Ultra-processed food consumption and its correlates among Italian children, adolescents and adults from the Italian Nutrition & Health Survey (INHES) cohort study

Abstract

Objective: To assess ultra-processed food (UPF) consumption and its sociodemographic, psychosocial and behavioural correlates in a general population of Italian children, adolescents and adults. Design: Cross-sectional telephone-based survey Setting: Italy, 2010-2013 Participants: 9,078 participants (5-97 y), from the Italian Nutrition & HEalth Survey (INHES). Dietary intakes were collected by a one-day 24-h dietary recall. UPF was defined by the NOVA classification and expressed as percentage of total calories. Results: Average energy intake from UPF (95% confidence interval) was 17·3% (17·1%, 17·6%) among adults and 25·9% (24·8%, 27·0%) in children/adolescents. Top sources of UPF were processed meats (32·5%) and bread substitutes (16·7%). Among adults, age (β=−3·10; 95%CI: −4·40, −1·80 for >65 y vs 20-40 y; βs are dimensionless) and residing in Southern Italy (β=−0·73; −1·32, −0·14 vs Northern) inversely associated with UPF. Screen view during meals was directly linked to UPF, as well as poor self-rated health (β=5·32; 2·66, 7·99), adverse life events (β=2·33; 1·48, 3·18) and low sleep quality (β=2·34; 1·45, 3·24). Boys consumed 2-point percent more UPF of the total energy than girls (β=2·01; 0·20, 3·82). For all ages, a Mediterranean diet was inversely associated with UPF (β=−4·86; −5·53, −4·20 for good vs poor adherence in adults and β=−5·08; −8·38, −1·77 for kids). Conclusions: UPF contribute a modest proportion of energy to the diets of Italian adults while being one quarter of the total calories in children/adolescents. UPF was associated with several psychosocial factors and eating behaviours. Increased adherence to Mediterranean diet would possibly result in lower UPF consumption.

Psychological distress resulting from the COVID-19 confinement is associated with unhealthy dietary changes in two Italian population-based cohorts

“…A favourable association between psychological health and an MD has been previously reported in numerous cross-sectional [ 36 – 38 ] and longitudinal analyses [ 39 , 40 ] from population studies; consistently, a diet rich in UPF was unfavourably associated with mental health rather being associated with increased risk of incident depression [ 41 , 42 ], while the association with other psychological disorders, such as stress or anxiety, has not been extensively addressed, with few exceptions [ 43 ]. Our study is one of the first to provide evidence of an association between anxiety, stress and PTSD symptoms with a diet rich in UPF.…”

Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples

“…A total of 29 additional studies were excluded for the following reasons: (i) did not report sufficient data (n = 14); (ii) did not include nationally representative samples (n = 6); (iii) did not use the NOVA classification system (n = 2); and (iv) were duplicates of previously selected more complete reports from the same survey (n = 7). Therefore, a total of 14 studies providing data for 13 unambiguously nationally representative samples were included in the present meta-analysis [22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

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

“…Eleven studies modelled ultra-processed food consumption as the exposure variable and mental disorder parameters as the outcome [17][18][19]21,[23][24][25][26]30,48,50], with the remaining six modelling associations in the opposite direction [20,22,[27][28][29]31].…”

“…Of the six studies that modelled mental disorder parameters as the exposure, one was coded continuously [22], with the remaining five coding these categorically (dichotomous [20,28,29], tertiles [27] and between-group comparison of patients with anorexia nervosa, bulimia nervosa and binge eating disorder [31]).…”

“…However, the meta-analysis assessing associations of ultra-processed food consumption with mental disorders was limited only to depression and by the number of studies available for inclusion at the time of publication (n = 2). Several additional studies have since been published assessing the link between ultra-processed food consumption and depression as well as other mental disorders [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The need for an updated review is further exacerbated by the fact that ultra-processed foods have become increasingly ubiquitous for many food systems globally [13], thus understanding any relationship with mental disorders is critical for understanding the health implications of this trend.…”