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“超加工食品”的概念是否有助于指导膳食,超越传统的分类系统?否。

Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? NO.

机构信息

Obesity and Nutrition Science, Novo Nordisk Foundation, Hellerup, Denmark.

Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.

出版信息

Am J Clin Nutr. 2022 Dec 19;116(6):1482-1488. doi: 10.1093/ajcn/nqac123.

Abstract

The Nova classification of ultra-processed foods (UPFs) rests on poorly defined food processes and the presence of food additives from a chemically heterogeneous group, easily leading to misclassification. UPFs are claimed to promote overconsumption of energy and obesity due to high palatability, but little evidence supports effects beyond those that can be accounted for by nutrient composition, energy density, and food matrices. Observational studies link dietary intake of UPFs with obesity, but none have demonstrated independent associations after controlling for likely confounders. A highly cited randomized controlled feeding study that compared a UPF diet with an unprocessed diet showed a rapidly weaning effect on energy intake that can be entirely explained by more conventional and quantifiable dietary factors, including energy density, intrinsic fiber, glycemic load, and added sugar. Clearly, many aspects of food processing can affect health outcomes, but conflating them into the notion of ultra-processing is unnecessary, because the main determinants of chronic disease risk are already captured by existing nutrient profiling systems. In conclusion, the Nova classification adds little to existing nutrient profiling systems; characterizes several healthy, nutrient-dense foods as unhealthy; and is counterproductive to solve the major global food production challenges.

摘要

超加工食品(UPF)的 Nova 分类依据的是定义不明确的食品加工过程和来自化学异质组的食品添加剂,这很容易导致分类错误。由于高适口性,UPF 据称会促进能量过度摄入和肥胖,但几乎没有证据支持除了营养成分、能量密度和食物基质可以解释的影响之外的影响。观察性研究将 UPF 的饮食摄入与肥胖联系起来,但在控制可能的混杂因素后,没有一项研究证明存在独立的关联。一项备受关注的随机对照喂养研究比较了 UPF 饮食和未加工饮食,结果表明,能量摄入的快速断奶效应可以完全用更传统和可量化的饮食因素来解释,包括能量密度、内在纤维、血糖负荷和添加糖。显然,食品加工的许多方面都可能影响健康结果,但将它们混为一谈认为是超加工是没有必要的,因为慢性疾病风险的主要决定因素已经被现有的营养成分分析系统所捕获。总之,Nova 分类法对现有的营养成分分析系统没有什么补充;将几种健康、营养丰富的食物定义为不健康;并且不利于解决主要的全球粮食生产挑战。

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