Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
Cardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
Nutrients. 2021 Jul 20;13(7):2471. doi: 10.3390/nu13072471.
The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI ( = 0.001) when using the NOVA system, and with systolic ( = 0.018) and diastolic ( = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.
超加工食品（UPF）与心血管代谢紊乱风险之间的关联一直是人们关注的问题。不同的基于食品加工的分类系统在研究结论中存在差异。为了检验 UPF 消费与心血管代谢标志物之间的关联是否随分类系统而变化，我们使用了 PREVENTION WITH MEDITERRANEAN DIET（PREDIMED-Plus）试验的 5636 名参与者（48.5%为女性，51.5%为男性，平均年龄 65.1±4.9）的基线数据。这些参与者超重或肥胖，且至少符合三项代谢综合征（MetS）标准。根据基于四种食品加工的分类方法（NOVA、国际癌症研究机构（IARC）、国际食品信息委员会（IFIC）和北卡罗来纳大学（UNC）），使用包含 143 种食物的食物频率问卷对食物消费进行分类。根据每个系统的 UPF 消费五分位数评估营养和心血管代谢标志物的平均变化。使用线性回归分析评估 UPF 消费与心血管代谢标志物之间的关联。使用组内相关系数（ICC3，总体=0.51）评估不同分类的一致性。使用 IARC 分类法（45.9%）获得的 UPF 消费最高，而使用 NOVA 分类法（7.9%）获得的 UPF 消费最低。高 UPF 消费组的饮食状况较差。当使用 NOVA 系统时，我们发现 UPF 消费与 BMI 之间存在直接关联（=0.001），而当使用 UNC 系统时，UPF 消费与收缩压（=0.018）和舒张压（=0.042）之间存在直接关联。食品分类方法显著影响 UPF 消费与心血管代谢风险标志物之间的关联。
