ultra-processed foods

Posted on Patient Talk

Eating high-processed foods impacts muscle quality

Axial T1-weighted bilateral thigh MR images

Caption

CreditRadiological Society of North Aurora (RSNA) and Zehra Akkaya, M.D.

A diet high in ultra-processed foods is associated with higher amounts of fat stored inside thigh muscles, regardless of the amount of calories consumed or level of physical activity, . Higher intramuscular fat in the thigh could also increase the risk for knee osteoarthritis.

The incorporation of natural and minimally processed ingredients in modern diets has declined, often being replaced by ingredients that are industrially processed, artificially flavoured, coloured, or chemically altered.

Foods such as breakfast cereals, margarine, spreads, packaged snacks, hot dogs, soft drinks, energy drinks, candies, desserts, frozen pizzas, ready-to-eat meals, and mass-produced packaged bread and buns are highly processed and contain synthesized ingredients.

These ultra-processed foods usually have longer shelf lives and are highly appealing. They are convenient and contain a combination of sugar, fat, salt, and carbohydrates that affect the brain’s reward system, making it hard to stop eating.

For the study, researchers assessed the association between ultra-processed food intake and intramuscular fat in the thigh.

“The novelty of this study is that it investigates the impact of diet quality, specifically the role of ultra-processed foods concerning intramuscular fat in the thigh muscles assessed by MRI,” said author Zehra Akkaya, M.D., researcher and former Fulbright Scholar in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “This is the first imaging study looking into the relationship between MRI-based skeletal muscle quality and diet quality.”

For the study, researchers analyzed data from 666 individuals who participated in the Osteoarthritis Initiative but were not yet affected by osteoarthritis based on imaging. The Osteoarthritis Initiative is a nationwide research study sponsored by the National Institutes of Health that helps researchers better understand how to prevent and treat knee osteoarthritis.

“Research from our group and others has previously shown that quantitative and functional decline in thigh muscles is potentially associated with onset and progression of knee osteoarthritis,” Dr. Akkaya said. “On MRI images, this decline can be seen as fatty degeneration of the muscle, where streaks of fat replace muscle fibres.”

The average age of the 666 individuals (455 men, 211 women) was 60. On average, participants were overweight, with a body mass index (BMI) of 27. Approximately 40% of the foods they ate in the past year were ultra-processed.  

The researchers found that the more ultra-processed foods people consumed, the more intramuscular fat they had in their thigh muscles, regardless of energy (caloric) intake.

“In an adult population at risk for but without knee or hip osteoarthritis, consuming ultra-processed foods is linked to increased fat within the thigh muscles,” Dr Akkaya said. “These findings held regardless of dietary energy content, BMI, sociodemographic factors or physical activity levels.”

Dr. Akkaya noted that targeting modifiable lifestyle factors—mainly preventing obesity via a healthy, balanced diet and adequate exercise—has been the mainstay of initial management for knee osteoarthritis.

“Osteoarthritis is an increasingly prevalent and costly global health issue. It is the largest contributor to non-cancer related health care costs in the U.S. and around the world,” Dr. Akkaya said. “Since this condition is highly linked to obesity and unhealthy lifestyle choices, there are potential avenues for lifestyle modification and disease management.”

Posted on Diabetes, Diet

Ultra-processed foods pose huge dangers for people with diabetes

Researchers found ultra-processed foods, even diet ones, bring distinct risks for people with diabetes.
Researchers found that ultra-processed foods, even diet ones, bring distinct risks for people with diabetes.

A team of researchers in nutritional sciences, kinesiology, and health education at the University of Texas at Austin has found that eating more ultra-processed foods—from diet sodas to packaged crackers to certain cereals and yoghurts—is closely linked with higher blood sugar levels in people with Type 2 diabetes.

In a recent paper published in the Journal of the Academy of Nutrition and Dietetics, the team describes how, more than just the presence of sugar and salt in the diet, consuming more ultra-processed foods loaded with additives can lead to higher average blood glucose levels over several months, as measured by HbA1C.

“We wanted to understand the impact of different types of foods on blood sugar control in people with Type 2 diabetes,” said Marissa Burgermaster, assistant professor of nutritional sciences at UT and the senior author of the study. “Our findings showed that individuals who consumed more ultra-processed foods had poorer blood sugar control, while those who included more minimally processed or unprocessed foods in their diet had better control.”

The researchers examined the diet recalls and scored them against three widely used indexes that look at the overall quality or nutrition in a person’s diet. Still, those tools were not associated with blood glucose control. Instead, how many grams of ultra-processed food the participants ate or drank was linked to worse control, and a correspondingly better control occurred in participants who ate more whole foods or foods and drinks with minimal processing.

Recent studies have indicated that eating more ultra-processed foods is linked to higher rates of cardiovascular disease, obesity, sleep disorders, anxiety, depression and early death. Ultra-processed foods are typically higher in added sugars and sodium. Still, the researchers concluded that the A1C increases were not about merely added sugar and sodium, or they would have correlated with the tools that measure overall nutritional quality in the diet. Synthetic flavours, added colours, emulsifiers, artificial sweeteners and other artificial ingredients may be in part to blame, hypothesized Erin Hudson, a graduate student author of the paper, and this would suggest that dietary guidelines may need to begin to place more emphasis on ultra-processed foods.

Posted on Diet

Vegans’ intake of protein and essential amino acids is adequate but ultra-processed foods are needed

The study concluded that textured soy protein and plant-based protein supplements were the main ultra-processed products determining adequate protein intake for Brazilian vegans. The research involved 774 men and women.
Textured soy protein and plant-based protein supplements were the main ultra-processed products that determined adequate protein intake for vegans.

Their findings show that, on average, the participants consumed the recommended amount of proteins and essential amino acids and that their diet consisted mainly of unprocessed and minimally processed foods. However, participants who consumed proportionally lower levels of industrialized products such as protein supplements and textured soy protein were more likely to exhibit inadequate protein intake, suggesting a significant reliance on nutrients from ultra-processed proteins for this population.

Coined by researchers at the same university’s School of Public Health (FSP-USP), the term “ultra-processed products” refers to industrially formulated edible substances synthesized from fractionated ingredients and blended with chemical additives (colours, aromas, emulsifiers, thickeners etc.) to enhance their palatability.

“Our results contradict the stigma that a vegan diet can’t provide the amount of protein and essential amino acids a person needs and show that a vegan diet can be nutritionally adequate. Moreover, the vegans in the study consumed ultra-processed products less than the general population,” said Hamilton Roschel, head of the Applied Physiology and Nutrition Research Group at FM-USP’s Center for Lifestyle Medicine.

F

“Animal food products are known to be generally more dense in protein and essential amino acids. For example, meat, milk and eggs contain more protein per gram than rice or beans. It was therefore important to investigate whether this requirement was met by diets consisting solely of plant protein,” Roschel said.

This was the main reason for investigating whether a vegan diet affords adequate protein and acceptable levels of essential amino acids.

The study also found a significant correlation between adequate protein intake and consumption of ultra-processed products. “Although this group consumed a small amount of ultra-processed products, some participants appeared to rely on them to meet their protein needs. This is partly because unprocessed foods are generally less dense in protein, which paved the way for the so-called meat substitute industry, whose market share is growing,” Roschel said.

Meat substitutes consist of plant protein processed to mimic different types of meat, such as vegan hamburgers, sausages, and nuggets. Cheese substitutes, such as soy, pea, rice, or potato protein, are also available. Both are considered ultra-processed products.

It is worth noting that consumption of ultra-processed products is associated with a heightened risk of weight gain, diabetes, hypertension and other cardiovascular diseases, depression, some types of cancer, and premature death. Not all the effects of plant-based ultra-processed products are known, but recent evidence suggests they, too, maybe unhealthy.

The researchers concluded that textured soy protein (TSP) and plant-based protein supplements were the main ultra-processed products that determined adequate protein intake for Brazilian vegans.

“Although they tend to be classified as ultra-processed products, TSP and protein supplements aren’t necessarily unhealthy, which can’t be said of ultra-processed products that contain high levels of fat, sugar, sodium, preservatives and artificial additives, for example,” Roschel said.

As a broad category, Ultra-processed products are considered unhealthy in many studies, but there is robust evidence that soy-derived foods do not harm human health. “TSP is an important source of protein and essential amino acids for vegans, even though it’s classified as ultra-processed. Ultra-processed products vary considerably in formulation, and despite the consensus that they should generally be avoided, it isn’t reasonable to ignore the clear differences between them,” he said.

As the researchers note, the same can be said about plant-based protein supplements, “an evidence-based strategy to support muscle health also associated with protein adequacy” in different contexts, such as when unprocessed and minimally processed foods do not supply sufficient protein or when a clinical condition requires a different kind of nutritional management. “In these contexts, plant-based protein plays an important role and should not be overlooked,” Roschel said.

“Our findings don’t show that ultra-processed products are good, and the findings should not be used to encourage their consumption. However, it would be wrong to close one’s eyes to their significant differences and the importance of their role in specific contexts.

Posted on Diabetes, Patient Talk

Replacing ultra-processed foods in diet lowers type 2 diabetes risk

An Italian research by the I.R.C.C.S. Neuromed shows that the consumption of highly processed foods, often industrially manufactured, increases the risk of death for people with type 2 diabetes, regardless of the nutritional quality of their diet

A new study led by researchers at UCL finds that people who eat more ultra-processed foods (UPF) are at increased risk of developing type 2 diabetes, but this risk can be lowered by consuming less processed foods instead.

The study, published in The Lancet Regional Health—Europe in collaboration with experts from the University of Cambridge and Imperial College London, examined the connection between the extent of food processing and the risk of type 2 diabetes. It also examined which types of ultra-processed foods (UPF) posed the highest risk.

The team analysed UPF intake and health outcomes for 311,892 individuals from eight European countries over an average of 10.9 years, during which time 14,236 people developed type 2 diabetes.

They discovered that a 10% increase in the consumption of ultra-processed foods is associated with a 17% rise in the risk of type 2 diabetes, but this risk can be reduced by opting for less processed foods instead.

The highest-risk UPF groups were savoury snacks, animal-based products such as processed meats, ready meals, and sugar-sweetened and artificially sweetened beverages, suggesting that particular attention should be paid to these foods to help tackle ill health.

The degree of food processing is commonly evaluated using the Nova classification. This classification divides foods into four groups:

1. Unprocessed or minimally processed foods (MPF), such as eggs, milk, and fruit.

2. Processed culinary ingredients (PCI), such as salt, butter, and oil.

3. Processed foods (PF), including tinned fish, beer, and cheese

.4. Ultra-processed foods, such as ready-to-eat or ready-to-heat mixed dishes, savoury snacks, sweets, and desserts.

The specific reasons for the connection between UPF and type 2 diabetes are not confirmed, although several factors are believed to be involved, including overconsumption and weight gain. In a prior study, supported by new analysis in this study, it was found that increased body fat contributed to about half of the association.

Samuel Dicken, the first author of the study from the UCL Division of Medicine, stated, “We are aware that ultra-processed foods are linked to a higher risk of certain diseases, such as type 2 diabetes. As anticipated, our findings validate this connection and demonstrate that a 10% increase in the consumption of ultra-processed foods significantly increases the risk of developing type 2 diabetes.”

“Most studies to date have only considered ultra-processed foods (UPF) as a whole. However, we suspect that there may be different health risks associated with different types of UPF, and the risks of other processing groups have not been well researched. Our analysis goes further than previous studies by examining all four processing groups in the Nova classification to assess the impact on type 2 diabetes risk when substituting UPF with less processed foods. Additionally, we are looking at nine subgroups of UPF to better understand their impact.”

Replacing UPF with less processed foods was linked to a reduced risk of type 2 diabetes.

In the study, researchers from UCL analyzed data from the EPIC study, which investigated the relationship between diet, lifestyle, and environmental factors, and the incidence of chronic diseases in more than half a million Europeans over time.

Additional analysis was conducted to separate UPF into nine subgroups to better understand the impact of processing level on type 2 diabetes risk.

The researchers also performed substitution modelling on the data to see how replacing one Nova food group with another would affect type 2 diabetes risk, alongside analyzing how eating UPF affected a person’s risk of developing type 2 diabetes.

The results showed that substituting 10% of UPF in the diet with 10% of MPF/PCI reduced type 2 diabetes risk by 14%.

When 10% of ultra-processed food (UPF) in the diet was replaced with 10% of processed food (PF), the risk of diabetes decreased by 18%. The authors suggest that this could be due to the fact that 30-50% of processed food intake in the study came from beer and wine, which have been linked to a reduced risk of type 2 diabetes in a previous EPIC study. Processed food also includes salted nuts, artisanal breads, and preserved fruits and vegetables.

Analysis of the nine UPF subgroups indicates that savoury snacks, animal-based products, ready meals, and sugar-sweetened and artificially sweetened beverages are linked to a higher incidence of type 2 diabetes.

Consuming large amounts of these less healthy foods increases the overall risk of developing type 2 diabetes. Among the top 25% of highly processed food consumers, where highly processed foods made up 23.5% of their total diet, sweetened beverages alone contributed to almost 40% of their highly processed food intake and 9% of their overall diet.

However, UPF breads, biscuits, breakfast cereals, sweets, desserts, and plant-based alternatives were associated with a lower incidence of type 2 diabetes.

Professor Rachel Batterham, the senior author of the study from the UCL Division of Medicine, stated, “The subgroup analysis of ultra-processed foods (UPF) in this study has been revealing and confirms that not all foods classified as UPF pose the same health risks.”

“Breads and cereals, for example, are a staple of many people’s diets. Based on our results, I think we should treat them differently than savory snacks or sugary drinks in terms of the dietary advice we provide.”

Posted on Diet

Limiting ultra-processed foods does not necessarily make for a healthy diet.

Study calls into question the level of processing as a proxy for diet quality
Study calls into question the level of processing as a proxy for diet quality

New research shows that eating mostly minimally processed foods, as defined by the NOVA classification system, may not necessarily result in a healthy diet. This suggests that the specific types of foods we consume could have a greater impact on our health than the level of processing used to make them.

When comparing two menus that represent a typical Western diet, one focusing on minimally processed foods and the other on ultra-processed foods as categorized by the NOVA classification system, the researchers discovered that the less processed menu was more than twice as expensive. Furthermore, it reached its expiration date over three times faster without providing any additional nutritional value.

“This study suggests that it’s possible to maintain a poor diet even when predominantly consuming minimally processed foods,” stated Julie Hess, PhD, a research nutritionist at the USDA-ARS Grand Forks Human Nutrition Research Center, who conducted the study. “It also demonstrates that both highly processed and less processed diets can be equally nutritious or non-nutritious, but the highly processed diet may have a longer shelf life and be more cost-effective.”

The latest research expands on a study published last year. It showed that it is achievable to create a nutritious menu that meets dietary recommendations while mostly using ultra-processed foods for its calories. In the new study, the researchers explored the reverse question: Can a low-quality menu primarily consist of calories from “simple” foods?

Two menus were created to determine the impact of food processing. The first menu derived 20% of its calories from ultra-processed foods, while the second menu derived 67% of its calories from ultra-processed foods. The level of processing for each menu was evaluated using the NOVA classification system.

The two menus were found to have a Healthy Eating Index score of approximately 43-44 out of 100. This score reflects poor adherence to the Dietary Guidelines for Americans. The researchers estimated that the less-processed menu would cost $34.87 per day per person, while the more-processed menu would cost $13.53 per day. Additionally, they calculated that the median time to expiration for the less-processed menu items was 35 days, compared to 120 days for the more-processed menu items.s

The study draws attention to the disconnect between food processing and nutritional value. Hess noted that some nutrient-dense packaged foods, such as unsweetened applesauce, ultrafiltered milk, liquid egg whites, and some brands of raisins and canned tomatoes, can be classified as ultra-processed.

“The results of this study indicate that building a nutritious diet involves more than a consideration of food processing as defined by NOVA,” said Hess. “The concepts of ‘ultra-processed’ foods and ‘less-processed’ foods need to be better characterized by the nutrition research community.”