Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
PLoS One. 2020 Jul 31;15(7):e0236738. doi: 10.1371/journal.pone.0236738. eCollection 2020.
Ultra-processed food consumption has been associated with several health outcomes such as obesity, hypertension, cardiovascular disease and cancer. The deleterious nutrient profile of these products, and the presence of food additives, neoformed contaminants and contact materials such as phthalates and bisphenol may be some of the potential pathways through which ultra-processed food influences disease outcomes. The aim of this study was to examine the association between dietary contribution of ultra-processed foods and urinary biomarker concentrations of parent compounds or their metabolites including Di(2-ethylhexyl) phthalate (ΣDEHP), Di-isononyl phthalate (ΣDiNP), Monocarboxynonyl phthalate (mCNP), Mono (3-carboxypropyl) phthalate (mCPP), Monobenzyl phthalate (mBzP), Bisphenol A (BPA), Bisphenol F (BPF) and Bisphenol S (BPS), in the US. Participants from the cross-sectional 2009-2016 National Health and Nutrition Examination Survey, aged 6+ years, with urinary measures and with one 24-hour dietary recall were included in the study. Ultra-processed foods were identified based on the NOVA classification system, a four-group food classification based on the extent and purpose of industrial food processing. Linear regression was used to compare average urinary creatinine-standardized concentrations across quintiles of energy contribution of ultra-processed foods. Models incorporated survey sample weights and were adjusted for different sociodemographic and life-style variables. Adjusted geometric means of ΣDiNP, mCNP, mCPP, mBzP and BPF increased monotonically from the lowest to the highest quintile of ultra-processed food consumption. As both phthalates/bisphenol and ultra-processed foods have been previously associated with insulin resistance, diabetes, general/abdominal obesity and hypertension, our results suggest the possibility of contact materials in ultra-processed foods as one link between ultra-processed food and these health outcomes. Future studies could confirm findings and further explore these mechanisms of action.
超加工食品的消费与多种健康结果有关，如肥胖、高血压、心血管疾病和癌症。这些产品的有害营养成分，以及食品添加剂、新形成的污染物和接触材料（如邻苯二甲酸二（2-乙基己基）酯和双酚 A）的存在，可能是超加工食品影响疾病结果的一些潜在途径。本研究旨在检验超加工食品的饮食摄入量与母体化合物或其代谢物的尿生物标志物浓度之间的关联，包括邻苯二甲酸二（2-乙基己基）酯（ΣDEHP）、邻苯二甲酸二异壬酯（ΣDiNP）、单羧基壬基邻苯二甲酸酯（mCNP）、单（3-羧基丙基）邻苯二甲酸酯（mCPP）、单苄基邻苯二甲酸酯（mBzP）、双酚 A（BPA）、双酚 F（BPF）和双酚 S（BPS），这些物质均在美国进行了检测。本研究纳入了横断面 2009-2016 年全国健康与营养调查中年龄在 6 岁及以上、有尿样且有一份 24 小时膳食回顾的参与者。超加工食品是根据 NOVA 分类系统确定的，这是一种基于工业食品加工程度和目的的四组食品分类。线性回归用于比较超加工食品能量贡献的五分位数的平均尿肌酐标准化浓度。模型纳入了调查样本权重，并根据不同的社会人口统计学和生活方式变量进行了调整。ΣDiNP、mCNP、mCPP、mBzP 和 BPF 的调整后几何平均值从超加工食品消耗的最低五分位数到最高五分位数呈单调递增。由于邻苯二甲酸酯/双酚和超加工食品都与胰岛素抵抗、糖尿病、一般/腹部肥胖和高血压有关，我们的研究结果表明，超加工食品中的接触材料可能是超加工食品与这些健康结果之间的联系之一。未来的研究可以证实这些发现，并进一步探讨这些作用机制。
