence of daily consumption of UPF was 42.8% (95%CI: 42.1-43.6%), higher than among those without sedentary behavior (29.8%; 95%CI: 29.0-30.5%). Longer time spent in seden- tary behavior was associated with higher preva- lence of consumption of UPF (p-value for linear trend < 0.001). Strategies to promote healthy eat- ing and decrease sedentary behavior, as well as regulation of advertising for UPF, are necessary to prevent unhealthy lifestyles from persisting into adulthood.
In relation to the individual food consumption of vegetables, we analyzed the variety of vegetables consumed (expressed in absolute numbers), the participation (%) of the types of culinary preparations based on vegetables in the total consumption of vegetables, and time of consumption. The adjusted variety of vegetables consumed per individual and the adjusted participation of the types of culinary preparations in the consumption were described for all Brazilians studied and for the Brazilians with the lowest (1st quintile) and highest (5th quintile) intake of ultra-processedfoods. Furthermore, we also described the adjusted amount of vegetables consumed (in grams), according to the time of consumption, for all Brazilians studied and for the Brazilians with the lowest and highest intake of ultra-processedfoods. We tested the difference between the ultra-processed food consumption groups (1st and 5th quintiles) for variety, each type of preparation, and each time of consumption using multiple linear regression models.
Data was collected in 2015, following a writ- ten authorization by the hypermarket’s manage- ment. Information included processedfoods that contained milk or lactose in different positions in the list of ingredients, of different brands and fla- vors. Foods with the above characteristics, with the same composition, but with different pack- aging sizes, were excluded. It is worth noting that the position in the list of ingredients indicates, in decreasing order, the amount of the ingredient in the final product of the processed food, that is, the ingredients with higher amounts 24 appear in
The main sodium source in diet is the table salt (NaCl). Although adequate sodium intake is necessary for the proper functioning of the body, the consumption of excessive amounts of sodium is associated with diseases such as hypertension. Studies have been conducted to promote the consumption of low sodium foods, thus some strategies for sodium reduction in processedfoods were presented in this review. Alternatively, there are a number of techniques that have or can be implemented in food manufacturing in various sectors, especially the high-pressure processing. However, challenges in the development of food products on a commercial scale indicate that further studies to optimize the sensory and technological properties of the salt reduced products should be performed. The joint work of research institutions, food industries and regulatory health agencies, especially when considering the consumer, can bring positive responses towards the salt reduction target.
The average daily caloric intake was 3,758 calories, of which > 50.0% was attributed to the consumption of ultra-processedfoods (Table 2). The analysis of consumption by food group indicates that bread repre- sented 15.1% of the daily calorie intake among men, followed by sweets with 13.0%. For women, sweets were the main contributors to the daily caloric intake (16.8%), followed by bread (13.0%). Snacks were the third group of ultra-processedfoods consumed by both genders (men: 10.8%; women: 10.4%). The percentage of caloric intake attributed to the consump- tion of sweets, cookies, and yoghurts was higher among women, whereas the intake of bread, soft drinks, and processed meats was higher among men. The consump- tion of ultra-processedfoods was more frequent among women living without a partner, individuals with higher education, those who had never been poor, and those who were not overweight (Table 3). After adjusting for other sociodemographic variables, education remained positively associated with the percentage of caloric intake attributed to the consumption of
This study’s aim was to characterize the food environment of Brazilian pub- lic and private schools. This was a national school-based cross-sectional study with 1,247 schools – among which 81.09% were public and 18.91% were private – in 124 Brazilian municipalities. The data originated from the Questionnaire on Aspects of the School Environment, used in the Study of Cardiovascular Risk in Adolescents (ERICA) in 2013 and 2014. Data analysis was conducted in 2017. The chi-square test was used to compare pro- portions. A greater proportion of public schools offered school meals (98.15%) in comparison to private schools (8.07%) (p < 0.001). The internal sale of food and beverages was more prevalent in private schools (97.75% vs. 45.06%, p < 0.001). Also, sale and advertisement of processed and ultra-processedfoods (sodas, cookies, savory snacks, sandwiches and pizza), as well as the presence of vending machines for industrialized products (18.02% vs. 4%) (p < 0.001) were more common in private schools. Street vendors at the school gate or surroundings were identified in 41.32% of the public schools and 47.75% of the private schools (p > 0.05). These findings reveal the predominance of obe- sogenic environments mainly in private schools, and can contribute to the de- sign of Brazilian public policies to promote a healthy school food environment.
Considering the cowpea high nutritive value, low production cost and the use of its flour is processedfoods, partially substituting wheat flour, the objective of this work was to determine the chemical composition and granulometry, and evaluate the microbiological characteristics of whole-bean flours from five cowpea cultivars and their potential for use in bakery products.
consumption of sodium, saturated fat and free sugar, which relect the increased prevalence of ultra-processed food intake, such as carbonated soft drinks, juices, uncarbonated soft drinks and low participation of healthy food markers such as milk and fruits, in the diet of this age group. Reducing the consumption of ultra-processedfoods is one of the recommendations set out in the new Guia Alimentar para População Brasileira (Dietary Guidelines for the Brazilian Population) 16 . hese foods are associated with excessive calorie consumption and higher
classified foods into two groups: ‘foods that should be recommended’ and ‘foods that should be controlled’; based on this indicator, the recommended foods include fresh fruits; salads; non-starchy plants; cereals, bread, pasta and starchy vegetables; whole foods; meat and eggs; legumes; and milk and dairy products. The controlled foods include processed sweets and added sugar; sausages and processed meats; ready-to-eat processedfoods; canned and preserved foods; dehydrated food concentrates or in those in powder form; breakfast cereals, cakes, and biscuits; flatulent foods and those difficult to digest; beverages with low nutritional value; preparations with repeated colors in the same meal; fried foods, fatty meats; and fatty sauces. With the exception of preparations with repeated colors and supply of flatulent food, it is clear that there is a similarity between the IQCAE assessed in the current study and AQPC-School. The concept of healthy eating has undergone constant changes throughout the history of the science of nutrition, responding to political and social influences as well as the interests of various stakeholders in food standards, particularly in the food sector. Academic studies that explore the concept of healthy eating by offering a critical analysis of different viewpoints broaden our understanding of what ‘eating well’ means in contemporary times 37 . Although
product obtained by kneading and convenient cooking of dough prepared from flour, starch, fermented starch, or not” and states that the clas- sification of these products varies according to the ingredient that characterizes it or its form of pre- sentation. The resolution mentions salty or sweet crackers or cookies, which can be stuffed, coated, grissini, in the form of sticks and waffles. In some regions of Brazil, the term biscuit (alone) alludes to a product made with starch, milk, eggs (consid- ered in natura or minimally processedfoods), oil and salt (considered culinary ingredients), which can be made at home; this product would be clas- sified as a processed food, as would bread made with wheat flour, yeast, water and salt. By con- trast, cream-filled cookies are made with a wide range of ingredients for industrial use such as vegetable fat, colorants, emulsifiers and flavour- ings. Therefore, the term cream-filled cookies is preferred as an example of an ultra-processed food. In this study, 67% of the participants agreed on the classification of cream-filled cookies be- fore the mini-course; after the mini-course, this percentage reached 100%.
Metabolic syndrome (MetS) has a high prevalence around the world. Considering the components used to classify MetS, it is clear that it is closely related to obe- sity. These two conditions begin with an increase in abdominal adipose tissue, which is metabolically more active, containing a greater amount of resident macrophages compared to other fat deposits. Abdominal adiposity promotes inlammation and oxidative stress, which are precursors of various complications involving MetS components, namely insulin resistance, hypertension and hy- perlipidemia. One way to block the effects of oxidative stress would be through the antioxidant defense system, which offsets the excess free radicals. It is known that individuals with metabolic syndrome and obesity have high consumption of fats and sugars originated from processedfoods containing high levels of sodium as well as low intake of fruits and vegetables, thus maintaining a state of oxidative stress, that can speed up the onset of MetS. Healthy eating habits could prevent or delay MetS by adding antioxidant-rich foods into the diet.
The individuals were classified into five strata in accordance with their consumption of ultra-processedfoods. These strata corresponded to quintiles of the population distribution according to the contribution of ultra-processedfoods to the total caloric value of the diet. The micronutrient content of the diet in these strata was subsequently evaluated. Linear regression analyses were used to describe the trend and the statis- tical signiicance of the association between the quin- tiles of relative ultra-processed food consumption and micronutrient content of the diet, with and without adjustment for monthly household income per capita. The household location (urban or rural), region of the country (Midwest, North, Northeast, Southeast and South), age and gender characteristics did not alter the regression model estimates and therefore were not included in the analyses.
are called proanthocyanidins, and have a wide distribution in plants as secondary metabolites. We consume small amounts of these compounds in daily life from fresh fruits such as apple and the processedfoods made from these fruits. Rather than nutrients, plant proanthocyanidins are known as the functional food factors that possess a variety of physiological activities including antioxidant [7-9] .
In this study, almost all menus had been planned by dieticians. However, some menus needed revision regarding the presence and frequency of fruits and non-starchy vegetables. Furthermore, the presence and frequency of whole grains also need to increase, while those of high-sugar, high-fat, and high-sodium foods, such as chocolate milk, biscuits, and commercially processedfoods need to decrease. The variety of foods in the meals should also increase, avoiding color, food, and preparation technique monotony.
Additionally, addictive substances are altered to increase the rate at which the addictive agent is absorbed into the bloodstream. For example, when a coca leaf is chewed, it is considered to have little addictive potential . However, once it is processed into a concentrated dose with rapid delivery into the system, it becomes cocaine, which is highly addictive . Similarly, high- ly processedfoods, compared to naturally occurring foods, are more likely to induce a blood sugar spike. This is important, because there is a known link between glucose levels and activa- tion of areas of the brain that are involved with addiction . While a food’s glycemic load (GL) and glycemic index (GI) are both measures of the blood sugar spike [24–26], the current study utilizes GL because it is calculated using not only the magnitude of the blood sugar spike but also the dose (grams) of refined carbohydrates. Many foods with a high GL (e.g. cake, pizza) have been highly processed to increase the concentration of refined carbohydrates, such as white flour and sugar. Simultaneously, fiber, protein, and water are stripped from the food, which fur- ther increases the rate that the refined carbohydrates are absorbed into the system. For example, the sugar in a highly processed, high GL food, such as a milk chocolate bar, will be more quickly absorbed into the system than the natural sugars in a banana (low GL). This is because the ba- nana is unprocessed, and though it contains sugar, it also has fiber, protein, and water, which slow the rate that the sugar enters the bloodstream. Given our knowledge of addictive sub- stances, it may then be hypothesized that the chocolate would have a higher abuse potential than the banana. In summary, it appears that highly processedfoods may be altered in a manner simi- lar to addictive substances to increase the food’s potency (dose) and absorption rate .
In general, high GI foods contain high refined carbohydrate content and are rapidly digested. Other factors that may favor the increase in GI include high glucose or starch or sucrose content relative to lactose and fructose content (lactose yields less glucose, and fructose does not increase blood glucose), low soluble fiber content (soluble fiber forms a gel in the stomach, reduces the rate of gastric emptying and therefore the rate of digestion and absorption); and finally soft, overcooked or highly processedfoods (intact grains and discrete harder pieces of food are digested at a slower rate than those types of foods) 6 .