Dataset Information

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).

ABSTRACT:

Background

Recent lifestyle changes include increased consumption of highly processed foods (HPF), which has been associated with an increased risk of non-communicable diseases (NCDs). However, nutritional information relies on the estimation of HPF consumption from food-frequency questionnaires (FFQ) that are not explicitly developed for this purpose. We aimed to develop a short screening questionnaire of HPF consumption (sQ-HPF) that integrates criteria from the existing food classification systems.

Methods

Data from 4400 participants (48.1% female and 51.9% male, 64.9 ± 4.9 years) of the Spanish PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial were used for this analysis. Items from the FFQ were classified according to four main food processing-based classification systems (NOVA, IARC, IFIC and UNC). Participants were classified into tertiles of HPF consumption according to each system. Using binomial logistic regression, food groups associated with agreement in the highest tertile for at least two classification systems were chosen as items for the questionnaire. ROC analysis was used to determine cut-off points for the frequency of consumption of each item, from which a score was calculated. Internal consistency of the questionnaire was assessed through exploratory factor analysis (EFA) and Cronbach's analysis, and agreement with the four classifications was assessed with weighted kappa coefficients.

Results

Regression analysis identified 14 food groups (items) associated with high HPF consumption for at least two classification systems. EFA showed that items were representative contributors of a single underlying factor, the "HPF dietary pattern" (factor loadings around 0.2). We constructed a questionnaire asking about the frequency of consumption of those items. The threshold frequency of consumption was selected using ROC analysis. Comparison of the four classification systems and the sQ-HPF showed a fair to high agreement. Significant changes in lifestyle characteristics were detected across tertiles of the sQ-HPF score. Longitudinal changes in HPF consumption were also detected by the sQ-HPF, concordantly with existing classification systems.

Conclusions

We developed a practical tool to measure HPF consumption, the sQ-HPF. This may be a valuable instrument to study its relationship with NCDs.

Trial registration

Retrospectively registered at the International Standard Randomized Controlled Trial Registry ( ISRCTN89898870 ) on July 24, 2014.

SUBMITTER: Martinez-Perez C

PROVIDER: S-EPMC8785596 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).

Martinez-Perez Celia C Daimiel Lidia L Climent-Mainar Cristina C Martínez-González Miguel Ángel MÁ Salas-Salvadó Jordi J Corella Dolores D Schröder Helmut H Martinez Jose Alfredo JA Alonso-Gómez Ángel M ÁM Wärnberg Julia J Vioque Jesús J Romaguera Dora D López-Miranda José J Estruch Ramón R Tinahones Francisco J FJ Lapetra José J Serra-Majem Lluis L Bueno-Cavanillas Aurora A Tur Josep A JA Sánchez Vicente Martín VM Pintó Xavier X Delgado-Rodríguez Miguel M Matía-Martín Pilar P Vidal Josep J Vázquez Clotilde C Ros Emilio E Basterra Javier J Babio Nancy N Guillem-Saiz Patricia P Zomeño María Dolores MD Abete Itziar I Vaquero-Luna Jessica J Barón-López Francisco Javier FJ Gonzalez-Palacios Sandra S Konieczna Jadwiga J Garcia-Rios Antonio A Bernal-López María Rosa MR Santos-Lozano José Manuel JM Bes-Rastrollo Maira M Khoury Nadine N Saiz Carmen C Pérez-Vega Karla Alejandra KA Zulet María Angeles MA Tojal-Sierra Lucas L Ruiz Zenaida Vázquez ZV Martinez Maria Angeles MA Malcampo Mireia M Ordovás José M JM San-Cristobal Rodrigo R

The international journal of behavioral nutrition and physical activity 20220124 1

<h4>Background</h4>Recent lifestyle changes include increased consumption of highly processed foods (HPF), which has been associated with an increased risk of non-communicable diseases (NCDs). However, nutritional information relies on the estimation of HPF consumption from food-frequency questionnaires (FFQ) that are not explicitly developed for this purpose. We aimed to develop a short screening questionnaire of HPF consumption (sQ-HPF) that integrates criteria from the existing food classific ...[more]

PMID: 35073909

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Project description:BackgroundProcessed packaged foods are readily available in Fiji; however, the extent to which ultra-processed foods (UPFs) currently contribute to energy and nutrient intake is unknown. This study aimed to assess the contribution of UPFs to total energy intake and nutrients of concern (sodium, sugar, fat) in a representative sample of adults in the central division of Fiji, identify the main food category sources of UPFs and assess variation by sociodemographic characteristics.MethodsA random sample of 700 adults was selected from two statistical enumeration areas (one semi-urban, one rural). Participant characteristics were collected, and a three-pass 24-h diet recall was undertaken. Foods consumed were coded based on the level of processing, in alignment with the NOVA categorisation system.ResultsThe contribution of UPFs to total energy, fat, sugar, and sodium intake and dietary sources of UPFs (based on the per cent daily energy contribution of UPFs from food groups) were estimated and assessed by sex, age group, ethnicity and location. A total of 534 adults participated (76% response rate, 50% female). UPFs contributed 21.5% (95% CI, 21.4% to 26.6%) of total energy intake, 22.8% (95% CI 20.5% to 25.1%) of total sodium intake, 24.0% (95% CI, 21.4% to 26.6%) of sugar intake and 18.6% (95% CI 16.5% to 20.7%) of total fat intake. Key food group contributors to UPF intake were bread and bakery products 42.9% (38.3% to 47.6%), non-alcoholic beverages 26.8% (22.4% to 31.1%), convenience foods 8.6% (6.3% to 10.8%), and meat, poultry, and meat alternatives 6.9% (4.8% to 8.9%). The contribution of UPFs to sodium, sugar and fat intake was similar for men and women; however, differences were observed by age group, ethnicity and region (semi-urban compared to rural).ConclusionsThis study identified that UPFs appear to be a large contributor to energy, sodium, fat and sugar intake in adults in the Central division of Fiji. A reduction of UPF consumption in Fiji may lead to a reduction of harmful nutrients such as sodium, fat, and sugar, crucial to reducing the diet-related burden of disease.

Project description:Frailty is a multidisciplinary public health issue and nutrition is key concern. Given the scientific consistency about inflammation as shared pathway to poor nutrition and frailty, food processing seems a suitable target to gain evidence in frailty prevention nutrition settings. This study aimed to assess diet in relation to nutritional frailty using the NOVA classification. Browsing the dataset of the Salus in Apulia, 2185 older adults were found to have completed the nutritional assessment, providing eligible data for this study goal. A validated construct, based on the co-presence of physical frailty by CHS criteria plus nutritional imbalance, was applied to characterize nutritional frailty phenotypes. Using the NOVA classification, daily food and beverage intakes from an 85-item self-administered FFQ were assigned to three categories, and effect sizes were tested among groups according to nutritional frailty status (presence/absence). Raw and adjusted logistic regression models were run to assess associations between NOVA food categories by quintiles of daily exposure (very-low, low, mild, moderate, high) and nutritional frailty. Nutritional frailty prevalence was 27%, being more frequent in males. Eating more unprocessed or minimally processed foods was inversely related to nutritional frailty, even after adjustment (OR: 0.10, 95%CI 0.07-0.16), showing a downward ORs behavior toward lower consumption quintiles. Listing in the quintile of moderate consumption of processed foods meant a nearly 50% increase in nutritional frailty probability (OR: 1.46, 95%CI 1.03-2.06), while the probability was double for the highest quintile against the lowest (OR: 3.22, 95%CI 2.27-4.58). A growing probability of nutritional frailty was found for increasing consumption of ultra-processed foods, but significance was lacking. The contribution of food processing to poor nutrition needs to be considered when promoting a better understanding of effective nutritional screening in aging. Therefore, food processing should be accounted for when composing diet guidelines for the older population within the framework of multidisciplinary efforts to ease the frailty healthcare burden.

Project description:Ultra-processed food (UPF) intake is associated with increased non-communicable disease risks. However, systematic reports on sociodemographic predictors of UPF intake are lacking. This review aimed to understand UPF consumption based on sociodemographic factors, using nationally representative cohorts. The systematic review was pre-registered (PROSPERO:CRD42022360199), following PRISMA guidelines. PubMed/MEDLINE searches (‘ultra-processed/ultraprocessed’ and ‘ultra-processing/ultraprocessing’) until 7 September 2022 retrieved 1131 results. Inclusion criteria included: observational, nationally representative adult samples, in English, in peer-reviewed journals, assessing the association between sociodemographics and individual-level UPF intake defined by the NOVA classification. Exclusion criteria included: not nationally representative, no assessment of sociodemographics and individual-level UPF intake defined by NOVA. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Fifty-five papers were included, spanning thirty-two countries. All thirteen sociodemographic variables identified were significantly associated with UPF intake in one or more studies. Significant differences in UPF intake were seen across age, race/ethnicity, rural/urbanisation, food insecurity, income and region, with up to 10–20% differences in UPF intake (% total energy). Higher UPF intakes were associated with younger age, urbanisation and being unmarried, single, separated or divorced. Education, income and socioeconomic status showed varying associations, depending on country. Multivariate analyses indicated that associations were independent of other sociodemographics. Household status and gender were generally not associated with UPF intake. NOS averaged 5·7/10. Several characteristics are independently associated with high UPF intake, indicating large sociodemographic variation in non-communicable disease risk. These findings highlight significant public health inequalities associated with UPF intake, and the urgent need for policy action to minimise social injustice-related health inequalities.

Project description:BackgroundRapid simultaneous increases in ultra-processed food sales and obesity prevalence have been observed worldwide, including in Australia. Consumption of ultra-processed foods by the Australian population was previously shown to be systematically associated with increased risk of intakes of nutrients outside levels recommended for the prevention of obesity. This study aims to explore the association between ultra-processed food consumption and obesity among the Australian adult population and stratifying by age group, sex and physical activity level.MethodsA cross-sectional analysis of anthropometric and dietary data from 7411 Australians aged ≥20 years from the National Nutrition and Physical Activity Survey 2011-2012 was performed. Food consumption was evaluated through 24-h recall. The NOVA system was used to identify ultra-processed foods, i.e. industrial formulations manufactured from substances derived from foods and typically added of flavours, colours and other cosmetic additives, such as soft drinks, confectionery, sweet or savoury packaged snacks, microwaveable frozen meals and fast food dishes. Measured weight, height and waist circumference (WC) data were used to calculate the body mass index (BMI) and diagnosis of obesity and abdominal obesity. Regression models were used to evaluate the association of dietary share of ultra-processed foods (quintiles) and obesity indicators, adjusting for socio-demographic variables, physical activity and smoking.ResultsSignificant (P-trend ≤ 0.001) direct dose-response associations between the dietary share of ultra-processed foods and indicators of obesity were found after adjustment. In the multivariable regression analysis, those in the highest quintile of ultra-processed food consumption had significantly higher BMI (0.97 kg/m2; 95% CI 0.42, 1.51) and WC (1.92 cm; 95% CI 0.57, 3.27) and higher odds of having obesity (OR = 1.61; 95% CI 1.27, 2.04) and abdominal obesity (OR = 1.38; 95% CI 1.10, 1.72) compared with those in the lowest quintile of consumption. Subgroup analyses showed that the trend towards positive associations for all obesity indicators remained in all age groups, sex and physical activity level.ConclusionThe findings add to the growing evidence that ultra-processed food consumption is associated with obesity and support the potential role of ultra-processed foods in contributing to obesity in Australia.

Dataset Information

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).

Background

Methods

Results

Conclusions

Trial registration

Publications

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).

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