Forde Ciarán G, Mars Monica, de Graaf Kees
Clinical Nutrition Research Center, ASTAR Singapore Institute for Clinical Sciences, Singapore.
Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Curr Dev Nutr. 2020 Feb 10;4(3):nzaa019. doi: 10.1093/cdn/nzaa019. eCollection 2020 Mar.
Recent observational data and a controlled in-patient crossover feeding trial show that consumption of "ultra-processed foods" (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A drawback of the NOVA classification is the lack of evidence supporting a causal mechanism for why UPFs lead to overconsumption of energy. In a recent study by Hall the energy intake rate in the UPF condition (48 kcal/min) was >50% higher than in the unprocessed condition (31 kcal/min). Extensive empirical evidence has shown the impact that higher energy density has on increasing ad libitum energy intake and body weight. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Energy density can be combined with eating rate to create a measure of energy intake rate (kcal/min), providing an index of a food's potential to promote increased energy intake.
The current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification.
Data were pooled from 5 published studies that measured energy intake rates across a total sample of 327 foods.
We show that going from unprocessed, to processed, to UPFs that the average energy intake rate increases from 35.5 ± 4.4, to 53.7 ± 4.3, to 69.4 ± 3.1 kcal/min (< 0.05). However, within each processing category there is wide variability in the energy intake rate.
We conclude that reported relations between UPF consumption and obesity should account for differences in energy intake rates when comparing unprocessed and ultra-processed diets. Future research requires well-controlled human feeding trials to establish the causal mechanisms for why certain UPFs can promote higher energy intake.
最近的观察数据以及一项住院患者对照交叉喂养试验表明，按照诺瓦分类系统定义的“超加工食品”（UPF）的摄入，与更高的能量摄入、肥胖以及在人群层面更高的肥胖患病率相关。诺瓦分类的一个缺点是缺乏证据支持UPF导致能量过度摄入的因果机制。在霍尔最近的一项研究中，UPF组的能量摄入速率（48千卡/分钟）比未加工组（31千卡/分钟）高出50%以上。大量实证证据表明，更高的能量密度对随意能量摄入和体重增加有影响。大量研究表明，以更高的进食速率进食与更高的能量摄入和更高的肥胖患病率有关。能量密度可以与进食速率相结合，以创建能量摄入速率（千卡/分钟）的度量，提供一种衡量食物促进能量摄入增加潜力的指标。
本文比较了测量的能量摄入速率与诺瓦分类定义的加工水平之间的关联。
汇总了5项已发表研究的数据，这些研究测量了总共327种食物样本的能量摄入速率。
我们发现，从未加工食品到加工食品再到UPF，平均能量摄入速率从35.5±4.4千卡/分钟增加到53.7±4.3千卡/分钟，再到69.4±3.1千卡/分钟（P<0.05）。然而，在每个加工类别中，能量摄入速率存在很大差异。
我们得出结论，在比较未加工和超加工饮食时，报告的UPF消费与肥胖之间的关系应考虑能量摄入速率的差异。未来的研究需要精心控制的人体喂养试验，以确定某些UPF能够促进更高能量摄入的因果机制。
