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  5. 薯片为何被称为“垃圾食品中的垃圾”？吃它对健康影响有多大？

薯片为何被称为“垃圾食品中的垃圾”？吃它对健康影响有多大？

深度研究匿名用户发表于 2025年12月30日 15:353阅读
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1. 垃圾食品的“垃圾”标准：超加工食品的健康警示

你有没有想过，为什么有些食物吃起来特别美味，却总被扣上“垃圾食品”的帽子？医生口中的薯片是“垃圾食品中的垃圾”，汽水、奶茶紧随其后，这背后到底藏着什么秘密？要理解这一点，我们得先认识一个在营养学界越来越受关注的“狠角色”——超加工食品（Ultra-Processed Foods, 简称UPF）。

想象一下，你从地里摘来一个新鲜的番茄，或者买回来一块未经处理的鸡胸肉，它们都是“天然食物”或者“最少加工食品”。它们的样子、味道都保留了食材本来的面貌。但超加工食品可就不同了，它们是食品工业的“魔术师”们，通过一系列复杂的加工手段，把天然食材的面目变得全非，甚至很多时候，我们吃进去的，已经不是食材本身，而是从食材中提取出来的各种成分，加上一大堆添加剂“组装”而成的。 1

那么，这些“魔术师”们是怎么操作的呢？超加工食品通常有以下几个典型特征，薯片、汽水、奶茶就是其中的“模范生”：

  • 高糖、高盐、高脂肪： 这是超加工食品最突出的特点。为了让口感更好，味道更浓郁，这些食物往往毫不吝啬地加入大量的糖、盐和不健康的脂肪。薯片香脆可口，离不开盐和油的“加持”；汽水甜度爆表，是因为加了大量的糖；奶茶那浓郁的口感，则少不了糖和植脂末（一种含有大量不健康脂肪的成分）。
  • 营养价值低： 尽管它们吃起来很满足，但从营养角度看，超加工食品就像是“空有其表”的美味。在加工过程中，天然食物中宝贵的膳食纤维、维生素和矿物质往往被大量去除，剩下的主要是能量，却缺乏身体真正需要的营养素。
  • 多种添加剂： 为了延长保质期、改善颜色、增加风味，超加工食品还会加入各种各样的食品添加剂，比如防腐剂、色素、香精、乳化剂等。虽然这些添加剂在规定剂量内被认为是安全的，但长期大量摄入，以及多种添加剂混合作用的潜在影响，仍然是科学家们正在研究的课题 2。

简单来说，超加工食品就是那些“高糖、高盐、高脂肪，营养价值低，并且含有多种添加剂”的工业化产物。它们和天然食物相比，就像是经过了“高度美颜”的假象，看起来很吸引人，但本质上已经失去了天然的营养价值。

正是因为这些特点，超加工食品带来了一个严峻的问题：“低营养高密度”。这意味着，你吃下一点超加工食品，就能获得大量的热量，但身体所需的维生素、矿物质、膳食纤维等却少得可怜。这就好比你的身体需要一台高性能电脑，结果你只给它喂了一堆廉价的电池，虽然“电量”看起来很足，但电脑根本无法正常运转，甚至还会因此受损。

这种“低营养高密度”的饮食模式，很容易导致热量摄入过剩，同时又造成营养不良，进而引发肥胖 34、代谢综合征、心血管疾病等一系列健康问题。而且，这些超加工食品常常会刺激我们大脑的奖励系统，让人越吃越想吃，就像“上瘾”一样，难以控制 56。下次当你拿起一包薯片、一瓶汽水或一杯奶茶时，不妨想想，它们不仅仅是美味的零食，更是藏着“低营养高密度”秘密的超加工食品。

2. 薯片的“垃圾”本质：从成分到加工的双重隐患

既然薯片是“垃圾食品中的垃圾”，那我们就要扒开它的“外衣”，看看它到底“垃圾”在哪里。薯片的“垃圾”并非空穴来风，而是体现在它的成分和加工方式上，简直是双重隐患。

2.1 成分拆解：高盐（钠超标）、高脂肪（反式脂肪酸风险）、零膳食纤维的配方如何诱发暴食与代谢负担

你有没有发现，一旦打开一包薯片，就很难停下来？一不小心，一整包就见了底。这可不是你的意志力不够坚定，而是薯片的配方设计，从一开始就“居心叵测”，旨在让你“欲罢不能”。我们来细细拆解一下：

  • 高盐（钠超标）： 薯片吃起来为什么那么香脆可口？盐是其中一个重要功臣。它不仅能提升风味，还能刺激味蕾，让人越吃越想吃。但大量的盐意味着高钠摄入。你知道吗，大多数美国人每天摄入的钠都超过了推荐的2300毫克上限 7。过量的钠会给我们的身体带来沉重负担，最直接的影响就是升高血压，增加患高血压、心脏病和中风的风险。想象一下，如果你的身体是一台精密的机器，高钠就像是给它加了过多的腐蚀剂，长此以往，部件就会出问题。
  • 高脂肪（反式脂肪酸风险）： 薯片的酥脆口感，主要来自油炸。薯片中的总脂肪含量在油炸食物中通常较高 8。而用来油炸的植物油，在高温反复加热的过程中，很可能会产生反式脂肪酸。反式脂肪酸可是心血管健康的“隐形杀手”，它会升高“坏胆固醇”（LDL），降低“好胆固醇”（HDL），显著增加患心脏病的风险。虽然现在很多薯片生产商已经开始避免使用氢化植物油（反式脂肪酸的主要来源），但一些不正规的生产商或者在油炸过程中对油品管理不善，依然可能带来反式脂肪酸的风险。而且，反复煎炸的油，其不饱和脂肪酸含量会显著下降，饱和脂肪酸含量增加，这也会对健康不利 8。更糟糕的是，一些食物添加剂，比如叔丁基对苯二酚（TBHQ），虽然被用作抗氧化剂以延长薯片的保质期，但其潜在的健康风险也引起了关注 9。
  • 零膳食纤维： 薯片的主要原料是土豆。土豆本身含有不少营养，比如膳食纤维、维生素C和钾等 10。但薯片在加工过程中，土豆被切成薄片，经过高温油炸，大部分的膳食纤维、维生素和矿物质都流失了。这意味着，你吃进去的薯片，几乎没有膳食纤维。膳食纤维对维持肠道健康、增加饱腹感、稳定血糖都有重要作用。没有了膳食纤维，薯片在胃里停留时间短，很快就会消化，饱腹感差，结果就是你吃了还想吃，很容易就吃过量。这就像是身体在喊饿，你却给它喂了一堆没有“内容”的能量，结果越吃越饿，越吃越多，最终导致热量超标。

这种“高盐+高脂肪+零膳食纤维”的组合，正是薯片让人暴食的“魔鬼配方”。盐和脂肪刺激了味蕾，让人感到愉悦；而缺乏膳食纤维则让人无法获得饱腹感，从而不断摄入。长此以往，不仅容易导致肥胖，还会给身体的代谢系统带来巨大负担。

2.2 高温加工的毒性：油炸过程产生的丙烯酰胺含量及儿童/成人风险差异，致癌性与神经毒性的科学证据

除了高盐、高脂肪和缺乏营养，薯片还有一个更令人担忧的“隐患”：丙烯酰胺。这个名字听起来很陌生，但它却是高温烹饪某些食物时，特别是富含碳水化合物的食物，容易产生的一种化学物质。你可以把丙烯酰胺想象成一种“高温副产物”，就像汽车尾气一样，在特定的条件下就会产生。

那么，薯片里的丙烯酰胺是怎么来的呢？

这要归咎于薯片的高温油炸过程。当土豆中的某些氨基酸（特别是天冬酰胺）和还原糖（比如葡萄糖、果糖）在超过120°C的高温下“亲密接触”时，就会发生一种叫做“美拉德反应”的化学变化。这个反应一方面赋予了薯片诱人的金黄色泽和酥脆口感，但另一方面，也悄悄地制造出了丙烯酰胺 1112。油炸温度越高，时间越长，产生的丙烯酰胺就越多。有研究表明，薯片中的丙烯酰胺含量通常较高，平均可达546微克/千克，甚至高于咖啡（353微克/千克）和茶叶产品（245微克/千克） 13。

丙烯酰胺可不是什么“善茬”。国际癌症研究机构（IARC）已将丙烯酰胺列为“可能对人类致癌的物质” 1114。这是因为它在体内经过代谢后，会转化成一种叫做“环氧丙酰胺”的物质，这种物质能够与我们细胞里的DNA结合，改变DNA的结构，进而增加细胞癌变的风险 111516。流行病学研究和动物实验都发现，丙烯酰胺摄入与多种癌症风险增加有关，例如卵巢癌、子宫内膜癌、肾细胞癌以及乳腺癌等 1417。在动物实验中，丙烯酰胺也被发现会导致甲状腺肿瘤、乳腺肿瘤等多种癌症 1416。

除了致癌性，丙烯酰胺还是一种神经毒素 111819。这意味着它可能损害神经系统。在人类中，高剂量的丙烯酰胺暴露（通常是职业性暴露）会导致神经系统损伤，表现为感觉迟钝、肢体无力、行走困难等 18。虽然通过饮食摄入的丙烯酰胺量通常远低于导致急性神经毒性的水平，但长期低剂量的暴露，特别是对儿童，其潜在的神经发育影响仍然值得关注。

儿童和成人的风险差异

值得我们特别关注的是，儿童群体对丙烯酰胺的健康风险可能更高。这是因为：

  1. 体重基数小，相对暴露量高： 同样的丙烯酰胺摄入量，由于儿童的体重比成人小得多，所以每公斤体重的丙烯酰胺摄入量（即相对暴露量）会显著高于成人 13。例如，韩国一项研究显示，学步儿童（≤2岁）的丙烯酰胺平均膳食暴露量为0.15微克/公斤体重/天，而成年人（20-64岁）则为0.08微克/公斤体重/天 13。
  2. 身体发育未成熟，更易受影响： 儿童的身体和神经系统仍在快速发育中，对环境中的有害物质通常比成人更敏感。长期的丙烯酰胺暴露，可能会对其神经发育产生潜在的负面影响 19。
  3. 饮食偏好： 薯片等零食在儿童群体中非常受欢迎，这使得儿童更容易成为丙烯酰胺的主要摄入者 131920。有研究指出，在韩国，饼干和薯片是儿童膳食丙烯酰胺暴露的主要来源 13。一项针对黑山市场的研究也发现，10-14岁的儿童通过薯片和面包摄入的丙烯酰胺，面临的癌症风险最高 20。

虽然目前关于膳食丙烯酰胺对人类致癌风险的流行病学研究结果并不完全一致，部分研究并未发现明确的关联 21，但这并不意味着我们可以忽视它的潜在风险。考虑到丙烯酰胺的致癌性和神经毒性，尤其是在儿童群体中较高的相对暴露量，减少薯片等高温油炸食品的摄入，对维护健康，特别是儿童健康，是十分必要的。一些研究也在积极探索通过酶处理（如L-天冬酰胺酶）或添加某些天然物质（如表儿茶素）来减少薯片中丙烯酰胺的生成 2223。

3. 汽水、奶茶的“第二梯队”：高糖与添加剂的隐形威胁

如果说薯片是“垃圾食品中的垃圾”，那么汽水和奶茶就是紧随其后的“第二梯队”。它们虽然不像薯片那样经过高温油炸，但却凭借着高糖和形形色色的添加剂，悄无声息地侵蚀着我们的健康。

3.1 汽水的“甜蜜陷阱”：游离糖摄入量与肥胖、龋齿、2型糖尿病的直接关联，人工甜味剂的长期安全性争议

汽水，这种我们日常生活中再常见不过的饮品，以其清爽的口感和瞬间的满足感征服了无数人。然而，它的甜美背后，却隐藏着一个巨大的“甜蜜陷阱”——游离糖。

世界卫生组织（WHO）对“游离糖”有一个明确的定义，它包括了食品生产商、厨师或消费者添加到食物和饮料中的所有单糖和双糖，以及蜂蜜、糖浆、未加糖的果汁和浓缩果汁中天然存在的糖。注意，完整水果中天然存在的糖和牛奶中天然存在的乳糖，不属于游离糖 24。WHO强烈建议，成人和儿童的游离糖摄入量应限制在总能量摄入的10%以下，并进一步建议最好能降至5%以下 25。这意味着，一个每天摄入2000卡路里的人，每天的游离糖摄入量最好不要超过25克（大约6茶匙）。

但一罐普通的汽水里有多少糖呢？通常一罐330毫升的汽水，含糖量可以达到35克左右，这已经远远超过了WHO的推荐上限！长期大量饮用汽水，就像是给我们的身体埋下了一颗颗定时炸弹：

  • 肥胖的元凶： 汽水中的游离糖被身体快速吸收，导致血糖迅速升高，胰岛素大量分泌。如果这些糖没有被及时消耗掉，就会被身体转化成脂肪储存起来。而液体形式的糖，饱腹感非常差，你可能喝了一大瓶汽水，但很快又会感到饥饿，从而摄入更多的食物，形成恶性循环，最终导致体重增加和肥胖 262728。全球范围内，儿童肥胖的案例持续增加，而高果糖摄入是肥胖发展的重要原因，它会导致白色脂肪堆积，引起脂肪组织炎症、氧化应激以及脂肪细胞因子释放失调 28。墨西哥实施糖税后，含糖饮料的购买量在两年内显著下降，其中低社会经济水平的家庭下降幅度最大，这也间接证明了含糖饮料与肥胖之间的关联 29。
  • 牙齿的“腐蚀剂”： 糖是口腔细菌最喜欢的“食物”。当糖分残留在牙齿表面，细菌就会分解糖产生酸性物质，腐蚀牙釉质，久而久之就会形成龋齿，也就是我们常说的蛀牙。儿童和青少年尤其容易受到影响，因为他们的牙齿还在发育中，牙釉质相对脆弱，对糖的抵抗力较差 2430。
  • 2型糖尿病的推手： 长期大量摄入游离糖，会反复刺激胰岛素分泌，导致胰腺负担过重，久而久之就可能出现胰岛素抵抗，细胞对胰岛素的反应变得迟钝，血糖无法有效进入细胞利用，最终发展成2型糖尿病 27。

面对游离糖的“甜蜜陷阱”，很多人转向了人工甜味剂（又称代糖）。市面上出现了各种“零度”、“无糖”的汽水，它们用阿斯巴甜、三氯蔗糖、糖精、安赛蜜等人工甜味剂来替代蔗糖，宣称可以享受甜味又不必担心热量。然而，人工甜味剂真的能让我们“鱼和熊掌兼得”吗？

目前，关于人工甜味剂的长期安全性仍然存在争议，科学界对此还在进行深入研究：

  • 对心脏代谢健康的影响： 有研究发现，人工甜味剂赤藓糖醇与心血管事件（如心脏病发作、中风）的风险增加有关 31。虽然这需要更多长期研究来证实，但也提示我们不能盲目认为代糖就完全健康。
  • 对肠道菌群的影响： 肠道菌群被称为我们的“第二大脑”，对身体健康至关重要。一些研究表明，三氯蔗糖和糖精等人工甜味剂可能会改变肠道菌群的组成和多样性 3233。肠道菌群的失衡可能影响新陈代谢、免疫功能甚至情绪。
  • 与某些疾病的关联： 一项针对绝经后女性的长期研究发现，每天饮用一份或更多含糖饮料的女性，患肝癌和慢性肝病死亡的风险更高。而人工甜味剂饮料与肝癌和慢性肝病死亡风险之间未发现显著关联 34。然而，另一项研究显示，长期摄入人工甜味剂与慢性肾病风险增加有关。研究发现，每天饮用超过一份人工甜味剂饮料的人，患慢性肾病的风险更高，甚至用人工甜味剂饮料替代含糖饮料也未能显著降低肾病风险 35。
  • 潜在的致癌风险争议： 阿斯巴甜是一种广泛使用的人工甜味剂，早在1965年就被发现。虽然其安全性经过多次评估，但在某些动物实验中，阿斯巴甜被发现可能具有致癌性，会增加多种恶性肿瘤的发生率，包括血液系统肿瘤和肝癌 36。然而，也有研究表明，长期（20周）摄入常用的人工甜味剂，如安赛蜜、阿斯巴甜、三氯蔗糖、糖精和甜菊糖苷，在正常饮食下并不会显著影响体重、体脂或葡萄糖代谢。某些甜味剂（如三氯蔗糖和甜菊糖苷）甚至可能改善胰岛素敏感性并减少体重增加，这表明它们在肥胖相关的代谢紊乱管理中具有潜在益处 37。
  • 免疫系统影响： 最近的研究还发现，高剂量摄入三氯蔗糖可能对T细胞介导的免疫反应产生抑制作用，这可能对免疫功能产生影响 38。

总而言之，人工甜味剂的出现，为我们提供了一种减少糖摄入的替代方案，但它的长期健康影响，特别是对心血管系统、肠道菌群和代谢功能的影响，还需要更多高质量的长期研究来明确 39。在明确这些影响之前，对人工甜味剂也应持谨慎态度，不宜过量摄入。

3.2 奶茶的“糖脂双杀”：植脂末中的反式脂肪酸对心血管的损害，香精/色素等添加剂的累积风险

奶茶，这种曾经被视为“休闲饮品”的时尚象征，如今也常常与“不健康”划上了等号。如果说汽水是“甜蜜陷阱”，那奶茶就是升级版的“糖脂双杀”陷阱，它不仅有高糖的危害，更因为一些特殊成分，带来了额外的健康风险。

3.2.1 植脂末中的“隐形杀手”：反式脂肪酸对心血管的损害

很多人以为奶茶中的“奶”是牛奶，但实际上，市面上大部分奶茶，尤其是街边小店的奶茶，为了追求更浓郁的口感和更低的成本，通常使用的是植脂末，而不是纯牛奶。植脂末是一种以植物油为原料，经过氢化、乳化、喷雾干燥等工艺制成的产品。它能让奶茶的口感更顺滑、更香浓，而且成本远低于牛奶。

问题就出在这个“氢化”工艺上。植物油在氢化过程中，会产生大量的反式脂肪酸。反式脂肪酸可不是什么好东西，它对心血管健康的危害是经过科学界广泛证实的：

  • 升高“坏胆固醇”，降低“好胆固醇”： 反式脂肪酸会升高我们血液中的低密度脂蛋白胆固醇（LDL-C，俗称“坏胆固醇”），同时降低高密度脂蛋白胆固醇（HDL-C，俗称“好胆固醇”）。一升一降之间，大大增加了动脉粥样硬化和冠心病的风险。动脉粥样硬化就像是血管壁上堆积了油腻的“垃圾”，让血管变窄、变硬，最终可能导致心梗或脑梗。
  • 增加心脏病风险： 大量研究表明，反式脂肪酸的摄入量与心血管疾病的风险呈正相关。世界卫生组织（WHO）建议，反式脂肪酸的摄入量应低于总能量摄入的1%，以最大限度地降低心血管疾病的风险。

虽然我国和许多国家都对食品中的反式脂肪酸含量有严格的规定，但由于奶茶通常不是预包装食品，消费者很难知道其中植脂末的具体含量和反式脂肪酸的实际水平。一项对韩国成人代谢综合征的研究发现，长期饮用含有糖和植脂末的速溶咖啡（类似奶茶的成分构成），可能与肥胖、腹部肥胖和低高密度脂蛋白胆固醇血症等代谢综合征风险升高有关 40。这再次提醒我们，含有植脂末的饮品，绝不能轻视其对健康的潜在危害。

3.2.2 香精、色素等添加剂的累积风险

除了植脂末，奶茶中还常常加入了各种各样的食品添加剂，例如香精、色素、乳化剂、稳定剂等。这些添加剂的目的是为了让奶茶的颜色更诱人、味道更丰富、口感更稳定，而且能长时间保持这些特性。

虽然这些添加剂在单个使用时，只要符合国家标准，通常被认为是安全的。但问题在于，我们每天接触的超加工食品中，添加剂种类繁多，累积效应和协同作用的潜在危害，目前科学界还没有完全研究清楚。

  • 对儿童健康的影响： 尤其值得关注的是儿童群体。儿童是超加工食品最大的消费者之一 41。研究表明，人工食用色素（如偶氮染料）和苯甲酸酯类防腐剂可能导致儿童行为紊乱，例如注意力缺陷多动症（ADHD） 41。多种添加剂的长期累积摄入，可能对儿童正在发育的身体和神经系统产生负面影响 41。
  • 对肠道菌群和免疫系统的潜在影响： 一些乳化剂，在动物研究中被发现可能改变肠道菌群，引发炎症反应。虽然这些研究结果不能直接推广到人体，但提示我们，食品添加剂对我们身体内部环境的影响可能比我们想象的更复杂。另外，如前文所述，高剂量摄入某些甜味剂（也是添加剂的一种）可能抑制T细胞介导的免疫反应，这可能对免疫功能产生影响。

更深层次的风险在于，这些“美味”的添加剂，往往会掩盖食物本身的平庸，甚至引导我们形成对某些“人造风味”的偏好，而忽视了天然食物的本味。长期饮用这样的奶茶，不仅可能摄入过多的糖和不健康的脂肪，还可能让身体长期暴露在多种化学添加剂的复杂环境中，其长期累积影响不容小觑。

所以，下次当你想点一杯奶茶时，不妨多问一句：“能用纯牛奶吗？”或者选择无糖、少糖，并尽量减少添加小料，以降低潜在的健康风险。

4. 从“偶尔吃”到“常吃”：垃圾食品的健康连锁反应

我们常说“病从口入”，这句话在“垃圾食品”身上体现得淋漓尽致。很多人可能会觉得，偶尔吃一次薯片、喝一次汽水、来一杯奶茶，应该没什么大碍吧？但如果这种“偶尔”变成了“常态”，甚至“离不开”，身体就会发出各种各样的“警报”，从短期的不适，到长期的慢性疾病，形成一系列的健康连锁反应。

4.1 短期身体信号：高盐引发的水肿/血压波动，高糖导致的血糖骤升骤降与疲劳感

垃圾食品的危害，不是一蹴而就的。它往往从一些不起眼的短期身体信号开始，这些信号就像身体发出的“求救信”，提醒我们注意。

  • 高盐引发的水肿和血压波动： 刚吃完一包薯片，或者吃了一顿重口味的麻辣烫，你有没有发现第二天早上起床，眼睛有点肿，手指也感觉胀胀的？这就是水肿，是身体为了稀释过多的盐分（钠）而潴留水分的表现。钠离子在体内的主要功能之一就是调节体液平衡。当摄入的钠过多时，身体为了维持细胞内外渗透压平衡，就会留住更多的水分，导致身体局部甚至全身出现水肿。

    更重要的是，高盐饮食还会直接影响血压。过量的钠会使血管内液体量增加，导致血管壁承受的压力增大，血压升高。虽然对于健康人群来说，偶尔的高盐饮食可能只引起短期的血压波动，但长期如此，特别是对于有高血压倾向的人群，就可能逐渐演变为持续性的高血压。高血压被称为“无声杀手”，它在初期可能没有任何症状，但却会悄悄地损害血管，增加心脏病、中风和肾脏疾病的风险。甚至有研究表明，短期的、高盐饮食就能对肝脏线粒体功能造成损伤 42。所以，别小看那些吃完咸零食后的水肿，那可能是身体在告诉你：“我的水盐平衡被打破了！”

  • 高糖导致的血糖骤升骤降与疲劳感： 喝完一大杯甜奶茶或者一瓶汽水，你可能会感到一阵短暂的兴奋和满足。这是因为饮料中的大量糖分被身体快速吸收，导致血糖水平在短时间内迅速飙升。为了应对这种“糖分冲击”，胰腺会紧急分泌大量胰岛素，把血糖“压”下去。

    然而，这种过高的胰岛素分泌常常会导致血糖“矫枉过正”，迅速从高点跌落到低点，甚至低于正常水平，形成“血糖骤降”（或称“反应性低血糖”）。当你感到精力不济、头晕、心慌，甚至有些烦躁不安时，很可能就是血糖骤降惹的祸。

    这种血糖大起大落的“过山车”效应，不仅会让你感到疲劳、注意力不集中，还会刺激食欲，让你更渴望摄入高糖食物，形成一个恶性循环。长期反复的血糖骤升骤降，不仅加重胰腺负担，增加胰岛素抵抗的风险，为2型糖尿病埋下伏笔，还会影响情绪稳定性。你的身体就像一个精密的发动机，需要稳定的燃料供应，而不是一会儿猛踩油门，一会儿又急刹车。

4.2 长期疾病风险：超加工食品与肥胖、代谢综合征、心血管病的流行病学数据，儿童长期摄入的发育影响

如果说短期信号是身体的“小抱怨”，那么长期且持续地摄入大量超加工食品，则会引发一系列严重的“健康危机”，这些危机往往是隐匿而持久的，最终可能导致多种慢性疾病的发生发展。大量的流行病学数据和科学研究都在不断地证实，超加工食品与肥胖、代谢综合征、心血管疾病等之间存在着密切的联系，对儿童的长期发育影响尤其值得警惕。

超加工食品与肥胖、代谢综合征、心血管病的流行病学数据：

  • 肥胖和体重增加： 这可能是超加工食品最广为人知也最直接的危害之一。多项研究表明，超加工食品的摄入量与体重增加、超重和肥胖的发生率呈正相关 43444546。这不仅仅是因为超加工食品通常热量高、营养密度低，还因为它们往往具有高度可口性（highly palatable）。食品工业通过优化糖、盐和脂肪的组合，让这些食物产生强烈的“奖励刺激”，促使人们过量进食，难以自控 47。一项研究发现，增加超加工食品的摄入，会显著增加普通肥胖和腹部肥胖的风险 48。
  • 代谢综合征： 代谢综合征是一组危险因素的集合，包括腹部肥胖、高血压、高血糖、血脂异常等，这些因素会显著增加患2型糖尿病和心血管疾病的风险。研究明确指出，超加工食品的摄入与代谢综合征的发生发展密切相关 49。高糖、高脂的超加工食品会导致胰岛素抵抗，使细胞对胰岛素的反应迟钝，从而推高血糖水平。同时，植脂末中的反式脂肪酸会扰乱血脂，进一步加剧代谢紊乱。
  • 心血管疾病： 长期摄入超加工食品被认为是心血管疾病的重要危险因素 4950。这与其中高钠、不健康脂肪（尤其是反式脂肪酸）以及可能导致体重增加和代谢紊乱的特点密不可分。一项伞形回顾（umbrella review）对大量流行病学荟萃分析进行评估后发现，摄入更多的超加工食品与更高的心血管疾病相关死亡风险存在直接关联，证据等级达到“令人信服”（convincing evidence）50。此外，超加工食品还与高血压、血脂异常等心血管危险因素的发生率增加有关 48。
  • 其他慢性疾病： 超加工食品的危害远不止于此。有“高度提示性”的证据表明，它与全因死亡率、2型糖尿病、抑郁症、焦虑症等风险增加有关 5051。甚至有研究提示，超加工食品摄入与某些癌症（如结直肠癌、乳腺癌、胰腺癌）的风险升高存在关联 52。

儿童长期摄入的发育影响：

儿童是超加工食品的主要消费者，但由于身体和大脑仍在发育，他们对这些食品的敏感性更高，长期摄入超加工食品的危害也可能更大。

  • 儿童肥胖： 超加工食品是导致儿童肥胖的重要驱动因素 45475354。从小养成偏爱超加工食品的饮食习惯，会显著增加儿童期和青少年期的肥胖风险。一项队列研究发现，从2岁到4岁，儿童超加工食品的消费量不断增加，且与较高的BMI和较低的身高（矮小）相关联，这提示了超加工食品对儿童生长发育的负面影响，并可能导致“营养不良的双重负担”（即肥胖和矮小并存）55。
  • 神经发育和认知功能： 孕期母亲超加工食品的摄入，甚至可能影响孩子的神经心理发展。一项西班牙出生队列研究发现，孕妇在怀孕期间超加工食品摄入量越高，其孩子在早期儿童阶段的言语能力得分越低 56。这表明，超加工食品对儿童大脑发育的潜在影响可能从胚胎时期就开始了。此外，儿童屏幕暴露时间过长，也与超加工食品消费增加以及较低的儿童发展得分相关联 57。
  • 其他健康风险： 超加工食品还会增加儿童患龋齿的风险。高糖食物为口腔细菌提供了温床，导致龋齿发生率升高。长期摄入高盐食物可能为儿童期高血压埋下隐患。一些食品添加剂，如人工色素和防腐剂，在动物研究中被发现可能引起神经毒性，并可能与儿童的行为问题（如多动症）有关 41。

综上所述，超加工食品绝非“无伤大雅”的零食，它对健康的威胁是全面而深远的。从短期的身体不适到长期的慢性疾病，再到对儿童生长发育的潜在危害，都向我们敲响了警钟。因此，限制超加工食品的摄入，选择更多天然、未经加工的食物，是维护健康的当务之急。

5. 不必“谈虎色变”：科学摄入垃圾食品的正确姿势

听了上面那么多关于垃圾食品的“罪状”，你是不是觉得这些食物都成了洪水猛兽，恨不得这辈子都别再碰了？别急，我们没必要“谈虎色变”，更没必要把生活搞得如履薄冰。毕竟，美食的诱惑难以抵挡，偶尔的放纵也能带来精神上的愉悦。关键在于，我们如何用科学的态度去面对它们，做到“心中有数，手中有度”。

科学地摄入垃圾食品，不是鼓励你放开吃，而是要让你明白，如何在享受美味的同时，最大限度地降低健康风险。这就像开车一样，明知道超速有危险，但我们也不是从此就不开车了，而是要懂得限速、保持车距、遵守交通规则。对待垃圾食品，也同样如此。我们需要了解它的“脾气秉性”，知道它可能带来的问题，然后采取一些聪明的策略，来规避风险。

所以，与其彻底戒断，不如学会如何在我们的日常饮食中，为这些“坏家伙”划定一个合理的“势力范围”。接下来，我们就来聊聊，如何科学地管理垃圾食品的摄入，既满足口腹之欲，又不至于让健康亮起红灯。

5.1 控制原则：世界卫生组织推荐的每日盐糖上限，单次食用的合理分量（如薯片≤30克/天）

既然要“心中有数，手中有度”，那这个“数”和“度”到底是多少呢？幸运的是，世界卫生组织（WHO）等权威机构已经为我们制定了明确的“红线”，帮助我们更好地管理每日的盐和糖摄入。

把握盐糖“红线”：WHO的推荐上限

  • 钠（盐）的每日上限： WHO强烈建议，成人每日钠摄入量应低于2000毫克，这大约相当于5克食盐（一啤酒瓶盖的量）5859。要知道，我们平时吃的很多加工食品，包括薯片，都含有大量的钠。例如，有些品牌的薯片，一小包（约30克）就可能含有超过150毫克的钠。如果吃了一大包，很容易就会超标。
  • 游离糖的每日上限： WHO建议，成人和儿童的游离糖摄入量应限制在总能量摄入的10%以下，并强调最好能进一步降至5%以下，以获得额外的健康益处 60。对于一个每天需要摄入2000卡路里的成年人来说，10%的上限意味着每日游离糖摄入不应超过50克（大约10茶匙）；而5%的上限则意味着不应超过25克（大约5茶匙）61。回想一下，一罐汽水可能就含有35克左右的糖，一杯奶茶的糖含量更是轻松超标。

这些数字可不是随便定的，而是基于大量的科学研究，为了预防高血压、心脏病、糖尿病和龋齿等一系列慢性疾病而给出的重要建议 596263。

薯片等垃圾食品的“合理分量”：

了解了每日的盐糖上限，我们就可以反推垃圾食品的“合理分量”了。当然，最理想的状态是尽可能少吃或不吃。但如果实在想吃，请务必控制好量：

  • 薯片： 如果真的嘴馋，可以偶尔吃，但请务必控制单次食用量在30克以内。30克的薯片大概是多大一包呢？通常超市里小袋装的薯片，很多都在30-50克之间。这意味着，你可能只能吃小袋薯片的一半甚至更少。一份30克的薯片，通常能提供约150大卡的热量和150-200毫克的钠，以及约10克的脂肪。这已经占用了你每日热量、钠和脂肪摄入的“份额”646566。吃完之后，当天的其他餐食就要有意识地清淡一些，减少盐和油的摄入。
  • 汽水/奶茶： 鉴于汽水和奶茶超高的糖含量，如果你实在想喝，请选择无糖或低糖选项。如果是非要喝含糖的，也请尽量选择小杯，并且减少加糖量。把奶茶中的“半糖”或“微糖”作为底线，并且要清楚，即使是“微糖”，其中仍然含有不少的游离糖。至于配料，比如珍珠、布丁等，它们同样是糖和热量的主要来源，尽量避免或减少添加。

控制摄入的重要性：

严格控制垃圾食品的摄入量，不仅仅是为了避免一次性摄入过多的盐、糖和脂肪，更重要的是培养健康的饮食习惯。当我们偶尔少量摄入这些食物时，身体的调节机制尚能应对。但如果频繁、大量摄入，就会给身体带来持续的负担，最终导致调节功能失衡，诱发各种疾病。所以，把“偶尔尝尝鲜”和“日常饮食”严格区分开来，是科学摄入垃圾食品的关键。

5.2 替代与优化：低丙烯酰胺薯片的工艺（如真空油炸）、自制烤薯片/蔬菜脆片的健康方案，汽水/奶茶的低卡替代选择

既然我们已经了解了薯片、汽水和奶茶的潜在健康风险，并且也明白了“管住嘴”的重要性，那么接下来，我们该如何“迈开腿”——也就是寻找更健康的替代品，或者优化我们的选择呢？这并不是要你完全告别这些美味，而是在满足口腹之欲的同时，尽可能地降低风险。

5.2.1 薯片的健康优化方案：低丙烯酰胺工艺与自制脆片

对于薯片，我们可以从两个方面来优化：一是选择市面上更健康的加工产品，二是自己动手制作。

  • 低丙烯酰胺薯片的工艺：

    你可能不知道，食品科学家们也在努力寻找减少薯片中丙烯酰胺的方法。其中一个比较有前景的技术就是真空油炸。传统的薯片是常压油炸，油温通常在160-180℃，甚至更高。而在真空环境下油炸，水的沸点会降低，因此可以在较低的温度下进行油炸。这样一来，不仅能有效减少丙烯酰胺的生成，还能更好地保留食物的营养成分和天然色泽，同时降低油脂的氧化程度。所以，如果市面上有标明采用真空油炸工艺的薯片，通常会比传统薯片更健康一些，但也要注意其脂肪和盐的含量。

    此外，一些食品公司还通过基因工程技术，培育出了低天冬酰胺的土豆品种。还记得吗？天冬酰胺是产生丙烯酰胺的关键前体。通过基因沉默技术，减少土豆中天冬酰胺的含量，可以在不影响口感和外观的前提下，将薯片中的丙烯酰胺含量降低高达95% 6768。虽然这类产品目前可能还未大规模普及，但这也预示着未来我们能吃到更安全的薯片。

    当然，这些优化只是减少了某种有害物质，薯片高脂肪、高盐、低营养的本质并没有改变，所以即便选择了这些“改良版”，依然要严格控制摄入量。

  • 自制烤薯片或蔬菜脆片：

    没有什么比自己动手制作更健康的了！你可以尝试在家制作烤薯片或各种蔬菜脆片。

    1. 自制烤薯片： 将土豆切成薄片（越薄越脆），用清水浸泡去除部分淀粉，沥干后用厨房纸吸干水分。薄薄地刷上一层橄榄油，撒上少量盐和自己喜欢的香料（如迷迭香、黑胡椒粉），然后放入烤箱中，以较低的温度（例如130-150℃）慢慢烘烤至金黄酥脆。这样制作出来的薯片，不仅避免了油炸产生的大量丙烯酰胺，而且用油量和盐量都可以自己控制，膳食纤维也保留得更多。
    2. 蔬菜脆片： 除了土豆，很多蔬菜也可以做成美味健康的脆片，比如红薯、紫薯、莲藕、香菇、羽衣甘蓝等。制作方法类似，切薄片，稍微调味，然后低温烘烤。这样既能享受到酥脆的口感，又能摄入蔬菜中的丰富维生素和膳食纤维。烹饪教育有助于提高儿童的烹饪素养和自我效能感，并可能促进他们对蔬菜的接受度69，而学校通过提供更多菜单选择、调整食谱以提高适口性等策略也能有效增加学生的餐食消费70。

5.2.2 汽水/奶茶的低卡替代选择

对于汽水和奶茶，替代和优化原则主要围绕“减糖”和“减添加剂”展开。

  • 汽水的健康替代：

    1. 苏打水加新鲜果汁： 如果你喜欢汽水的“气泡感”，可以用无糖苏打水（气泡水）代替。挤入新鲜柠檬汁、橙汁、青柠汁，或者加入几片黄瓜、薄荷叶，就能制作出一杯清爽可口、天然无糖的健康饮品。
    2. 康普茶： 康普茶是一种发酵茶饮，由茶、糖和共生菌群（SCOBY）发酵而成。它含有益生菌、有机酸和抗氧化剂，对肠道健康和新陈代谢有潜在益处 7172。虽然它也含有糖，但在发酵过程中大部分糖分会被酵母和细菌消耗，所以糖含量通常低于传统汽水。市面上也有低糖或无糖康普茶可供选择，但购买时仍需注意配料表中的糖含量。值得注意的是，目前康普茶的健康益处主要来自动物实验和体外研究，在人类身上的临床证据相对有限，需要更多研究来证实 7374。
    3. 无糖茶饮： 各种花草茶、绿茶、红茶、乌龙茶等，都是零热量、无糖的健康饮品。它们富含抗氧化剂，对健康大有裨益。例如抹茶，就以其丰富的茶多酚和抗氧化剂而闻名 75。

  • 奶茶的健康替代：

    1. 自制纯牛奶茶： 最好的替代方案就是自己在家用纯牛奶和茶叶制作奶茶。选择红茶、普洱茶或乌龙茶泡好后，加入热牛奶，可以根据个人口味添加少量蜂蜜或枫糖浆调味。这样可以完全避免植脂末和各种人工添加剂，还能摄入牛奶中的钙质和蛋白质。
    2. 选择鲜奶茶并控制糖量： 如果实在想在外面买，务必选择用鲜牛奶制作的奶茶，并要求无糖或最低糖度。同时，尽量减少或不加珍珠、布丁、奶盖等配料，这些都是糖和脂肪的重灾区。
    3. 植物奶茶： 如果对牛奶过敏或喜欢其他风味，可以选择用豆奶、燕麦奶、杏仁奶等植物奶制作的奶茶。同样，选择无糖或低糖版本，并注意配料表，避免不必要的添加剂。

总而言之，面对垃圾食品，我们的策略不是一味地抵制，而是要学会选择、学会控制、学会替代。偶尔的放纵可以有，但要让健康的饮食成为常态，将这些高风险食物从“日常主角”变为“客串嘉宾”，这样才能在享受美味的同时，守护我们的健康。

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参考文献

1How and why ultra-processed foods harm human health.PubMed

Renata Bertazzi Levy, Mayra Figueiredo Barata, Maria Alvim Leite, et al.
Proc Nutr Soc. 2024 Feb;83(1):1-8. doi: 10.1017/S0029665123003567. Epub 2023 Jul 10.
The analysis of food using a perspective centred on nutrients seems inadequate for understanding the dietary transition and its impact on the growth of obesity and chronic diseases. Industrial food processing is now proposed as the key to explain the relationship between food and health. The NOVA food classification considers the degree and the purpose of food processing, which includes physical, biological and chemical processes used after foods are separated from nature, and before being consumed or prepared as dishes and meals. NOVA has four food groups: (1) unprocessed and minimally processed foods; (2) processed culinary ingredients; (3) processed foods and (4) ultra-processed foods, which are formulations made mostly or entirely from substances derived from group 1 foods and additives, with little if any intact group 1 food. Many investigations linking high ultra-processed food consumption with deterioration of diets and adverse health outcomes are reinforced by prospective studies, systematic reviews and meta-analyses. There are various plausible explanations of why diets high in ultra-processed foods are harmful. Their production and consumption continue to rise worldwide. Efficient and effective public policies and actions that reduce production and consumption of ultra-processed products are needed, to protect human health now and in future.

2Ultra-processed foods and food additives in gut health and disease.PubMed

Kevin Whelan, Aaron S Bancil, James O Lindsay, et al.
Nat Rev Gastroenterol Hepatol. 2024 Jun;21(6):406-427. doi: 10.1038/s41575-024-00893-5. Epub 2024 Feb 22.
Ultra-processed foods (UPFs) and food additives have become ubiquitous components of the modern human diet. There is increasing evidence of an association between diets rich in UPFs and gut disease, including inflammatory bowel disease, colorectal cancer and irritable bowel syndrome. Food additives are added to many UPFs and have themselves been shown to affect gut health. For example, evidence shows that some emulsifiers, sweeteners, colours, and microparticles and nanoparticles have effects on a range of outcomes, including the gut microbiome, intestinal permeability and intestinal inflammation. Broadly speaking, evidence for the effect of UPFs on gut disease comes from observational epidemiological studies, whereas, by contrast, evidence for the effect of food additives comes largely from preclinical studies conducted in vitro or in animal models. Fewer studies have investigated the effect of UPFs or food additives on gut health and disease in human intervention studies. Hence, the aim of this article is to critically review the evidence for the effects of UPF and food additives on gut health and disease and to discuss the clinical application of these findings.

3Physical Activity and Weight Loss MaintenancePubMed

Anees Alyafei, James Balfour, Daniel Keyes
Obesity constitutes a major public health concern around the globe, with serious medical, economic, and social consequences. The condition is associated with elevated risks of cardiovascular disease, type 2 diabetes, certain cancers, osteoarthritis, and all-cause mortality (see . Relative Mortality Risk by Body Mass Index). The World Health Organization identifies obesity as having a body mass index of or more than 30 kg/m², with recent data showing increasing prevalence. In the U.S., adult obesity increased from 30.5% during the years 1999 to 2000 to 42.4% in 2017 to 2018. The global burden of obesity has escalated markedly. A pooled analysis of 1,698 population-based studies encompassing 19.2 million adults found that worldwide obesity prevalence more than doubled between 1975 and 2014. High-income countries experienced particularly steep increases, although low- and middle-income countries are also increasingly affected. While obesity is multifactorial, a primary driver is an imbalance between energy intake and expenditure. Weight management involves more than calories in versus calories out. Dietary quality also plays a critical role. Plant-based diets, in particular, may support weight loss by enhancing satiety and regulating hormones. Additional contributors include physical inactivity, consumption of ultra-processed foods, sleep deprivation, psychological stress, and socioeconomic factors. Genetics, microbiome composition, and neuroendocrine feedback loops further modulate individual susceptibility to weight gain. Therefore, strategies for obesity prevention and treatment must be multifaceted and personalized, with emphasis on long-term behavioral and environmental interventions.

4Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults.PubMed

Maria Laura da Costa Louzada, Larissa Galastri Baraldi, Euridice Martinez Steele, et al.
Prev Med. 2015 Dec;81:9-15. doi: 10.1016/j.ypmed.2015.07.018. Epub 2015 Jul 29.
OBJECTIVES: The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents. METHODS: We used cross-sectional data on 30,243 individuals aged ≥10 years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. RESULTS: Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94 kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. CONCLUSION: Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.

5Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle?PubMed

David A Wiss, Erica M LaFata
Nutrients. 2024 Jun 19;16(12):1955. doi: 10.3390/nu16121955.
Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.

6Ultra-processed foods and health: a comprehensive review.PubMed

Yin Zhang, Edward L Giovannucci
Crit Rev Food Sci Nutr. 2023;63(31):10836-10848. doi: 10.1080/10408398.2022.2084359. Epub 2022 Jun 6.
Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.

7Consumer Acceptance of Reduced Sodium Potato Chips and Puffed Rice: How Does Ingredient Information and Education Influence Liking?PubMed

Aimee E Buechler, Soo-Yeun Lee
J Food Sci. 2019 Dec;84(12):3763-3773. doi: 10.1111/1750-3841.14907. Epub 2019 Nov 19.
Approximately 90% of Americans consume more than the 2,300 mg of sodium recommended daily; therefore, the Food and Drug Administration (FDA) has recommended short- and long-term sodium reduction goals in food products. Reduced sodium products have not been previously liked, so flavor enhancers may increase their palatability. The objective of this research was to compare the acceptability of FDA-recommended short- and long-term sodium reduction goals for potato chips (18 and 51% reduction) and puffed rice (20 and 57% reduction) seasoned with and without monosodium glutamate (MSG) and disodium inosinate and guanylate (I + G) combinations across three conditions: blind tasting, ingredient information, and ingredient information with educational phrase of the need for sodium reduction and safety of flavor enhancers. Data were collected for 83 potato chip panelists and 81 puffed rice panelists. A significant difference was seen across the samples with different levels of sodium and flavor enhancers for potato chips (P < 0.01) and puffed rice (P < 0.001). For potato chips, ingredient information increased the acceptance of samples with flavor enhancers. Education increased the liking of samples with short- and long-term sodium reduction and samples that combined only salt and MSG. For puffed rice, ingredient information increased acceptance except the long-term reduced sodium samples with MSG and I + G. Education increased the liking of all samples with MSG and I + G. The combination of flavor enhancers with consumer education increased the acceptance of reduced sodium products. Future research on specific sensory differences across samples that influence acceptability will be valuable for industrial application of the findings. PRACTICAL APPLICATION: The findings of our study suggest the overall liking of reduced sodium potato chip and puffed rice samples could be improved with the addition of flavor enhancers. Additionally, reduced sodium product liking was maintained or improved when paired with ingredient labeling and sodium reduction education. The acceptance of reduced sodium products would lead to the decreased risk of hypertension, heart attacks, and strokes for Americans.

8Total fat and fatty acid profile including TFA content of Indian fried foods versus the oils used for frying.PubMed

Akanksha Jain, Santosh Jain Passi, William Selvamurthy
J Food Sci Technol. 2024 Nov;61(11):2185-2195. doi: 10.1007/s13197-024-05989-z. Epub 2024 Apr 30.
UNLABELLED: Due to deleterious health effects, consumption of fat containing fried foods is a major concern. The present study has assessed total fat, SFA, UFA and TFA content of Indian fried foods-, , and (), at varying number of frying cycles/temperatures as well as composition of the oils extracted from the foods and the oils used for frying. Total fat in the food items was significantly higher at 32nd (x̄27.4%) versus the 1st frying cycle (x̄22.5%; < 0.05). Progressive frying cycles (1st vs. 32nd)/temperatures demonstrated declining levels of UFAs (at 180 °C: x̄16.33% vs. x̄11.29%; at 160 °C: x̄19.54% vs. x̄13.81%) with concomitant increase in SFA (at 180 °C: x̄4.97% vs. x̄14.97%; at 160 °C: x̄5.19% vs. x̄13.79%) and TFA content (at 180 °C: x̄0.05% vs. x̄0.89%; at 160 °C: x̄0.04% vs. x̄0.17%). Compared to the unheated oil, at 32nd frying cycle (irrespective of the frying temperatures), oils extracted from fried foods registered a significant decrease in UFA (x̄17.41%) coupled with an increase in SFA (x̄63.74%) and an exponential increase in TFA (39-301 folds); however, the change was slightly lesser in oils used for frying (UFA: x̄15.06%; SFA: x̄53.75%; TFA: 20-264 folds). To curb TFA in fried foods, necessary regulations are needed for restricting the number of frying cycles as well as the frying temperatures along with awareness generation regarding appropriate frying practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13197-024-05989-z.

9Rapid detection of tertiary butylated hydroquinone in food samples using Mn-MOF@f-CNF composite-modified screen-printed electrode.PubMed

Praveenkannan Srinivasan, Umamaheswari Rajaji, Mathur Gopalakrishnan Sethuraman, et al.
Mikrochim Acta. 2024 Sep 6;191(10):576. doi: 10.1007/s00604-024-06642-4.
Hydroquinone-based organic molecules are often used as unavoidable preservatives in the food industry. Among these additives, tertiary butylated hydroquinone (TBHQ) is widely employed as a preservative in various processed foods. However, the potential health risks associated with the excessive presence of TBHQ in food products have raised significant concerns. To address this pressing issuea novel binder-free composite composed of a manganese metal-organic framework and functionalized carbon nanofibers (Mn-MOF/f-CNF) has been developed as an electrode modifier for the ultrasensitive detection of TBHQ in food samples. The Mn-MOF/f-CNF composite was achieved using the ultrasonication method, revealing a lamellar sheet-like structure of the Mn-MOF and the curly thread-like fibrous structure of f-CNF. The developed Mn-MOF/f-CNF/SPE sensor system resulted in well-defined redox signals for TBHQ detection in a neutral pH solution. Compared to the unmodified SPE system, the modified system showed approximately a 300 mV reduction in overpotential and a twofold increase in peak current signal for TBHQ detection. The Mn-MOF/f-CNF/SPE sensor system showed a linear concentration window of 0.01 to 800 μM with a sensitivity of 6.28 µA µM cm and the obtained detection limit was 1.36 nM. Additionally, the proposed sensor displayed excellent reproducibility and repeatable results with an RSD of less than 5%. The real-time applicability of the Mn-MOF/f-CNF/SPE sensor system was demonstrated using real samples such as potato chips and instant noodles, showing excellent results with a recovery range of 95.1-98.5%.

10Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001-2018 Analysis.PubMed

Sanjiv Agarwal, Victor L Fulgoni
Nutrients. 2021 Jul 29;13(8):2614. doi: 10.3390/nu13082614.
Potatoes are nutrient rich white vegetables, however, research on their impact on public health is limited. The objective of this study was to provide updated evaluation of the cross-sectional association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four hour diet recall data from adolescents ( = 16,633; age 9-18 years) were used to assess intakes. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures, fried potatoes, and potato chips) had higher ( < 0.05) HEI-2015 total score and subcomponent scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers also had higher ( < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus, potassium, selenium, sodium, zinc, niacin, vitamin B, vitamin C, vitamin K and total choline; and higher ( < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine, niacin, vitamin B, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore encouraging their consumption may be an effective strategy for improving nutritional status.

11Acrylamide: a common food toxin related to physiological functions and health.PubMed

M Semla, Z Goc, M Martiniaková, et al.
Physiol Res. 2017 May 4;66(2):205-217. doi: 10.33549/physiolres.933381. Epub 2016 Dec 16.
Acrylamide (AA) is a highly reactive organic compound capable of polymerization to form polyacrylamide, which is commonly used throughout a variety of industries. Given its toxic effect on humans and animals, the last 20 years have seen an increased interest in research devoted to the AA. One of the main sources of AA is food. AA appears in heated food following the reaction between amino acids and reduced sugars. Large concentrations of AA can be found in popular staples such as coffee, bread or potato products. An average daily consumption of AA is between 0.3-2.0 microg/kg b.w. Inhalation of acrylamide is related with occupational exposure. AA delivered with food is metabolized in the liver by cytochrome P450. AA biotransformation and elimination result in formation of toxic glycidamide (GA). Both, AA and GA can be involved in the coupling reaction with the reduced glutathione (GSH) forming glutathione conjugates which are excreted with urine. Biotransformation of AA leads to the disturbance in the redox balance. Numerous research proved that AA and GA have significant influence on physiological functions including signal propagation in peripheral nerves, enzymatic and hormonal regulation, functions of muscles, reproduction etc. In addition AA and GA show neurotoxic, genotoxic and cancerogenic properties. In 1994, International Agency for Research on Cancer (IARC) classified acrylamide as a potentially carcinogenic substance to human.

12Acrylamide: formation, occurrence in food products, detection methods, and legislation.PubMed

Ioannis S Arvanitoyannis, Niki Dionisopoulou
Crit Rev Food Sci Nutr. 2014;54(6):708-33. doi: 10.1080/10408398.2011.606378.
This review aims at summarizing the most recent updates in the field of acrylamide (AA) formation (mechanism, conditions) and the determination of AA in a number of foods (fried or baked potatoes, chips, coffee, bread, etc). The methods applied for AA detection [Capillary Electrophoresis-Mass Spectrometry (CE-MS), Liquid Chromatography-Mass Spectrometry (LC-MS), Non-Aqueous Capillary Electrophoresis (NACE), High Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS), Pressurized Fluid Extraction (PFE), Matrix Solid-Phase Dispersion (MSPD), Gas Chromatography-Mass Spectrometry (GC-MS), Solid-Phase MicroExtraction-Gas Chromatography (SPME-GC), Enzyme Linked Immunosorbent Assay (ELISA), and MicroEmulsion ElectroKinetic Chromatography (MEEKC) are presented and commented. Several informative figures and tables are included to show the effect of conditions (temperature, time) on the AA formation. A section is also included related to AA legislation in EU and US.

13Dietary Exposure to Acrylamide and Associated Health Risks for the Korean Population.PubMed

Sanghee Lee, Hyun Jung Kim
Int J Environ Res Public Health. 2020 Oct 19;17(20):7619. doi: 10.3390/ijerph17207619.
The aim of the study was to estimate the dietary exposure to acrylamide (AA) from the consumption of various processed food and to assess the associated health risks in different age groups in Korea. Potato crisps and French fries presented the highest mean levels of AA (546 and 372 μg/kg, respectively) followed by coffee (353 μg/kg) and tea products (245 μg/kg). The mean AA dietary exposure values for toddlers (≤2 years), children (3-6 years), children (7-12 years), adolescents (13-19 years), adults (20-64 years), and seniors (≥65 years) were estimated to be 0.15, 0.13, 0.06, 0.06, 0.08, and 0.06 μg/kg body weight (BW)/day, respectively. Based on the benchmark dose lower confidence limit (BMDL) of 0.18 and 0.31 mg/kg BW/day, the calculated mean and 95th percentile values for the margin of exposure were below 10,000 for the all age groups suggesting possible health concern for Koreans. Biscuits, crisps, and coffee were the primary foods contributing to dietary AA exposure among these in the Korean populations. In children, considering the health risk of AA dietary exposure, especially from biscuits and crisps, there is a need to further control and modify dietary habits to ensure lower AA exposure.

14The carcinogenicity of dietary acrylamide intake: a comparative discussion of epidemiological and experimental animal research.PubMed

Janneke G F Hogervorst, Bert-Jan Baars, Leo J Schouten, et al.
Crit Rev Toxicol. 2010 Jul;40(6):485-512. doi: 10.3109/10408440903524254.
Since 2002, it is known that the probable human carcinogen acrylamide is present in commonly consumed carbohydrate-rich foods, such as French fries and potato chips. In this review, the authors discuss the body of evidence on acrylamide carcinogenicity from both epidemiological and rodent studies, including variability, strengths and weaknesses, how both types of evidence relate, and possible reasons for discrepancies. In both rats and humans, increased incidences of various cancer types were observed. In rats, increased incidences of mammary gland, thyroid tumors and scrotal mesothelioma were observed in both studies that were performed. In humans, increased risks of ovarian and endometrial cancers, renal cell cancer, estrogen (and progesterone) receptor-positive breast cancer, and oral cavity cancer (the latter in non-smoking women) were observed. Some cancer types were found in both rats and humans, e.g., endometrial cancer (observed in one of the two rat studies), but there are also some inconsistencies. Interestingly, in humans, some indications for inverse associations were observed for lung and bladder cancers in women, and prostate and oro- and hypopharynx cancers in men. These latter observations indicate that genotoxicity may not be the only mechanism by which acrylamide causes cancer. The estimated risks based on the epidemiological studies for the sites for which a positive association was observed were considerably higher than those based on extrapolations from the rat studies. The observed pattern of increased risks in the rat and epidemiological studies and the decreased risks in the epidemiological studies suggests that acrylamide might influence hormonal systems, for which rodents may not be good models.

15Carcinogenicity of acrylamide: a computational study.PubMed

Katja Galesa, Urban Bren, Agata Kranjc, et al.
J Agric Food Chem. 2008 Sep 24;56(18):8720-7. doi: 10.1021/jf800965y. Epub 2008 Aug 23.
This paper reports a series of ab initio, density functional theory (DFT), and semiempirical molecular orbital (MO) calculations concerning the reaction between the ultimate carcinogen of acrylamide and guanine. Acrylamide--a product of the Maillard reaction--is present in a variety of fried and oven-cooked food. After intake, it is epoxidized by cytochrome P450 2E1 to yield the ultimate carcinogen--glycidamide. Effects of solvation were considered using the Langevin dipoles (LD) model of Florian and Warshel and the solvent reaction field (SCRF) model of Tomasi and co-workers. In silico activation free energies are in very good agreement with the experimental value of 22.8 kcal/mol. This agreement presents strong evidence in favor of the validity of the proposed S N2 reaction mechanism and points to the applicability of quantum chemical methods to studies of reactions associated with carcinogenesis. In addition, insignificant stereoselectivity of the studied reaction was predicted. Finally, the competing reaction of glycidamide with adenine was simulated, and the experimentally observed regioselectivity was successfully reproduced.

16Evidence-based dose-response assessment for thyroid tumorigenesis from acrylamide.PubMed

Michael Dourson, Richard Hertzberg, Bruce Allen, et al.
Regul Toxicol Pharmacol. 2008 Dec;52(3):264-89. doi: 10.1016/j.yrtph.2008.08.004. Epub 2008 Aug 20.
Acrylamide is commonly found in various foods. Cancer studies in rats have reported increases in tumors of the thyroid, mammary tissues, tunica vaginalis of the testis, and sometimes tumors at other sites. We review relevant studies on acrylamide's DNA toxicity, tumor formation and the manner of its tumor formation. We find, as do others, that glycidamide (a metabolite of acrylamide) causes point mutations, but acrylamide does not. We also find that thyroid tumors are most consistently sensitive in rats, being evoked in each of four long-term experiments. We evaluate the common manners of this tumor formation in the thyroid, including both mutagenicity and thyroid growth-stimulation. Consistent with the overall weight of the evidence, we conclude that both of these manners or modes of action may be occurring. We conservatively assume that the mutagenic mode of action determines the low-dose-response and we conclude that growth stimulation likely dominates the response at higher doses. Following US EPA guidelines, we determined that the probit model best reflects the overall data set; this model is also preferred because it better reflects the underlying "decoupled" biology of contributions from potentially two modes of action. We use the probit model to identify a health-protective, linear cancer slope factor (SF) of 0.030 (mg/kg-day)(-1) for the low area of the dose-response curve associated with possible mutagenicity. We also identify a Reference Dose (RfD) in the range of 0.05-0.02 mg/kg-day for the high area of the dose-response curve associated with the growth stimulation. This latter value can be used to determine the upper range of risk. This dose-response assessment is briefly summarized in light of other related work.

17The burden of disease due to dietary exposure to acrylamide in Italy: A risk assessment-based approach.PubMed

Octavian Augustin Mihalache, Chiara Dall'Asta
Food Chem Toxicol. 2024 Jun;188:114699. doi: 10.1016/j.fct.2024.114699. Epub 2024 Apr 30.
The aim of this study was to assess Italian consumers' risk of cancer and burden of disease due to dietary exposure to acrylamide. Our model considered six age groups such as infants, toddlers, other children, adolescents, adults, and the elderly, and the consumption of 31 food items. Using a risk-assessment-based approach, we first characterized the risk of neoplastic effects using the margin of exposure method. Then the risk of kidney, endometrial, breast, ovarian cancer, and total cancer was estimated using adjusted cancer slope factors while the burden of disease was quantified using Disability-adjusted Life Years (DALYs). The highest risk for females was related to breast cancer while the lowest was for kidney cancer. We found a comparable risk of total cancer among Italian males and females, estimated at around 1.59 to 3.57 cases per 100,000 individuals annually with the burden ranging between 12.3 - 25.4 and 11.4 - 24.1 DALYs respectively. Our findings provide insights on the multifaceted impact of acrylamide on public health by offering detailed insights into age-specific exposure levels, diverse cancer risks, and the dietary burden of disease related to acrylamide. Targeted interventions and policies can be developed towards mitigating the health risks associated with acrylamide exposure.

18Neuro-reproductive toxicity and carcinogenicity of 1-bromopropane: studies for evidence-based preventive medicine.PubMed

Gaku Ichihara
J Occup Health. 2025 Jan 7;67(1). doi: 10.1093/joccuh/uiaf004.
Bromopropane was introduced commercially as an alternative to ozone-depleting and global-warming solvents. The identification of 1-bromopropane neurotoxicity in animal experiments was followed by reports of human cases of 1-bromopropane toxicity. In humans, the most common clinical features of 1-bromopropane neurotoxicity are decreased sensation, weakness in extremities, and walking difficulties. Moreover, decreased cognition, abnormal findings on brain magnetic resonance imaging, urinary incontinence, and numbness in the perineal area have also been described in workers exposed to 1-bromopropane. Murine histological studies showed that exposure to 1-bromopropane reduced the density of brain noradrenergic axons. Furthermore, proteome studies demonstrated 1-bromopropane-induced changes in the expression of proteins in the hippocampus of rats, similar to the changes seen in mice exposed to acrylamide, suggesting a common mechanism of electrophile-induced neurotoxicity. In addition to its neurotoxicity, 1-bromopropane also induces male reproductive toxicity in rats, although the targeted areas in the reproductive system differ from those affected by 2-bromopropane. However, exposure to high levels of 1-bromopropane was reported to induce spermatogenic cell degeneration, similar to that caused by 2-bromopropane, suggesting common mechanism(s) underlying 1- and 2-bromopropane-induced male reproductive toxicity. Plural approaches, including human, animal, and mechanistic studies, are useful for identification of 1-bromopropane neurotoxicity. The International Agency for Research on Cancer summarized that 1-bromopropane as well as 2-bromopropane share several key characteristics of carcinogens. Plural approaches can establish evidence-based preventive medicine by modification of the conventional evidence-based medicine (EBM), which has been developed for therapeutic medicine and is represented by the EBM pyramid.

19Potato chips and childhood: what does the science say? An unrecognized threat?PubMed

Allal Ouhtit, Marwan Al-Sharbati, Ishita Gupta, et al.
Nutrition. 2014 Oct;30(10):1110-2. doi: 10.1016/j.nut.2014.01.008. Epub 2014 Feb 15.
With recent rapid progress in technology and advancing lifestyle associated with modernization, individuals are consuming increasing quantities of unhealthy food, a major risk factor for the onset of a variety of diseases. In particular, fried potato chips (FPCs), are the most commonly consumed snack, especially by children. However, research in the field of nutrition demonstrated that FPCs encompass significant quantities of acrylamide, a known carcinogen and neurotoxin. Thus, frequent intake of FPC, especially at younger age, might generate cumulative amounts of acrylamide in the body, thereby silently increasing the risk for various diseases. Although intake of a balanced diet can prevent this scenario, further measures should be set to overcome the oxidative damage from fried food. This review outlines existing scientific evidence suggesting an urgent need for systematic study regarding the health effects of consumption of FPC and French fries in the general population.

20Acrylamide content in selected food products collected from Montenegrin market and health risk assessment.PubMed

Dijana Đurović, Miljan Bigović, Ljubica Ivanović, et al.
Cent Eur J Public Health. 2024 Dec;32(4):273-278. doi: 10.21101/cejph.a8260.
OBJECTIVES: This study aimed to investigate the acrylamide exposure of different children and adult population groups (10-14 years, 15-17 years, 18-24 years, 25-44 years, 45-64 years, and 65-74 years) resulting from the consumption of potato chips and wheat-based bread from Montenegrin market and to evaluate it in terms of health risk. METHODS: The acrylamide content was monitored in 51 samples of bread and 20 samples of chips. The carcinogenic health risk in different population groups was assessed through the incremental lifetime cancer risk (CR) and total cancer risk (TCR). RESULTS: The average acrylamide content in potato chips and bread was calculated to be 238 μg/kg and 30 μg/kg, respectively. Acrylamide content in a tested sample met the criteria prescribed by Commission Regulation (EU) 2017/2158 in 98% of the tested samples of chips and 85% of bread samples. The carcinogenic health risk of acrylamide exposure for the investigated population groups is of concern. The values of CR for all the investigated groups were in the range of 10 < CR < 10 and the values of TCR were 10 order of magnitude, indicating a potential cancer risk. CONCLUSION: The youngest population (10-14 years) was exposed to the highest cancer risk through the consumption of both, chips and bread. For the population of 10-14 years, 15-17 years, 25-44 years, 45-64 years, and 65-74 years, a higher risk of cancer was found due to the consumption of bread compared to the consumption of chips. Only the population aged 18-24 years was faced with a higher risk of cancer due to the consumption of chips compared to the consumption of bread.

21Acrylamide intake through diet and human cancer risk.PubMed

Lorelei A Mucci, Kathryn M Wilson
J Agric Food Chem. 2008 Aug 13;56(15):6013-9. doi: 10.1021/jf703747b. Epub 2008 Jul 15.
More than one-third of the calories consumed by U.S. and European populations contain acrylamide, a substance classified as a "probable human carcinogen" based on laboratory data. Thus, it is a public health concern to evaluate whether intake of acrylamide at levels found in the food supply is an important cancer risk factor. Mean dietary intake of acrylamide in adults averages 0.5 microg/kg of body weight per day, whereas intake is higher among children. Several epidemiological studies examining the relationship between dietary intake of acrylamide and cancers of the colon, rectum, kidney, bladder, and breast have been undertaken. These studies found no association between intake of specific foods containing acrylamide and risk of these cancers. Moreover, there was no relationship between estimated acrylamide intake in the diet and cancer risk. Results of this research are compared with other epidemiological studies, and the findings are examined in the context of data from animal models. The importance of epidemiological studies to establish the public health risk associated with acrylamide in food is discussed, as are the limitations and future directions of such studies.

22Epicatechin Adducting with 5-Hydroxymethylfurfural as an Inhibitory Mechanism against Acrylamide Formation in Maillard Reactions.PubMed

Yajing Qi, Hui Zhang, Hao Zhang, et al.
J Agric Food Chem. 2018 Nov 28;66(47):12536-12543. doi: 10.1021/acs.jafc.8b03952. Epub 2018 Nov 13.
This study aimed to investigate the inhibitory mechanism of epicatechin (EC) on the formation of acrylamide in Maillard reactions. The glucose + asparagine model is a typical chemical system used to investigate acrylamide formation. 5-Hydroxymethylfurfural (HMF) is an important carbonyl intermediate in Maillard reactions and can also react with asparagine to form acrylamide. Time courses showed that EC inhibited more HMF than acrylamide in the glucose + asparagine model heated at 180 °C. The reduction of EC on acrylamide formation in the HMF + asparagine model was about 70%, while that in the glucose + asparagine model was about 50%. Moreover, HMF decreased significantly faster when it was heated in the presence of EC. Liquid chromatography-mass spectrometry analysis revealed the formation of adducts between EC and HMF, and the dimeric adducts were verified in fried potato chips. These results suggested that the condensation of EC and HMF was one of the key steps leading to the inhibition of acrylamide. UV-visible spectra analysis showed that some polymerization products had absorption in the visible region and contributed to the development of browning, which was underestimated in the past.

23Thermostability Improvement of L-Asparaginase from via Consensus-Designed Cysteine Residue Substitution.PubMed

Linshu Jiao, Huibing Chi, Bingjie Xia, et al.
Molecules. 2022 Oct 7;27(19):6670. doi: 10.3390/molecules27196670.
To extend the application range of L-asparaginase in food pre-processing, the thermostability improvement of the enzyme is essential. Herein, two non-conserved cysteine residues with easily oxidized free sulfhydryl groups, Cys8 and Cys283, of L-asparaginase (AsA) were screened out via consensus design. After saturation mutagenesis and combinatorial mutation, the mutant C8Y/C283Q with highly improved thermostability was obtained with a half-life of 361.6 min at 40 °C, an over 34-fold increase compared with that of the wild-type. Its melting temperature () value reaches 62.3 °C, which is 7.1 °C higher than that of the wild-type. Molecular dynamics simulation and structure analysis revealed the formation of new hydrogen bonds of Gln283 and the aromatic interaction of Tyr8 formed with adjacent residues, resulting in enhanced thermostability. The improvement in the thermostability of L-asparaginase could efficiently enhance its effect on acrylamide inhibition; the contents of acrylamide in potato chips were efficiently reduced by 86.50% after a mutant C8Y/C283Q treatment, which was significantly higher than the 59.05% reduction after the AsA wild-type treatment. In addition, the investigation of the mechanism behind the enhanced thermostability of AsA could further direct the modification of L-asparaginases for expanding their clinical and industrial applications.

24Sugar in Infants, Children and Adolescents: A Position Paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition.PubMed

Nataša Fidler Mis, Christian Braegger, Jiri Bronsky, et al.
J Pediatr Gastroenterol Nutr. 2017 Dec;65(6):681-696. doi: 10.1097/MPG.0000000000001733.
The consumption of sugars, particularly sugar-sweetened beverages (SSBs; beverages or drinks that contain added caloric sweeteners (ie, sucrose, high-fructose corn syrup, fruit juice concentrates), in European children and adolescents exceeds current recommendations. This is of concern because there is no nutritional requirement for free sugars, and infants have an innate preference for sweet taste, which may be modified and reinforced by pre- and postnatal exposures. Sugar-containing beverages/free sugars increase the risk for overweight/obesity and dental caries, can result in poor nutrient supply and reduced dietary diversity, and may be associated with increased risk of type 2 diabetes mellitus, cardiovascular risk, and other health effects. The term "free sugars," includes all monosaccharides/disaccharides added to foods/beverages by the manufacturer/cook/consumer, plus sugars naturally present in honey/syrups/unsweetened fruit juices and fruit juice concentrates. Sugar naturally present in intact fruits and lactose in amounts naturally present in human milk or infant formula, cow/goat milk, and unsweetened milk products is not free sugar. Intake of free sugars should be reduced and minimised with a desirable goal of <5% energy intake in children and adolescents aged ≥2 to 18 years. Intake should probably be even lower in infants and toddlers <2 years. Healthy approaches to beverage and dietary consumption should be established in infancy, with the aim of preventing negative health effects in later childhood and adulthood. Sugar should preferably be consumed as part of a main meal and in a natural form as human milk, milk, unsweetened dairy products, and fresh fruits, rather than as SSBs, fruit juices, smoothies, and/or sweetened milk products. Free sugars in liquid form should be replaced by water or unsweetened milk drinks. National Authorities should adopt policies aimed at reducing the intake of free sugars in infants, children and adolescents. This may include education, improved labelling, restriction of advertising, introducing standards for kindergarten and school meals, and fiscal measures, depending on local circumstances.

25The Importance of the World Health Organization Sugar Guidelines for Dental Health and Obesity Prevention.PubMed

Joao Breda, Jo Jewell, Amélie Keller
Caries Res. 2019;53(2):149-152. doi: 10.1159/000491556. Epub 2018 Aug 7.
The World Health Organization (WHO) recommends a reduced intake of free sugars throughout the life course (strong recommendation) with a reduction of free sugars intake to less than 10% of the total energy intake (strong recommendation) and preferably below 5% of the total energy intake (conditional recommendation) in both adults and children. Available data clearly show that people already consume significantly more sugar than they should, increasing the risk for dental caries, overweight and obesity. The WHO recommendations are intended for use by the policy makers as a benchmark for assessing intake of sugars by populations and as a driving force for policy change. To create a favorable environment, enabling the overall amount of free sugar intake to be as low as possible and to reduce the frequency of consumption of sugar-rich foods, a range of public health interventions is advised.

26Sugar-Sweetened Beverages and Metabolic Risk in Children and Adolescents with Obesity: A Narrative Review.PubMed

Valeria Calcaterra, Hellas Cena, Vittoria Carlotta Magenes, et al.
Nutrients. 2023 Jan 30;15(3):702. doi: 10.3390/nu15030702.
UNLABELLED: Sugar-sweetened beverages (SSBs) are major contributors of free sugars to the diet. A strong relationship between SSB intake and weight gain is described. METHODS: we performed a narrative review to present an overview of the role of SSBs as a pivotal contributor in the development of obesity and metabolism-related complications. RESULTS: different factors influence SSB consumption in children, including economic variables, individual attributes and behaviors to environmental factors, parent features and parents' behaviors. Data suggest that SSB intake has a negative effect on weight and obesity-related diseases. The leading mechanism linking SSB intake to the risk of gaining weight is decreased satiety and incomplete compensatory reduction in energy intake at meals following ingestion of liquid calories. Additionally, the effects of SSBs on gut microbiota and on eating behaviors were also reported. An association between SSB intake, weight gain and cardiometabolic risks is evident. Consumption of SSBs had a significant impact on the prevalence of obesity and related metabolic risks, including insulin resistance, type 2 diabetes, hypertension and metabolic syndrome. CONCLUSIONS: Limiting consumption of SSBs and increasing knowledge of the effect of SSBs on early metabolic and cardiovascular disorders will be useful in developing strategies to counteract the problem and to prevent obesity and related complications.Key future research areas for which further studies are needed include investigating the long-term effects of SSBs on health outcomes as well as analyzing the health effects of sugar consumed in solid compared to liquid forms and further elucidating the biological mechanisms of sugar addiction and energy compensation.

27The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases.PubMed

Vasanti S Malik, Frank B Hu
Nat Rev Endocrinol. 2022 Apr;18(4):205-218. doi: 10.1038/s41574-021-00627-6. Epub 2022 Jan 21.
Sugar-sweetened beverages (SSBs) are a major source of added sugars in the diet. A robust body of evidence has linked habitual intake of SSBs with weight gain and a higher risk (compared with infrequent SSB consumption) of type 2 diabetes mellitus, cardiovascular diseases and some cancers, which makes these beverages a clear target for policy and regulatory actions. This Review provides an update on the evidence linking SSBs to obesity, cardiometabolic outcomes and related cancers, as well as methods to grade the strength of nutritional research. We discuss potential biological mechanisms by which constituent sugars can contribute to these outcomes. We also consider global trends in intake, alternative beverages (including artificially-sweetened beverages) and policy strategies targeting SSBs that have been implemented in different settings. Strong evidence from cohort studies on clinical outcomes and clinical trials assessing cardiometabolic risk factors supports an aetiological role of SSBs in relation to weight gain and cardiometabolic diseases. Many populations show high levels of SSB consumption and in low-income and middle-income countries, increased consumption patterns are associated with urbanization and economic growth. As such, more intensified policy efforts are needed to reduce intake of SSBs and the global burden of obesity and chronic diseases.

28The Impact of Excessive Fructose Intake on Adipose Tissue and the Development of Childhood Obesity.PubMed

Anna Karenina Azevedo-Martins, Matheus Pedro Santos, Julie Abayomi, et al.
Nutrients. 2024 Mar 25;16(7):939. doi: 10.3390/nu16070939.
Worldwide, childhood obesity cases continue to rise, and its prevalence is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. Thus, comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is strongly associated with high fructose intake since the excessive consumption of this highly lipogenic sugar leads to white fat accumulation and causes white adipose tissue (WAT) inflammation, oxidative stress, and dysregulated adipokine release. Unfortunately, the global consumption of fructose has increased dramatically in recent years, which is associated with the fact that fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Therefore, here, we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity, and current strategies for reducing high fructose and/or free sugar intake. To achieve such reductions, we conclude that it is important that the population has access to reliable information about food ingredients via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children.

29In Mexico, Evidence Of Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax.PubMed

M Arantxa Colchero, Juan Rivera-Dommarco, Barry M Popkin, et al.
Health Aff (Millwood). 2017 Mar 1;36(3):564-571. doi: 10.1377/hlthaff.2016.1231. Epub 2017 Feb 22.
Mexico implemented a 1 peso per liter excise tax on sugar-sweetened beverages on January 1, 2014, and a previous study found a 6 percent reduction in purchases of taxed beverages in 2014. In this study we estimated changes in beverage purchases for 2014 and 2015. We used store purchase data for 6,645 households from January 2012 to December 2015. Changes in purchases of taxed and untaxed beverages in the study period were estimated using two models, which compared 2014 and 2015 purchases with predicted (counterfactual) purchases based on trends in 2012-13. Purchases of taxed beverages decreased 5.5 percent in 2014 and 9.7 percent in 2015, yielding an average reduction of 7.6 percent over the study period. Households at the lowest socioeconomic level had the largest decreases in purchases of taxed beverages in both years. Purchases of untaxed beverage increased 2.1 percent in the study period. Findings from Mexico may encourage other countries to use fiscal policies to reduce consumption of unhealthy beverages along with other interventions to reduce the burden of chronic disease.

30Relationship Between Dietary Sugar Intake and Dental Caries Among Japanese Preschool Children with Relatively Low Sugar Intake (Japan Nursery School SHOKUIKU Study): A Nationwide Cross-Sectional Study.PubMed

Miyuki Saido, Keiko Asakura, Shizuko Masayasu, et al.
Matern Child Health J. 2016 Mar;20(3):556-66. doi: 10.1007/s10995-015-1854-3.
OBJECTIVES: The WHO has recently proposed to halve the recommendation for free sugar intake from 10 to 5 % of energy intake to reduce the incidence of diseases such as obesity and dental caries. The Japanese population is suitable to confirm the appropriateness of this proposal, because dietary sugar intake in Japan is exceptionally low among developed countries. We sought to establish a method to estimate dietary sugar intake in Japan and to examine the relationship between sugar and the number of dental caries using data obtained from the Japan Nursery School SHOKUIKU study. METHODS: Dietary intake during the preceding month and the number of caries was examined in children aged 5-6 years using a brief-type self-administered diet history questionnaire for Japanese preschool children completed by their guardians and another questionnaire on lifestyle. Multivariate Poisson regression models were used for the analysis. RESULTS: When subjects were ranked into quintiles by the proportion of energy from free sugar, those in higher quintiles had more caries than those in the lowest quintile. On close analysis, the number of caries among children with a relatively small proportion of energy intake from free sugar (3.18-3.77 %) was not significantly different from that in the lowest group (0.95-3.17 %). CONCLUSIONS: The recent proposition of WHO might be valid, because the adverse effect of relatively small proportion (approximately less than 5 %) of energy intake from free sugar on caries was not detected among the subjects in this study. However, more study will be necessary to reach a conclusion.

31The artificial sweetener erythritol and cardiovascular event risk.PubMed

Marco Witkowski, Ina Nemet, Hassan Alamri, et al.
Nat Med. 2023 Mar;29(3):710-718. doi: 10.1038/s41591-023-02223-9. Epub 2023 Feb 27.
Artificial sweeteners are widely used sugar substitutes, but little is known about their long-term effects on cardiometabolic disease risks. Here we examined the commonly used sugar substitute erythritol and atherothrombotic disease risk. In initial untargeted metabolomics studies in patients undergoing cardiac risk assessment (n = 1,157; discovery cohort, NCT00590200 ), circulating levels of multiple polyol sweeteners, especially erythritol, were associated with incident (3 year) risk for major adverse cardiovascular events (MACE; includes death or nonfatal myocardial infarction or stroke). Subsequent targeted metabolomics analyses in independent US (n = 2,149, NCT00590200 ) and European (n = 833, DRKS00020915 ) validation cohorts of stable patients undergoing elective cardiac evaluation confirmed this association (fourth versus first quartile adjusted hazard ratio (95% confidence interval), 1.80 (1.18-2.77) and 2.21 (1.20-4.07), respectively). At physiological levels, erythritol enhanced platelet reactivity in vitro and thrombosis formation in vivo. Finally, in a prospective pilot intervention study ( NCT04731363 ), erythritol ingestion in healthy volunteers (n = 8) induced marked and sustained (>2 d) increases in plasma erythritol levels well above thresholds associated with heightened platelet reactivity and thrombosis potential in in vitro and in vivo studies. Our findings reveal that erythritol is both associated with incident MACE risk and fosters enhanced thrombosis. Studies assessing the long-term safety of erythritol are warranted.

32Potential Effects of Sucralose and Saccharin on Gut Microbiota: A Review.PubMed

Susana Del Pozo, Sonia Gómez-Martínez, Ligia E Díaz, et al.
Nutrients. 2022 Apr 18;14(8):1682. doi: 10.3390/nu14081682.
Artificial sweeteners are additives widely used in our diet. Although there is no consensus, current evidence indicates that sucralose and saccharin could influence the gut microbiota. The aim of this study was to analyze the existing scientific evidence on the effects of saccharin and sucralose consumption on gut microbiota in humans. Different databases were used with the following search terms: sweeteners, non-caloric-sweeteners, sucralose, splenda, saccharin, sugartwin, sweet'n low, microbiota, gut microbiota, humans, animal model, mice, rats, and/or in vitro studies. In vitro and animal model studies indicate a dose-dependent relationship between the intake of both sweeteners and gut microbiota affecting both diversity and composition. In humans, long-term study suggests the existence of a positive correlation between sweetener consumption and some bacterial groups; however, most short-term interventions with saccharin and sucralose, in amounts below the ADI, found no significant effect on those groups, but there seems to be a different basal microbiota-dependent response of metabolic markers. Although studies in vitro and in animal models seem to relate saccharin and sucralose consumption to changes in the gut microbiota, more long-term studies are needed in humans considering the basal microbiota of participants and their dietary and lifestyle habits in all population groups. Toxicological and basal gut microbiota effects must be included as relevant factors to evaluate food safety and nutritional consequences of non-calorie sweeteners. In humans, doses, duration of interventions, and number of subjects included in the studies are key factors to interpret the results.

33A critical review on effects of artificial sweeteners on gut microbiota and gastrointestinal health.PubMed

Yizhe Sun, Baojun Xu
J Sci Food Agric. 2025 Mar 30;105(5):2737-2747. doi: 10.1002/jsfa.14148. Epub 2025 Jan 29.
Artificial sweeteners have emerged as popular alternatives to traditional sweeteners, driven by the growing concern over sugar consumption and its associated rise in obesity and metabolic disorders. Despite their widespread use, the safety and health implications of artificial sweeteners remain a topic of debate, with conflicting evidence contributing to uncertainty about their long-term effects. This review synthesizes current scientific evidence regarding the impact of artificial sweeteners on gut microbiota and gastrointestinal health. Our analysis of in vitro experiments, animal models, and clinical trials reveals that artificial sweeteners can alter the composition and abundance of gut microbes. These changes raise concerns about their potential to affect overall gut health and contribute to gastrointestinal disorders. Additionally, artificial sweeteners have been shown to influence the production of metabolites by gut bacteria, further impacting systemic health. The findings suggest that artificial sweeteners may have complex and sometimes contradictory effects on gut microbiota. While some studies indicate potential benefits, such as reduced caloric intake and weight management, others highlight detrimental effects on microbial balance and metabolic functions. The inconsistent results underscore the need for further research to comprehensively understand the physiological impacts of various artificial sweeteners on human health. Future studies should aim for long-term, well-controlled investigations to clarify these relationships, ensuring evidence-based guidelines for the safe use of artificial sweeteners in diet management. © 2025 Society of Chemical Industry.

34Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Liver Cancer and Chronic Liver Disease Mortality.PubMed

Longgang Zhao, Xinyuan Zhang, Mace Coday, et al.
JAMA. 2023 Aug 8;330(6):537-546. doi: 10.1001/jama.2023.12618.
IMPORTANCE: Approximately 65% of adults in the US consume sugar-sweetened beverages daily. OBJECTIVE: To study the associations between intake of sugar-sweetened beverages, artificially sweetened beverages, and incidence of liver cancer and chronic liver disease mortality. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort with 98 786 postmenopausal women aged 50 to 79 years enrolled in the Women's Health Initiative from 1993 to 1998 at 40 clinical centers in the US and were followed up to March 1, 2020. EXPOSURES: Sugar-sweetened beverage intake was assessed based on a food frequency questionnaire administered at baseline and defined as the sum of regular soft drinks and fruit drinks (not including fruit juice); artificially sweetened beverage intake was measured at 3-year follow-up. MAIN OUTCOMES AND MEASURES: The primary outcomes were (1) liver cancer incidence, and (2) mortality due to chronic liver disease, defined as death from nonalcoholic fatty liver disease, liver fibrosis, cirrhosis, alcoholic liver diseases, and chronic hepatitis. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% CIs for liver cancer incidence and for chronic liver disease mortality, adjusting for potential confounders including demographics and lifestyle factors. RESULTS: During a median follow-up of 20.9 years, 207 women developed liver cancer and 148 died from chronic liver disease. At baseline, 6.8% of women consumed 1 or more sugar-sweetened beverage servings per day, and 13.1% consumed 1 or more artificially sweetened beverage servings per day at 3-year follow-up. Compared with intake of 3 or fewer servings of sugar-sweetened beverages per month, those who consumed 1 or more servings per day had a significantly higher risk of liver cancer (18.0 vs 10.3 per 100 000 person-years [P value for trend = .02]; adjusted HR, 1.85 [95% CI, 1.16-2.96]; P = .01) and chronic liver disease mortality (17.7 vs 7.1 per 100 000 person-years [P value for trend <.001]; adjusted HR, 1.68 [95% CI, 1.03-2.75]; P = .04). Compared with intake of 3 or fewer artificially sweetened beverages per month, individuals who consumed 1 or more artificially sweetened beverages per day did not have significantly increased incidence of liver cancer (11.8 vs 10.2 per 100 000 person-years [P value for trend = .70]; adjusted HR, 1.17 [95% CI, 0.70-1.94]; P = .55) or chronic liver disease mortality (7.1 vs 5.3 per 100 000 person-years [P value for trend = .32]; adjusted HR, 0.95 [95% CI, 0.49-1.84]; P = .88). CONCLUSIONS AND RELEVANCE: In postmenopausal women, compared with consuming 3 or fewer servings of sugar-sweetened beverages per month, those who consumed 1 or more sugar-sweetened beverages per day had a higher incidence of liver cancer and death from chronic liver disease. Future studies should confirm these findings and identify the biological pathways of these associations.

35Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study.PubMed

Ga Young Heo, Hee Byung Koh, Jung Tak Park, et al.
JAMA Netw Open. 2024 Feb 5;7(2):e2356885. doi: 10.1001/jamanetworkopen.2023.56885.
IMPORTANCE: An increasing body of evidence indicates an association between consuming sugar or its alternatives and cardiometabolic diseases. However, the effects of the consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices on kidney health remain unclear. OBJECTIVE: To investigate the association of the intake of sugar-sweetened beverages, artificially sweetened beverages, and natural juices with the risk of chronic kidney disease (CKD), and the effect of substituting these beverage types for one another on this association. DESIGN, SETTING, AND PARTICIPANTS: This prospective, population-based cohort study analyzed data from the UK Biobank. Participants without a history of CKD who completed at least 1 dietary questionnaire were included. The follow-up period was from the date of the last dietary questionnaire until October 31, 2022, in England; July 31, 2021, in Scotland; and February 28, 2018, in Wales. Data were analyzed from May 1 to August 1, 2023. EXPOSURES: Consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices. MAIN OUTCOMES AND MEASURES: The primary outcome was incident CKD. Multivariable Cox proportional hazards models were used to estimate the associations between the 3 beverage types and incident CKD. A substitution analysis was used to evaluate the effect on the associations of substituting one beverage type for another. RESULTS: A total of 127 830 participants (mean [SD] age, 55.2 [8.0] years; 66 180 female [51.8%]) were included in the primary analysis. During a median (IQR) follow-up of 10.5 (10.4-11.2) years, 4459 (3.5%) cases of incident CKD occurred. The consumption of more than 1 serving per day of sugar-sweetened beverages was associated with higher risk of incident CKD (adjusted hazard ratio [AHR], 1.19 [95% CI, 1.05-1.34]) compared with not consuming sugar-sweetened beverages. The AHR for participants consuming more than 0 to 1 serving per day of artificially sweetened beverages was 1.10 (95% CI, 1.01-1.20) and for consuming more than 1 serving per day was 1.26 (95% CI, 1.12-1.43) compared with consuming no artificially sweetened beverages. By contrast, there was no significant association between natural juice intake and incident CKD (eg, for >1 serving per day: HR, 0.99 [95% CI, 0.87-1.11]; P = .10). Substituting sugar-sweetened beverages with artificially sweetened beverages did not show any significant difference in the risk of CKD (HR, 1.03 [95% CI, 0.96-1.10]). Conversely, replacing 1 serving per day of sugar-sweetened beverage with natural juice (HR, 0.93 [95% CI, 0.87-0.97]) or water (HR, 0.93 [95% CI, 0.88-0.99]) or replacing 1 serving per day of artificially sweetened beverage with natural juice (HR, 0.90 [95% CI, 0.84-0.96]) or water (HR, 0.91 [95% CI, 0.86-0.96]) was associated with a reduced risk of incident CKD. CONCLUSIONS AND RELEVANCE: Findings from this cohort study suggest that lower consumption of sugar-sweetened beverages or artificially sweetened beverages may reduce the risk of developing CKD.

36Understanding the link between aspartame and cancer.PubMed

Morando Soffritti
Expert Rev Anticancer Ther. 2024 Sep;24(9):793-802. doi: 10.1080/14737140.2024.2383675. Epub 2024 Jul 31.
INTRODUCTION: Aspartame, invented in 1965 by GD-Searle, is an intense artificial sweetener taste approximately 200 times as sweet as sucrose and used as an additive in more than 6,000 products. Aspartame (APM) was submitted for pre-marketing safety evaluation in early 1980. The studies, performed by GD-Searle, produced controversial results. AREAS COVERED: Because of the great commercial diffusion of aspartame, in 1997 the Ramazzini Institute (RI) started a large experimental project on rodents to test the carcinogenic effects of aspartame following an experimental model with more sensitive characteristics, namely a large number of rat and mice, starting treatment from prenatal life, observation until spontaneous death. Overall, the project included studying 2270 rats and 852 mice. These studies have shown that aspartame is a carcinogenic agent in experimental animals, inducing a significant dose-related increased incidence of several types of malignant tumors and, among them, hematological neoplasia, and liver cancer. EXPERT OPINION: The results of these studies on aspartame by the Ramazzini Institute opened a real front on the evaluation of artificial sweeteners and their possible health risks. Adequate long-term carcinogenicity bioassays on other diffuse artificial sweeteners such as acesulfame-k, sucralose, saccharin, including their blends, are likewise important for public health.

37Long-term metabolic effects of non-nutritive sweeteners.PubMed

Moran Rathaus, Loziana Azem, Rinat Livne, et al.
Mol Metab. 2024 Oct;88:101985. doi: 10.1016/j.molmet.2024.101985. Epub 2024 Jul 6.
OBJECTIVE: Excessive consumption of added sugars has been linked to the rise in obesity and associated metabolic abnormalities. Non-nutritive sweeteners (NNSs) offer a potential solution to reduce sugar intake, yet their metabolic safety remains debated. This study aimed to systematically assess the long-term metabolic effects of commonly used NNSs under both normal and obesogenic conditions. METHODS: To ensure consistent sweetness level and controlling for the acceptable daily intake (ADI), eight weeks old C57BL/6 male mice were administered with acesulfame K (ace K, 535.25 mg/L), aspartame (411.75 mg/L), sucralose (179.5 mg/L), saccharin (80 mg/L), or steviol glycoside (Reb M, 536.25 mg/L) in the drinking water, on the background of either regular or high-fat diets (in high fat diet 60% of calories from fat). Water or fructose-sweetened water (82.3.gr/L), were used as controls. Anthropometric and metabolic parameters, as well as microbiome composition, were analyzed following 20-weeks of exposure. RESULTS: Under a regular chow diet, chronic NNS consumption did not significantly affect body weight, fat mass, or glucose metabolism as compared to water consumption, with aspartame demonstrating decreased glucose tolerance. In diet-induced obesity, NNS exposure did not increase body weight or alter food intake. Exposure to sucralose and Reb M led to improved insulin sensitivity and decreased weight gain. Reb M specifically was associated with increased prevalence of colonic Lachnospiracea bacteria. CONCLUSIONS: Long-term consumption of commonly used NNSs does not induce adverse metabolic effects, with Reb M demonstrating a mild improvement in metabolic abnormalities. These findings provide valuable insights into the metabolic impact of different NNSs, aiding in the development of strategies to combat obesity and related metabolic disorders.

38The dietary sweetener sucralose is a negative modulator of T cell-mediated responses.PubMed

Fabio Zani, Julianna Blagih, Tim Gruber, et al.
Nature. 2023 Mar;615(7953):705-711. doi: 10.1038/s41586-023-05801-6. Epub 2023 Mar 15.
Artificial sweeteners are used as calorie-free sugar substitutes in many food products and their consumption has increased substantially over the past years. Although generally regarded as safe, some concerns have been raised about the long-term safety of the consumption of certain sweeteners. In this study, we show that the intake of high doses of sucralose in mice results in immunomodulatory effects by limiting T cell proliferation and T cell differentiation. Mechanistically, sucralose affects the membrane order of T cells, accompanied by a reduced efficiency of T cell receptor signalling and intracellular calcium mobilization. Mice given sucralose show decreased CD8 T cell antigen-specific responses in subcutaneous cancer models and bacterial infection models, and reduced T cell function in models of T cell-mediated autoimmunity. Overall, these findings suggest that a high intake of sucralose can dampen T cell-mediated responses, an effect that could be used in therapy to mitigate T cell-dependent autoimmune disorders.

39Sugar-Free but Not Risk-Free? Exploring Artificial Sweeteners and Cardiovascular Disease.PubMed

Lillian Huang, Ellen Huhulea, Eseiwi Aifuwa, et al.
Cardiol Rev. 2025 Feb 19. doi: 10.1097/CRD.0000000000000873.
The consumption of artificial sweeteners has significantly increased globally, particularly as a substitute for sugar for the management of conditions such as diabetes and obesity, which are significant risk factors for cardiovascular disease. Despite their widespread use, the health impacts of artificial sweeteners remain contentious. Research has suggested that certain sweeteners may contribute to systemic inflammation, endothelial dysfunction, and disruptions in gut microbiota, potentially altering glucose metabolism and exacerbating metabolic conditions such as diabetes and obesity. However, other studies highlight potential benefits, such as weight control and improved glucose tolerance. Still, the long-term safety of artificial sweeteners, particularly with chronic consumption, remains uncertain. This literature review explores the cardiovascular risks associated with various artificial sweeteners, focusing on the 6 US Food and Drug Administration-approved nonnutritive sweeteners, aspartame, sucralose, saccharin, acesulfame K, cyclamate, and neotame, as well as nutritive sweeteners such as polyols (erythritol, xylitol, sorbitol, and maltitol). Ongoing research, including in vitro, animal, and clinical studies, aims to clarify the long-term cardiovascular and metabolic implications of artificial sweeteners and assess the safety of their widespread use across diverse populations.

40Instant coffee consumption may be associated with higher risk of metabolic syndrome in Korean adults.PubMed

Hyo-Jin Kim, Seongbeom Cho, David R Jacobs, et al.
Diabetes Res Clin Pract. 2014 Oct;106(1):145-53. doi: 10.1016/j.diabres.2014.07.007. Epub 2014 Jul 22.
AIMS: Cumulative evidence suggests that coffee consumption may have beneficial effects on metabolic diseases; however, few previous studies have considered the types of coffee consumed and the additives used. We investigated the relationship between coffee consumption and metabolic syndrome (MetSyn) and its components. METHODS: We analyzed 17,953 Korean adults, aged 19-65 years, using cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2007-2011). Coffee consumption level, types of coffee consumed, and the additives used were assessed based on a food frequency questionnaire and 24-h recall. Demographic and lifestyle factors were assessed using self-administered questionnaires. Data on metabolic biomarkers were obtained from a health examination. Multivariable logistic regression was used to determine the odds ratios of prevalent metabolic syndrome and its components according to frequency and type of coffee consumption. RESULTS: We found that 76% of the subjects were habitual coffee drinkers, most of whom consumed instant coffee mix containing sugar and powder creamer. After multivariable adjustment, the odds ratios (95% CI) comparing those who consumed coffee ≥3 times/day with those who consumed coffee <1 time/week were 1.37 (1.15-1.63) for obesity, 1.33 (1.11-1.59) for abdominal obesity, 1.28 (1.09-1.51) for hypo-HDL cholesterolemia, and 1.37 (1.10-1.72) for metabolic syndrome. Instant-coffee drinkers were observed to have elevated risks of these metabolic conditions. CONCLUSIONS: Consumption of coffee, particularly instant coffee mix, may have harmful effects on MetSyn, perhaps partly deriving from excessive intake of sugar and powder creamer.

41Artificial food additives: hazardous to long-term health?PubMed

John O Warner
Arch Dis Child. 2024 Oct 18;109(11):882-885. doi: 10.1136/archdischild-2023-326565.
Many additives, some of which have no nutritional value, can be legally used in processed foods. They intensify colour, thicken, increase shelf life and enhance flavour. Regulatory authorities issue approvals as safe within acceptable quantitative limits. Ultra-processed foods (UPFs) contain combinations of all these additives and are particularly attractive to children.Many publications suggest that artificial colourants, benzoate preservatives, non-caloric sweeteners, emulsifiers and their degradation derivatives have adverse effects by increasing risks of mental health disorders, attention deficit hyperactivity disorder, cardiovascular disease, metabolic syndrome and potential carcinogenic effects.A systematic review has established that artificial azo dye food colourants (AFCs) and sodium benzoate preservative cause disturbed behaviour in children. AFCs and benzoates in animal models have neurotoxic properties through gut microbial generation of toxic metabolites. Observational studies show associations between high emulsifier intake and cardiovascular disease. Animal models and in vitro studies have highlighted neurotoxic, cytotoxic, genotoxic and carcinogenic effects. High intake of non-caloric sweeteners has been linked to cardiovascular disease and depression in adults and is linked to childhood obesity.Little research has focused on children who are the largest consumers of UPFs. Potentially, they are a ticking time bomb for adult obesity, metabolic syndrome, cardiovascular diseases, mental health disorders and cancers. Based on risk/benefit analysis, azo dye AFCs should be banned. Benzoates, emulsifiers and sweeteners require assessment of quantitative limits and cumulative effects of combinations. Consumers purchasing UPFs require information through ingredient health warnings and recommendations to use natural unprocessed foods which have well-described health-promoting properties.

42Short-term high salt intake impairs hepatic mitochondrial bioenergetics and biosynthesis in SIRT3 knockout mice.PubMed

Lihan Jiang, Qinghua Chen, Meiling Wu, et al.
Free Radic Res. 2019 Apr;53(4):387-396. doi: 10.1080/10715762.2019.1580499. Epub 2019 May 2.
High salt intake (HS) is an important factor in the development of many metabolic diseases. The liver is the metabolic center in the body. However, the effect of short-term HS on the liver mitochondria and its mechanism are still unclear. In this study, we investigated the effects of short-term HS on liver mitochondrial function. We found that HS reduced Sirtuin3 (SIRT3) protein level, increasing protein carbonylation in mice liver. HS intake decreased ATP production, mitochondrial transcription factor A (TFAM), and complex I level. SIRT3 knockout (SKO) mice exhibited similar results with HS-treated wild-type mice but with a less extent of carbonylation and ATP reduction. Our study shows that short-term HS led to increased hepatic oxidative state, impaired mitochondrial biosynthesis, and bioenergetics. HS-treated mice could still maintain hepatic glucose homeostasis by compensatory activation of Adenosine 5'-monophosphate-activated protein kinase (AMPK). However, in HS-treated SKO mice, AMPK was not activated, instead, the glycogen synthase activity increased, which caused an exceptionally increased glycogen accumulation. This study provides evidence that short-term HS intake could cause the early hepatic metabolic changes, highlighting the importance of controlling salt intake especially in those patients with defects in SIRT3. Highlights High salt intake down-regulates SIRT3 protein level and increases oxidation. High salt intake activates AMPK via AMP-dependent pathway. High salt intake impairs energy metabolism. High salt combined with SIRT3 knockout results in glycogen accumulation.

43Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content?PubMed

Jennifer M Poti, Bianca Braga, Bo Qin
Curr Obes Rep. 2017 Dec;6(4):420-431. doi: 10.1007/s13679-017-0285-4.
PURPOSE OF REVIEW: The aim of this narrative review was to summarize and critique recent evidence evaluating the association between ultra-processed food intake and obesity. RECENT FINDINGS: Four of five studies found that higher purchases or consumption of ultra-processed food was associated with overweight/obesity. Additional studies reported relationships between ultra-processed food intake and higher fasting glucose, metabolic syndrome, increases in total and LDL cholesterol, and risk of hypertension. It remains unclear whether associations can be attributed to processing itself or the nutrient content of ultra-processed foods. Only three of nine studies used a prospective design, and the potential for residual confounding was high. Recent research provides fairly consistent support for the association of ultra-processed food intake with obesity and related cardiometabolic outcomes. There is a clear need for further studies, particularly those using longitudinal designs and with sufficient control for confounding, to potentially confirm these findings in different populations and to determine whether ultra-processed food consumption is associated with obesity independent of nutrient content.

44[Ultra-processed food consumption and obesity-a systematic review].PubMed

Amelia Martí Del Moral, Carmen Calvo, Ana Martínez
Nutr Hosp. 2021 Feb 23;38(1):177-185. doi: 10.20960/nh.03151.
A number of studies suggest a relationship between the intake of ultra-processed foods and the prevalence of obesity. Specifically, this type of food provides large amounts of free sugars and saturated fats, which contribute to a high energy intake. In the last few decades the consumption of these products has increased to the point of representing an important amount of calories in the daily diet of several populations. As a result, foods that are usually consumed in healthy eating patterns, containing fiber, complex carbohydrates, and good fats, have been displaced. This systematic review aims to compile the information available in the literature, and to examine the scientific evidence about the relationship between ultra-processed food and obesity. Nevertheless, there are a number of limitations due to the heterogeneity of the methodologies or food classification systems used in the different studies, which makes it difficult to draw definitive conclusions on the relationship between consumption of ultra-processed food and development of obesity.

45Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review.PubMed

Ramona De Amicis, Sara Paola Mambrini, Marta Pellizzari, et al.
Eur J Nutr. 2022 Aug;61(5):2297-2311. doi: 10.1007/s00394-022-02873-4. Epub 2022 Mar 24.
PURPOSE: According to the NOVA classification, ultra-processed foods are products made through physical, biological and chemical processes and typically with multiple ingredients and additives, in which whole foods are mostly or entirely absent. From a nutritional point of view, they are typically energy-dense foods high in fat, sugar, and salt and low in fiber. The association between the consumption of ultra-processed food and obesity and adiposity measurements has been established in adults. However, the situation remains unclear in children and adolescents. METHODS: We carried out a systematic review, in which we summarize observational studies investigating the association between the consumption of ultra-processed food, as defined by NOVA classification, and obesity and adiposity parameters among children and adolescents. A literature search was performed using PUBMED and Web of Science databases for relevant articles published prior to May 2021. RESULTS: Ten studies, five longitudinal and five cross-sectional, mainly conducted in Brazil, were included in this review. Four longitudinal studies in children with a follow-up longer than 4 years found a positive association between the consumption of ultra-processed food and obesity and adiposity parameters, whereas cross-sectional studies failed to find an association. CONCLUSION: These data suggest that a consistent intake of ultra-processed foods over time is needed to impact nutritional status and body composition of children and adolescents. Further well-designed prospective studies worldwide are needed to confirm these findings considering country-related differences in dietary habits and food production technologies.

46Ultra-processed Food and Obesity: What Is the Evidence?PubMed

Samuel J Dicken, Rachel L Batterham
Curr Nutr Rep. 2024 Mar;13(1):23-38. doi: 10.1007/s13668-024-00517-z. Epub 2024 Jan 31.
PURPOSE OF REVIEW: Obesity is a growing global healthcare concern. A proposed driver is the recent increase in ultra-processed food (UPF) intake. However, disagreement surrounds the concept of UPF, the strength of evidence, and suggested mechanisms. Therefore, this review aimed to critically appraise the evidence on UPF and obesity. RECENT FINDINGS: Observational studies demonstrate positive associations between UPF intake, weight gain, and overweight/obesity, more clearly in adults than children/adolescents. This is supported by high-quality clinical data. Several mechanisms are proposed, but current understanding is inconclusive. Greater UPF consumption has been a key driver of obesity. There is a need to change the obesogenic environment to support individuals to reduce their UPF intake. The UPF concept is a novel approach that is not explained with existing nutrient- and food-based frameworks. Critical analysis of methodologies provides confidence, but future observational and experimental research outputs with greater methodological rigor will strengthen findings, which are outlined.

47Ultra-Processed Food, Reward System and Childhood Obesity.PubMed

Valeria Calcaterra, Hellas Cena, Virginia Rossi, et al.
Children (Basel). 2023 Apr 29;10(5):804. doi: 10.3390/children10050804.
Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in childhood may increase the BMI/BMI z-score, body fat percentage, or likelihood of overweight. A strict feeding regulation system allows for sufficient food to be consumed to meet ongoing metabolic demands while avoiding overconsumption. This narrative review explores the issues of obesity and the regulation of food intake related to reward systems and UPF consumption. Nutrient composition alone cannot explain the influence of UPFs on the risk of obesity. Furthermore, the non-nutritional properties of UPFs may explain the mechanisms underlying the relationship with obesity and NCDs. UPFs are designed to be highly palatable, appealing, and energy dense with a unique combination of the main taste enhancer ingredients to generate a strong rewarding stimulus and influence the circuits related to feeding facilitation. How individual UPF ingredients influence eating behavior and reward processes remains not fully elucidated. To increase the knowledge on the relationship between UPFs and pediatric obesity, it may be useful to limit the rapid growth in the prevalence of obesity and subsequent related complications, and to develop new strategies for appropriate food and nutrition policies.

48Ultra-Processed Food Consumption and Incidence of Obesity and Cardiometabolic Risk Factors in Adults: A Systematic Review of Prospective Studies.PubMed

Sara Paola Mambrini, Francesca Menichetti, Simone Ravella, et al.
Nutrients. 2023 May 31;15(11):2583. doi: 10.3390/nu15112583.
Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has increased likewise the incidence of obesity and cardiometabolic diseases. To highlight a possible relationship, we conducted a systematic review of prospective studies from PubMed and Web of Science investigating the association between UPF consumption and the incidence of obesity and cardiometabolic risk factors. Seventeen studies were selected. Eight evaluated the incidence of general and abdominal obesity, one the incidence of impaired fasting blood glucose, four the incidence of diabetes, two the incidence of dyslipidemia, and only one the incidence of metabolic syndrome. Studies' quality was assessed according to the Critical Appraisal Checklist for cohort studies proposed by the Joanna Briggs Institute. Substantial agreement emerged among the studies in defining UPF consumption as being associated with the incident risk of general and abdominal obesity. More limited was the evidence on cardiometabolic risk. Nevertheless, most studies reported that UPF consumption as being associated with an increased risk of hypertension, diabetes, and dyslipidemia. In conclusion, evidence supports the existence of a relationship between UPF consumption and the incidence of obesity and cardiometabolic risk. However, further longitudinal studies considering diet quality and changes over time are needed.

49Ultra-processed Foods and Cardiometabolic Health Outcomes: from Evidence to Practice.PubMed

Filippa Juul, Andrea L Deierlein, Georgeta Vaidean, et al.
Curr Atheroscler Rep. 2022 Nov;24(11):849-860. doi: 10.1007/s11883-022-01061-3. Epub 2022 Sep 7.
PURPOSE OF REVIEW: Poor diet quality is the leading risk factor related to the overall cardiometabolic disease burden in the USA and globally. We review the current evidence linking ultra-processed foods and cardiometabolic health risk and provide recommendations for action at the clinical and public health levels. RECENT FINDINGS: A growing body of evidence conducted in a variety of study populations supports an association between ultra-processed food intake and increased risk of metabolic syndrome, hypertension, type 2 diabetes, overweight and obesity trajectories, and cardiovascular disease. The strongest evidence is observed in relation to weight gain and obesity among adults, as this association is supported by high-quality epidemiological and experimental evidence. Accumulating epidemiologic evidence and putative biological mechanisms link ultra-processed foods to cardiometabolic health outcomes. The high intake of ultra-processed foods in all population groups and its associated risks make ultra-processed foods an ideal target for intensive health promotion messaging and interventions.

50Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses.PubMed

Melissa M Lane, Elizabeth Gamage, Shutong Du, et al.
BMJ. 2024 Feb 28;384:e077310. doi: 10.1136/bmj-2023-077310.
OBJECTIVE: To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes. DESIGN: Systematic umbrella review of existing meta-analyses. DATA SOURCES: MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as "high," "moderate," "low," or "very low" quality. RESULTS: The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality. CONCLUSIONS: Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023412732.

51Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies.PubMed

Melissa M Lane, Elizabeth Gamage, Nikolaj Travica, et al.
Nutrients. 2022 Jun 21;14(13):2568. doi: 10.3390/nu14132568.
Since previous meta-analyses, which were limited only to depression and by a small number of studies available for inclusion at the time of publication, several additional studies have been published assessing the link between ultra-processed food consumption and depression as well as other mental disorders. We aimed to build on previously conducted reviews to synthesise and meta-analyse the contemporary evidence base and clarify the associations between the consumption of ultra-processed food and mental disorders. A total of 17 observational studies were included ( = 385,541); 15 cross-sectional and 2 prospective. Greater ultra-processed food consumption was cross-sectionally associated with increased odds of depressive and anxiety symptoms, both when these outcomes were assessed together (common mental disorder symptoms odds ratio: 1.53, 95%CI 1.43 to 1.63) as well as separately (depressive symptoms odds ratio: 1.44, 95%CI 1.14 to 1.82; and, anxiety symptoms odds ratio: 1.48, 95%CI 1.37 to 1.59). Furthermore, a meta-analysis of prospective studies demonstrated that greater ultra-processed food intake was associated with increased risk of subsequent depression (hazard ratio: 1.22, 95%CI 1.16 to 1.28). While we found evidence for associations between ultra-processed food consumption and adverse mental health, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.

52Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis.PubMed

Irja Minde Isaksen, Simon Nitter Dankel
Clin Nutr. 2023 Jun;42(6):919-928. doi: 10.1016/j.clnu.2023.03.018. Epub 2023 Mar 30.
BACKGROUND: Ultra-processed foods (UPF) have become a staple of the diet in many countries, concomitant with increases in non-communicable diseases including cancer. AIM: The aim of this systematic literature review was to evaluate associations between the consumption of UPF and cancer risk. METHODS: A systematic literature search for observational studies investigating the association between cancer risk and UPF consumption, determined by the NOVA classification system, was performed. Random-effects meta-analyses were conducted. Independent review and risk of bias assessment was performed independently by the authors using the National Institutes of Health's Study Quality Assessment Tools. RESULTS: Eleven reports were identified, including eight retrospective case-control studies and three prospective cohorts. The outcome was risk of total cancer and/or one or more of the following cancers: colorectal, breast, prostate, pancreatic, chronic lymphocytic leukemia and central nervous system tumors. Nine studies reported a significant positive association between UPF intake and all the assessed cancers except prostate, after adjustment for confounding factors including obesity and total energy intake. A 10% increment in the diet's proportion of UPF was associated with increased risk of overall cancer (HR = 1.13, 95% CI 1.07 to 1.18) and breast cancer (HR = 1.11, 95% CI 1.01 to 1.21). In addition, a high intake of UPF was associated with increased risk of colorectal cancer (OR = 1.30, 95% CI 1.11 to 1.51) and pancreatic cancer (HR = 1.49, 95% CI 1.07 to 2.07). More modest associations were found for chronic lymphocytic leukemia and central nervous system tumors. Common limitations of several of the studies included no prior assessment of diet before known diagnosis (the case-control studies), higher participation rates among cases, and likely misclassification of several foods as UPF or non-UPF. CONCLUSION: In conclusion, the available suggestive evidence shows a consistent significant association between intake of UPF and the risk of overall and several cancers, including colorectal-, breast- and pancreatic cancer. These data may inform updated dietary guidelines, policy makers and the public towards improving public health.

53Ultra-processed food consumption and children and adolescents' health.PubMed

Samantha Bittencourt Mescoloto, Gabriela Pongiluppi, Semíramis Martins Álvares Domene
J Pediatr (Rio J). 2024 Mar-Apr;100 Suppl 1(Suppl 1):S18-S30. doi: 10.1016/j.jped.2023.09.006. Epub 2023 Oct 20.
OBJECTIVES: To present observational studies investigating associations between the consumption of ultra-processed foods and health outcomes in childhood and adolescence. DATA SOURCE: Observational, cross-sectional, or longitudinal studies were considered, and identified in the Scopus, Web of Science, Pubmed and Scielo databases, without date restrictions. DATA SYNTHESIS: The most frequent combinations of risk factors in children and adolescents involved an unhealthy diet, with regular consumption of ultra-processed foods to the detriment of a diet based on fresh or minimally-processed foods and insufficient levels of physical activity; records on alcohol and tobacco use were identified. Combined, these practices contribute to the findings that indicate an increase in the prevalence of obesity in children and adolescents and a sedentary lifestyle, with a decrease in physical activity, in addition to representing a risk for the development of chronic non-communicable diseases, such as cardiovascular diseases and periodontal disease in childhood and adolescence. CONCLUSIONS: The present study maps the current literature on the topic and indicates the direction of the approach for health promotion and prevention of NCDs in children and adolescents. Among the different risk factors that negatively affect the full development of this population, frequently eating breakfast and practicing physical activity is most strongly associated with a lower consumption of ultra-processed foods and should be part of an integrated approach to promoting eating practices that favor the reduction of diseases also in adult life.

54Effect of a Community-Based Program on Preschoolers' Physical Activity and Nutrition in Chile.PubMed

Gabriela Salazar, Fabian Vasquez, Margarita Andrade, et al.
J Funct Morphol Kinesiol. 2025 Mar 12;10(1):93. doi: 10.3390/jfmk10010093.
Childhood obesity has reached critical levels in Chile, particularly among preschoolers from low-income families who face barriers to nutritious food and physical activity. Early interventions are essential to mitigate long-term health risks. This study evaluates the Chile Active Intervention, a community-based program promoting physical activity and healthy eating among preschoolers attending public daycare centers in Antofagasta, Santiago, and Temuco. To assess the effectiveness of a structured intervention in improving physical activity levels, dietary habits, and obesity-related risk factors in children aged 3 to 5 years old. A quasi-experimental design was implemented with intervention and control groups, including 1204 children from public daycare centers. The intervention-comprised educator training on healthy eating structured physical activity sessions tailored for young children and family engagement through "Healthy Days" events. Pre- and post-intervention assessments measured anthropometric variables, body composition, physical activity, and dietary intake. The intervention led to positive changes in weight-for-height Z-scores, body fat percentage, and skinfold thickness, particularly among high-risk children. Physical activity assessments showed reduced sedentary time and increased active play. Dietary improvements included higher fruit and vegetable consumption and reduced ultra-processed food intake. This study demonstrates that early, community-based interventions can effectively improve health behaviors in preschoolers. The program's scalability across Chile is promising, with parental involvement and institutional support being key to sustaining impact. Long-term evaluations are recommended to assess its lasting effects on childhood health outcomes.

55Consumption of ultra-processed foods and growth outcomes in early childhood: 2015 Pelotas Birth Cohort.PubMed

Caroline Dos Santos Costa, Romina Buffarini, Thaynã Ramos Flores, et al.
Br J Nutr. 2023 Jun 28;129(12):2153-2160. doi: 10.1017/S0007114522002926. Epub 2022 Sep 12.
The current study aims to describe the consumption of ultra-processed foods, from 2 to 4 years old, and evaluate its association with growth outcomes during the same period. It is a prospective cohort study using data from the 2015 Pelotas-Brazil Birth Cohort. Outcomes assessed at the 2- and 4-year-old follow-ups were BMI-for-age -score and length/height-for-age -score. The exposure was a score of ultra-processed food consumption calculated at each follow-up by summing up the positive answers for the consumption of nine specific items/subgroups of ultra-processed foods: (i) instant noodles; (ii) soft drink; (iii) chocolate powder in milk; (iv) nuggets, hamburger or sausages; (v) packaged salty snacks; (vi) candies, lollipops, chewing gum, chocolate or jelly; (vii) sandwich cookie or sweet biscuit; (viii) juice in can or box or prepared from a powdered mix and (ix) yogurt. Crude and adjusted analyses between the score of ultra-processed foods and the outcomes were run using generalised estimating equations. Prevalence of consumption of ultra-processed foods increased from 2 to 4 years old, for all evaluated items/subgroups, except yogurt. In prospective analyses, higher scores of ultra-processed food consumption were associated with higher BMI-for-age -score and lower length/height-for-age -score, after adjustment for confounders. Ultra-processed food consumption, measured using a short questionnaire with low research burden, increased from 2 to 4 years old and was related to deleterious growth outcomes in early childhood. These results reinforce the importance of avoiding the consumption of these products in childhood to prevent the double burden of malnutrition and non-communicable chronic diseases throughout the life.

56The association between maternal ultra-processed food consumption during pregnancy and child neuropsychological development: A population-based birth cohort study.PubMed

Júlia Puig-Vallverdú, Dora Romaguera, Sílvia Fernández-Barrés, et al.
Clin Nutr. 2022 Oct;41(10):2275-2283. doi: 10.1016/j.clnu.2022.08.005. Epub 2022 Aug 19.
BACKGROUND & AIMS: Maternal ultra-processed food (UPF) consumption during pregnancy may adversely affect child development. Pregnancy sugar-sweetened beverage consumption (as a part of UPF) has been associated with child cognitive dysfunction in the general population, but the role of total UPF consumption during pregnancy in later child neuropsychological development has not been studied. We aimed to analyse the association between maternal pregnancy UPF consumption and child neurodevelopment. METHODS: This study involved 2377 pairs of pregnant women and their offspring from a Spanish birth cohort (recruitment period: 2004-2008, INMA project). Dietary intake was estimated using a 101-item food frequency questionnaire in the third trimester of pregnancy. The NOVA classification was used to identify UPFs, and their consumption was calculated as the daily percentage of total food consumption and categorized into tertiles. Child neuropsychological development was assessed with the Bayley Scales of Infant and Toddler Development (1-year-old, n = 1929) and the McCarthy Scales of Children's Abilities (4-5 years-old, n = 1679). Potential associations were analysed using multivariate linear regression models adjusted for a range of family and child characteristics. RESULTS: UPF consumption among pregnant women represented an average of 17% of the total diet, with sugar-sweetened beverages being the most commonly consumed type of UPF (40%). Children born to mothers in the highest tertile of UPF consumption (28.9% or more of the total diet) vs the lowest tertile (7.2% or less), showed a lower score (B = -2.29 [95% Confidence Interval (CI), -4.13; -0.46]) in the Verbal Scale of the McCarthy Scales (p-for-trend = 0.02). No associations were observed with the McCarthy Scales assessing other cognitive domains or with the Bayley Scales. CONCLUSION: Of the seven cognitive domains studied, we observed an adverse association between maternal consumption of UPF during pregnancy and verbal functioning in early childhood, which is an important cognitive domain of neurodevelopment.

57Screen Exposure in 4-Year-Old Children: Association with Development, Daily Habits, and Ultra-Processed Food Consumption.PubMed

Gabriela M D Gomes, Rafaela C V Souza, Tamires N Santos, et al.
Int J Environ Res Public Health. 2024 Nov 13;21(11):1504. doi: 10.3390/ijerph21111504.
This study aimed to investigate the association between child development, daily habits, and ultra-processed food consumption with screen exposure in 4-year-old children. A cross-sectional study was conducted using a questionnaire that included sociodemographic data, the child's daily habits, and screenings for child development and eating habits. The daily screen exposure time (cell phone, computer, television, and/or tablet) was measured in minutes and classified as inadequate if >60 min. We conducted bivariate analyses and a generalized linear model. Overall, 362 caregivers-children pairs were investigated. The average screen time per child was 120 min (IQR: 120), and most of the children (71%) showed inadequate screen time for the age group. The longest screen time was associated with the lowest score in child development (β = -0.03; = 0.01), an increased habit of eating in front of screens (β = 0.34; < 0.001), and the highest score of ultra-processed foods (UPFs) (β = 0.05; = 0.001). The sample showed a high prevalence of inadequate screen time, and this has been associated with the lowest score in child development, an increased habit of eating in front of screens, and the highest score of UPFs.

58Global guidelines recommendations for dietary sodium and potassium intake.PubMed

Ebtehal Salman, Aya Kadota, Katsuyuki Miura
Hypertens Res. 2024 Jun;47(6):1620-1626. doi: 10.1038/s41440-024-01663-1. Epub 2024 Apr 8.
Non-communicable diseases (NCDs) cause a significant global health challenge, with unhealthy diets identified as a major risk factor. Sodium and potassium, which are essential minerals for human health, play important roles in various bodily functions, and an imbalance in their intake can have significant health implications, particularly concerning hypertension and cardiovascular diseases. This review compiles dietary sodium and potassium intake recommendations from prominent global health organizations and compares global guidelines to Japan's Dietary Reference Intake (DRI) guidelines. Sodium and potassium intake guidelines from organizations such as the World Health Organization (WHO), American College of Cardiology (ACC) and American Heart Association (AHA), Dietary Guidelines for Americans (DGA), European Food Safety Authority (EFSA), and DRI for Japanese exhibit variations. Compared to other Asian countries, Japan's historically higher sodium goal aligns with Southeast Asia where traditional preserved foods contribute to high sodium intake. Contrarily, Japan's lower potassium goal contrasts with other countries in Asia promoting a diet rich in fruits and vegetables. The ongoing effort by Japan to align with global recommendations reflects a gradation approach considering social habits. While harmonizing international efforts is essential, appreciating regional diversities is paramount through tailoring guidelines to cultural and dietary habit practices. Implementing context-specific guidelines informed by scientific research can contribute to global efforts in promoting healthy diets and reducing the burden of NCDs. Global guidelines that recommended the daily dietary intake goal for sodium and potassium exhibit variations. These disparities are influenced by diverse factors, including cultural dietary habits, socioeconomic status, health priorities, and available scientific research. Each population should follow the recommendations of their region.

59Dietary salt intake and hypertension.PubMed

Sung Kyu Ha
Electrolyte Blood Press. 2014 Jun;12(1):7-18. doi: 10.5049/EBP.2014.12.1.7. Epub 2014 Jun 30.
Over the past century, salt has been the subject of intense scientific research related to blood pressure elevation and cardiovascular mortalities. Moderate reduction of dietary salt intake is generally an effective measure to reduce blood pressure. However, recently some in the academic society and lay media dispute the benefits of salt restriction, pointing to inconsistent outcomes noted in some observational studies. A reduction in dietary salt from the current intake of 9-12 g/day to the recommended level of less than 5-6 g/day will have major beneficial effects on cardiovascular health along with major healthcare cost savings around the world. The World Health Organization (WHO) strongly recommended to reduce dietary salt intake as one of the top priority actions to tackle the global non-communicable disease crisis and has urged member nations to take action to reduce population wide dietary salt intake to decrease the number of deaths from hypertension, cardiovascular disease and stroke. However, some scientists still advocate the possibility of increased risk of CVD morbidity and mortality at extremes of low salt intake. Future research may inform the optimal sodium reduction strategies and intake targets for general populations. Until then, we have to continue to build consensus around the greatest benefits of salt reduction for CVD prevention, and dietary salt intake reduction strategies must remain at the top of the public health agenda.

60Intake and sources of added sugars among Australian children and adolescents.PubMed

Jimmy Chun Yu Louie, Hanieh Moshtaghian, Anna M Rangan, et al.
Eur J Nutr. 2016 Dec;55(8):2347-2355. doi: 10.1007/s00394-015-1041-8. Epub 2015 Sep 16.
PURPOSE: To examine the intake and sources of added sugars (AS) of Australian children and adolescents, and compare their intake of free sugars (FS) to the recommended limit set by the World Health Organization (<10 % energy from FS). METHOD: Data of 4140 children and adolescents aged 2-16 years with plausible intakes based on 2 × 24 h recalls from the 2007 Australian National Children Nutrition and Physical Activity Survey were used. AS content of foods was estimated based on a published method. Intakes of AS and FS, as well as food sources of AS, were calculated. One-way ANOVA was used for comparisons between age groups and gender. RESULTS: The mean (SD) AS intake was 58.9 (35.1) g/day, representing 11.9 (5.6) % of daily energy intake and 46.9 (17.5) % of daily total sugars intake. More than 80 % of the subjects had % energy from FS > 10 %. Significant increasing trends for AS intake, % energy from AS, % energy from FS across age groups were observed. Sugar-sweetened beverages (19.6 %), cakes, biscuits, pastries and batter-based products (14.3 %), and sugar and sweet spreads (10.5 %) were the top three contributors of AS intake in the whole sample. Higher contribution of AS from sugar-sweetened beverages was observed in adolescents (p < 0.001). CONCLUSIONS: A large proportion of Australian youths are consuming excessive amounts of energy from AS. Since the main sources of AS were energy-dense, nutrient-poor foods, interventions which target the reduction in these foods would reduce energy and AS intake with minimal impact to core nutrient intake.

61Intake of added sugar in Malaysia: a review.PubMed

Maria Sofia V Amarra, Geok Lin Khor, Pauline Chan
Asia Pac J Clin Nutr. 2016;25(2):227-40. doi: 10.6133/apjcn.2016.25.2.13.
The term 'added sugars' refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Malaysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to determine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar.

62Sugar intake above international recommendations and oral disease burden: A population-based study.PubMed

Lorena Lucia Costa Ladeira, Gustavo G Nascimento, Fabio Renato Manzolli Leite, et al.
Oral Dis. 2024 Mar;30(2):615-623. doi: 10.1111/odi.14464. Epub 2022 Dec 28.
OBJECTIVE: To evaluate the association between added sugar intake above the daily limit for the risk of noncommunicable diseases (NCDs) and the Chronic Oral Disease Burden in adolescents. METHODS: This was a population-based study using cross-sectional data nested to RPS Cohorts Consortium, São Luís, Brazil, from the 18-19-year-old follow-up (n = 2515). High consumption of added sugars was estimated according to the limits of the World Health Organization guidelines (WHO) (≥5% of total energy/day) and the American Heart Association statement (AHA) (≥25 g/day). The Chronic Oral Disease Burden was a latent variable (number of decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing). Models were adjusted for Socioeconomic Status, sex, obesity, and plaque index and analyzed through structural equation modeling. RESULTS: Adolescents had high sugar consumption according to the WHO (78.6%) and AHA (81.4%) recommendations. High sugar intake, according to WHO (SC = 0.096; p = 0.007) and AHA (SC = 0.056; p = 0.027), was associated with a heavier Chronic Oral Disease Burden. Even half of the recommended dose was sufficient to affect some oral disease indicators. CONCLUSION: Sugar intake over international statements to prevent NCDs is associated with higher Chronic Oral Disease Burden among adolescents.

63Challenges and way forward for implementation of sugar taxation in the Middle East and North Africa (MENA).PubMed

Hazem Abbas, Carol C Guarnizo-Herreño, Maha El Tantawi, et al.
Community Dent Oral Epidemiol. 2024 Aug;52(4):375-380. doi: 10.1111/cdoe.12955. Epub 2024 Apr 8.
BACKGROUND: Over consumption of added sugar beyond the World Health Organization (WHO) recommended level of 10% of daily energy intake has well-established negative health consequences including oral diseases. However, the average consumption of added sugar in the Middle East and North Africa region (MENA-World Bank's regional classification) is 70% higher than the WHO recommended level. Imposing taxes on added sugar has been proposed by the WHO to decrease its consumption. Yet, only 21.6% of the total MENA population are covered by taxation policies targeting added sugar. CHALLENGES: Well-recognized challenges for the implementation of sugar taxation in MENA include the tactics used by the food and beverage industry to block these type of policies. However, there are also other unfamiliar hurdles specific to MENA. Historically, there have been incidents of protest and riots partially sparked by increased price of basic commodities, including sugar, in MENA countries. This may affect the readiness of policy makers in the region to impose added sugar taxes. In addition, there are also cultural, lifestyle and consumption behavioural barriers to implementing added sugar taxation. Ultra-processed foods and sugar-sweetened-beverages (SSBs) rich in added sugar are perceived by many in MENA as essential treats regardless of their health risks. Furthermore, some countries even provide subsidies for added sugar. Also, (oral) healthcare providers generally do not engage in policy advocacy mainly due to limited training on health policy. WAYS FORWARD: Here, we discuss these challenges and suggest some ways forward such as (1) support from a health-oriented political leadership, (2) raising public awareness about the health risks of over consumption of sugar, (3) transparency during the policy-cycle development process, (4) providing a free and safe environment for a community dialogue around the proposed policy, (5) training of (oral) healthcare professionals on science communication and policy advocacy in local lay language/dialect, ideally evidence informed from local/regional studies, (6) selecting the appropriate political window of opportunity to introduce a sugar tax policy, and (7) clear and strict conflict of interest regulations to limit the influence of commercial players on health policy.

64Eating habits of a population undergoing a rapid dietary transition: portion sizes of traditional and non-traditional foods and beverages consumed by Inuit adults in Nunavut, Canada.PubMed

Tony Sheehy, Cindy Roache, Sangita Sharma
Nutr J. 2013 Jun 2;12:70. doi: 10.1186/1475-2891-12-70.
BACKGROUND: To determine the portion sizes of traditional and non-traditional foods being consumed by Inuit adults in three remote communities in Nunavut, Canada. METHODS: A cross-sectional study was carried out between June and October, 2008. Trained field workers collected dietary data using a culturally appropriate, validated quantitative food frequency questionnaire (QFFQ) developed specifically for the study population. RESULTS: Caribou, muktuk (whale blubber and skin) and Arctic char (salmon family), were the most commonly consumed traditional foods; mean portion sizes for traditional foods ranged from 10 g for fermented seal fat to 424 g for fried caribou. Fried bannock and white bread were consumed by >85% of participants; mean portion sizes for these foods were 189 g and 70 g, respectively. Sugar-sweetened beverages and energy-dense, nutrient-poor foods were also widely consumed. Mean portion sizes for regular pop and sweetened juices with added sugar were 663 g and 572 g, respectively. Mean portion sizes for potato chips, pilot biscuits, cakes, chocolate and cookies were 59 g, 59 g, 106 g, 59 g, and 46 g, respectively. CONCLUSIONS: The present study provides further evidence of the nutrition transition that is occurring among Inuit in the Canadian Arctic. It also highlights a number of foods and beverages that could be targeted in future nutritional intervention programs aimed at obesity and diet-related chronic disease prevention in these and other Inuit communities.

65Changes in diet and lifestyle and long-term weight gain in women and men.PubMed

Dariush Mozaffarian, Tao Hao, Eric B Rimm, et al.
N Engl J Med. 2011 Jun 23;364(25):2392-404. doi: 10.1056/NEJMoa1014296.
BACKGROUND: Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain. METHODS: We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis. RESULTS: Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day). CONCLUSIONS: Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

66Composition of Common Junk Food Items and Their Contribution to the Dietary Requirement of Children and Adolescents.PubMed

Priya Mehar, Rajarshi Bera, Swarnim Swarnim, et al.
Indian Pediatr. 2023 Mar 15;60(3):221-223. Epub 2023 Jan 2.
OBJECTIVE: To estimate the carbohydrate, energy, fat, protein, and sodium content of commonly consumed junk food items and to compare these to the Recommended Dietary Allowance (RDA) and Estimated Average Requirements (EAR) of children. METHODS: A list of eight common junk food categories was made, and the median nutritional content of carbohydrate, energy, fat, protein and sodium was determined from the commonly consumed brands in these categories. It was compared to the RDA and EAR for two different age groups viz., age 4-6 year, and male adolescents aged 13-15 years. RESULTS: The junk food groups with the highest carbo-hydrate were packaged potato chips and cakes, the group with the highest fat content was packaged potato chips, and the groups with the highest salt content were burgers and packaged potato chips. The %EAR of one packet of some items was 80-90% of daily fat requirement, and more than 60% of daily sodium requirement. CONCLUSIONS: Junk foods contribute substantially to the daily intake of carbohydrates, free sugars, total fats, saturated fats, and sodium of children.

67Low-acrylamide French fries and potato chips.PubMed

Caius M Rommens, Hua Yan, Kathy Swords, et al.
Plant Biotechnol J. 2008 Oct;6(8):843-53. doi: 10.1111/j.1467-7652.2008.00363.x. Epub 2008 Jul 23.
Acrylamide is produced in starchy foods that are baked, roasted or fried at high temperatures. Concerns about the potential health issues associated with the dietary intake of this reactive compound led us to reduce the accumulation of asparagine, one of its main precursors, in the tubers of potato (Solanum tuberosum). This metabolic change was accomplished by silencing two asparagine synthetase genes through 'all-native DNA' transformation. Glasshouse-grown tubers of the transformed intragenic plants contained up to 20-fold reduced levels of free asparagine. This metabolic change coincided with a small increase in the formation of glutamine and did not affect tuber shape or yield. Heat-processed products derived from the low-asparagine tubers were also indistinguishable from their untransformed counterparts in terms of sensory characteristics. However, both French fries and potato chips accumulated as little as 5% of the acrylamide present in wild-type controls. Given the important role of processed potato products in the modern Western diet, a replacement of current varieties with intragenic potatoes could reduce the average daily intake of acrylamide by almost one-third.

68Reduction in Dietary Acrylamide Exposure-Impact of Potatoes with Low Acrylamide Potential.PubMed

Nga L Tran, Leila M Barraj, Susan Collinge
Risk Anal. 2017 Sep;37(9):1754-1767. doi: 10.1111/risa.12709. Epub 2016 Nov 20.
Acrylamide forms primarily from a reaction between reducing sugars (e.g., glucose and fructose) and an amino acid (asparagine, Asn) formed naturally in foods, including potatoes. This reaction occurs when carbohydrate-rich foods are heated at temperatures above 120 °C. Multiple potato varieties were transformed with potato genomic DNA that results in down-regulation of the expression of the asparagine synthetase-1 gene (Asn1), significantly reducing synthesis of free Asn, and consequently lowering the potential to form acrylamide during cooking. These potatoes with low acrylamide potential (LAP) were tested in agronomic trials, and processed into French fries and potato chips. Decreased levels of acrylamide were measured in these cooked food products when derived from LAP potatoes compared with those derived from conventional potatoes. These reductions can be directly attributed to reduction in Asn levels in the LAP potatoes. The corresponding average reduction in exposure to acrylamide from French fry and potato chip consumption is estimated to be 65%, which would amount to approximately a 25% reduction in overall dietary exposure. Considering that children consume nearly three times more acrylamide than adults on a per kg body weight basis, they would experience the most impact from the reduced acrylamide associated with LAP potatoes. The potential public health impacts, in context of dietary acrylamide exposure reduction, are discussed in this study.

69Healthy helpers: using culinary lessons to improve children's culinary literacy and self-efficacy to cook.PubMed

Peggy Policastro, Alison H Brown, Erin Comollo
Front Public Health. 2023 Nov 6;11:1156716. doi: 10.3389/fpubh.2023.1156716. eCollection 2023.
BACKGROUND: Children do not eat the recommended amounts of vegetables, and school-based nutrition education has not been found to impact this behavior. Cooking education is associated with improved children's culinary literacy (CL) and eating behaviors. This study investigated the impact of a culinary literacy (CL) curriculum on children's acceptance of vegetable-added (mushrooms) recipes, CL, self-efficacy to cook (SE), and willingness to try vegetables (WV). METHODS: A convenience sample of 39 fourth and fifth graders were exposed to a six-lesson virtual CL curriculum that taught basic cooking skills and how to prepare six recipes, including three traditional recipes and the same recipes with added vegetables. RESULTS: Children who participated in the CL curriculum accepted vegetables added to pizza pockets, but vegetables added to macaroni and cheese and fajitas negatively affected the acceptance of recipes. Children improved their CL and SE but did not show a significant change in their WV. CONCLUSION: Findings suggest that CL programs focusing on vegetables may drive factors associated with dietary behavior change, SE, and acceptance of vegetables. Future studies should consider CL as a potential method to improve vegetable intake in children in tandem with nutrition education or as a sole intervention. The study was limited by its small sample size, the virtual setting, and the use of mushrooms as the primary vegetable source. Future studies should be conducted with a larger sample size, in a traditional classroom setting, use a variety of vegetables, and collect qualitative data on the sensory characteristics affecting children's WV.

70Strategies to Improve School Meal Consumption: A Systematic Review.PubMed

Juliana F W Cohen, Amelie A Hecht, Erin R Hager, et al.
Nutrients. 2021 Oct 7;13(10):3520. doi: 10.3390/nu13103520.
School meals can play an integral role in improving children's diets and addressing health disparities. Initiatives and policies to increase consumption have the potential to ensure students benefit from the healthy school foods available. This systematic review evaluates studies examining initiatives, interventions, and policies to increase school meal consumption. Following PRISMA guidelines, this review was conducted using four databases and resulted in a total of 96 studies. The research evidence supports the following strategies to increase school meal consumption: (1) offering students more menu choices; (2) adapting recipes to improve the palatability and/or cultural appropriateness of foods; (3) providing pre-sliced fruits; (4) rewarding students who try fruits and vegetables; (5) enabling students to have sufficient time to eat with longer (~30 min) lunch periods; (6) having recess before lunch; and (7) limiting students' access to competitive foods during the school day. Research findings were mixed when examining the impact of nutrition education and/or offering taste tests to students, although multiple benefits for nutrition education outside the cafeteria were documented. There is some evidence that choice architecture (i.e., "Smarter Lunchroom") techniques increase the proportion of students who select targeted meal components; however, there is not evidence that these techniques alone increase consumption. There were limited studies of the impact of increasing portion sizes; serving vegetables before other meal components; and strengthening local district and/or school wellness policies, suggesting that further research is necessary. Additionally, longer-term studies are needed to understand the impact of policies that limit students' access to flavored milk. Several studies found increases in students' meal consumption following the Healthy Hunger-Free Kids Act (HHFKA) and concerns regarding an increase in food waste following the HHFKA were not supported. Overall, there are a range of effective strategies to increase school meal consumption that can be implemented by schools, districts, and policymakers at the local, state, and federal levels (PROSPERO registration: CRD42021244688).

71Effect of kombucha intake on the gut microbiota and obesity-related comorbidities: A systematic review.PubMed

Mirian Aparecida de Campos Costa, Darlene Larissa de Souza Vilela, Gabriela Macedo Fraiz, et al.
Crit Rev Food Sci Nutr. 2023;63(19):3851-3866. doi: 10.1080/10408398.2021.1995321. Epub 2021 Oct 26.
Kombucha is a fermented nonalcoholic tea-based beverage produced through a symbiotic culture of bacteria and yeasts. studies have demonstrated antimicrobial, antioxidant, antiproliferative, and anti-carcinogenic properties of kombucha. However, no systematic reviews have evaluated the effects of kombucha . Thus, we aimed to evaluate the evidence that exists so far about kombucha consumption on comorbidities associated with obesity as well as on the gut microbiota. The search was conducted in accordance with PRISMA and the protocol was registered in PROSPERO (registration number: CRD42020158917). The MEDLINE/PubMed, Web of Science, LILACS, SciELO, Scopus, and Science Direct databases were used in the search considering the following terms: "kombucha" OR "kombucha tea" OR "kombucha teas" OR "tea, kombucha" OR "teas, kombucha" NOT "review." Fifteen studies were included in this review. The results suggest that kombucha consumption attenuates oxidative stress and inflammation, improves the liver detoxification process, and reduces intestinal dysbiosis. There is evidence that kombucha consumption is beneficial for the control and treatment of obesity and associated comorbidities, as well as for the modulation of the gut microbiota .

72Kombucha as a Health-Beneficial Drink for Human Health.PubMed

Ramona Massoud, Reyhaneh Jafari, Kianoush Khosravi-Darani
Plant Foods Hum Nutr. 2024 Jun;79(2):251-259. doi: 10.1007/s11130-024-01169-8. Epub 2024 Apr 11.
Kombucha is a unique fermented beverage made from a symbiotic culture of yeast and bacteria. Kombucha is normally based on black tea added to water, then sugar is added as a substrate for fermentation in this beverage. This unique beverage is composed of amino acids, flavonoids, vitamins, and some active enzymes. Several beneficial health effects such as antioxidant, antimicrobial effects have been reported as a result of probiotics and prebiotics presence. These health effects of kombucha are attributed to its bioactive chemical and biological agents of probiotics bacteria e.g., Gluconobacter, Acetobacter and yeasts like Saccharomyces sps., along with glucuronic acid as the main sources of the health protection. This review focuses on the beneficial effects of Kombucha including antimicrobial, antioxidant, anti-cancer antidiabetic properties, as well as liver protection, treat of gastrointestinal problems, AIDS, gastric ulcers, obesity (and energy production), detoxification, and skin health.

73Kombucha, the fermented tea: microbiology, composition, and claimed health effects.PubMed

C J Greenwalt, K H Steinkraus, R A Ledford
J Food Prot. 2000 Jul;63(7):976-81. doi: 10.4315/0362-028x-63.7.976.
Kombucha is a slightly sweet, slightly acidic tea beverage consumed worldwide, but historically in China, Russia, and Germany. Kombucha is prepared by fermenting sweetened black tea preparations with a symbiotic culture of yeasts and bacteria. Potential health effects have created an increased interest in Kombucha. Yet, only a few research studies have shown that Kombucha has in vitro antimicrobial activity and enhances sleep and pain thresholds in rats. Furthermore, Kombucha consumption has proven to be harmful in several documented instances.

74Kombucha: a systematic review of the empirical evidence of human health benefit.PubMed

Julie M Kapp, Walton Sumner
Ann Epidemiol. 2019 Feb;30:66-70. doi: 10.1016/j.annepidem.2018.11.001. Epub 2018 Nov 10.
PURPOSE: Kombucha tea, a fermented beverage, has recently become popular in the United States as part of the functional food movement. This popularity is likely driven by its touted health benefits, coupled with the recent scientific movement investigating the role of the microbiome on human health. The purpose of this systematic review is to describe the literature related to empirical health benefits of kombucha as identified from human subjects research. METHODS: In July 2018, we searched the term "kombucha" for all document types in the following databases across all available years: PubMed, Scopus, and Ovid. To identify federal research grants related to kombucha, we searched the National Institutes of Health Research Portfolio Online Reporting Tools. Finally, to identify ongoing human subjects research, we searched clinicaltrials.gov and clinicaltrialsregister.eu. We reviewed a total of 310 articles. RESULTS: We found one study reporting the results of empirical research on kombucha in human subjects. We found no results for kombucha in Research Portfolio Online Reporting Tools, clinicaltrials.gov, or clinicaltrialsregister.eu. CONCLUSIONS: The nonhuman subjects literature claims numerous health benefits of kombucha; it is critical that these assertions are tested in human clinical trials. Research opportunities are discussed.

75Health Benefits and Chemical Composition of Matcha Green Tea: A Review.PubMed

Joanna Kochman, Karolina Jakubczyk, Justyna Antoniewicz, et al.
Molecules. 2020 Dec 27;26(1):85. doi: 10.3390/molecules26010085.
Japanese matcha is a type of powdered green tea, grown in a traditional way. Shading of the plants during the growth period enhances the processes of synthesis and accumulation of biologically active compounds, including theanine, caffeine, chlorophyll and various types of catechins. Green tea contains four main catechins, i.e., (-)-epicatechin (EC), (-)-epicatechin-3-gallate (ECG), (-)-epigallocatechin (EGC) and (-)-epigallocatechin-3-gallate (EGCG), of which the latter is the most active and abundant and matcha is their best condensed source. Due to its unique chemical composition and prized flavour, which sets it apart from other tea beverages, it is considered the highest quality tea. Its health-promoting properties are attributed to the high content of antioxidant and anti-inflammatory substances. Studies confirming the high antioxidant potential of tea beverages claim that it originates from the considerable content of catechins, a type of phenolic compound with beneficial effects on human health. Due to its potential for preventing many diseases and supporting cognitive function, regular consumption of matcha may have a positive effect on both physical and mental health. The aim of this review was to compile the health benefits of matcha tea. It is the first such review to be undertaken, and presents its main bioactive compounds in a systematic manner.