Chang Kiara, Parnham Jennie C, Rauber Fernanda, Levy Renata B, Huybrechts Inge, Gunter Marc J, Millett Christopher, Vamos Eszter P
Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom.
Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
EClinicalMedicine. 2024 Nov 14;78:102931. doi: 10.1016/j.eclinm.2024.102931. eCollection 2024 Dec.
Dietary shift towards more plant-based options is increasingly popular, but the quantity of ultra-processed foods (UPFs) they contain is largely unknown. This study assessed the level of UPF and minimally processed food consumption among regular and low red meat eaters, flexitarians, pescatarians, vegetarians and vegans in a large dataset of United Kingdom (UK) adults.
This is a cross-sectional analysis of the UK Biobank participants recruited between December 19, 2006, and October 1, 2010. Responses to food frequency questions were used to identify diet types for vegans (never eating any animal-based foods); vegetarians (never eating meat/fish); pescatarians (never eating meat); flexitarians (consumed fish/meat under twice a week); low red meat eaters (consumed fish/poultry more than once a week but red/processed meat under twice a week); and regular red meat eaters (consumed red/processed meat more than once a week). Consumption of all food and drinks collected in 24-h recalls between April 29, 2009, and June 28, 2012, were categorised using the Nova classification. The primary outcomes are the consumption of UPFs and minimally processed foods, expressed as a percentage of daily food intake (grams/day). Multivariable linear regression assessed the mean percentage point difference in UPF and minimally processed food consumption between diet types.
This study included 199,502 UK Biobank participants (mean age 58.2 [standard deviation 7.9] years; 55.1% women). The mean UPF consumption was 24.2%, 21.9%, 22.0%, 20.4%, 23.8%, and 22.7% among 75,091 regular red meat eaters, 70,144 low red meat eaters, 45,057 flexitarians, 4932 pescatarians, 4119 vegetarians and 159 vegans, respectively. The adjusted results suggested that compared with regular red meat eaters, UPF consumption was 1.3 percentage points higher among vegetarians (95% confidence interval [CI]: 0.9, 1.7) and lower among low red meat eaters (-1.3, 95% CI: -1.4, -1.1), flexitarians (-0.8, 95% CI: -1.0, -0.7), and pescatarians (-1.6, 95% CI: -1.9, -1.2). The UPF consumption in vegans were not significantly different from regular red meat eaters (1.2 percentage points, 95% CI: -0.7, 3.2). Minimally processed food consumption was higher in all other types of diet than regular red meat eaters, with an adjusted percentage point difference ranged from 0.4 (95% CI: 0.005, 0.9) for vegetarians to 3.2 (95% CI: 1.0, 5.5) for vegans compared with regular red meat eaters.
This UK-based study found higher UPF consumption in vegetarian diets and lower in diets with a modest amount of meat or fish. It is important that policies which encourage the urgently needed transition to more sustainable dietary patterns also promote rebalancing diets towards minimally processed foods.
National Institute for Health and Care Research (NIHR) School for Public Health Research, World Cancer Research Fund.
向更多以植物为基础的饮食选择转变越来越流行，但其中所含超加工食品（UPF）的数量 largely 未知。本研究在一个英国成年人的大型数据集中评估了经常食用红肉和少量食用红肉者、弹性素食者、纯素食者、素食者和严格素食者中 UPF 和最低限度加工食品的消费水平。
这是对 2006 年 12 月 19 日至 2010 年 10 月 1 日招募的英国生物银行参与者的横断面分析。对食物频率问题的回答用于确定不同饮食类型：严格素食者（从不吃任何动物性食物）；素食者（从不吃肉/鱼）；纯素食者（从不吃肉）；弹性素食者（每周食用鱼/肉少于两次）；少量食用红肉者（每周食用鱼/禽超过一次，但红肉/加工肉少于两次）；以及经常食用红肉者（每周食用红肉/加工肉超过一次）。使用诺瓦分类法对 2009 年 4 月 29 日至 2012 年 6 月 28 日期间 24 小时膳食回忆中收集的所有食物和饮料的消费情况进行分类。主要结果是 UPF 和最低限度加工食品的消费量，以每日食物摄入量的百分比（克/天）表示。多变量线性回归评估了不同饮食类型之间 UPF 和最低限度加工食品消费的平均百分点差异。
本研究纳入了 199,502 名英国生物银行参与者（平均年龄 58.2[标准差 7.9]岁；55.1%为女性）。在 75,091 名经常食用红肉者、70,144 名少量食用红肉者、45,057 名弹性素食者、4,932 名纯素食者、4,119 名素食者和 159 名严格素食者中，UPF 的平均消费量分别为 24.2%、21.9%、22.0%、20.4%、23.8%和 22.7%。调整后的结果表明，与经常食用红肉者相比，素食者的 UPF 消费量高 1.3 个百分点（95%置信区间[CI]：0.9，1.7），少量食用红肉者（-1.3，95%CI：-1.4，-1.1）、弹性素食者（-0.8，95%CI：-1.0，-0.7）和纯素食者（-1.6，95%CI：-1.9，-1.2）的 UPF 消费量较低。严格素食者的 UPF 消费量与经常食用红肉者无显著差异（1.2 个百分点，95%CI：-0.7，3.2）。所有其他饮食类型的最低限度加工食品消费量均高于经常食用红肉者，与经常食用红肉者相比，调整后的百分点差异范围从素食者的 0.4（95%CI：0.005，0.9）到严格素食者的 3.2（95%CI：1.0，5.5）。
这项基于英国的研究发现，素食饮食中的 UPF 消费量较高，而肉类或鱼类摄入量适中的饮食中的 UPF 消费量较低。重要的是，鼓励向更可持续饮食模式进行迫切需要的转变的政策，也应促进饮食向最低限度加工食品重新平衡。
国家卫生与保健研究机构（NIHR）公共卫生研究学院、世界癌症研究基金会。
