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Longitudinal studies evaluating the relationship between UPF consumption and the incidence of Metabolic Syndrome (MetS) and its components are still scarce. This study aimed to evaluate the effect of UPF consumption on the incidence of MetS and its components in adults. A prospective study was conducted with 896 participants from the 1978/79 Ribeirão Preto cohort, São Paulo, Brazil. UPF consumption was evaluated in %kcal and %g at ages 23–25 years. Incidence of MetS and its components were estimated at ages 37–39 years, according to the Joint Interim Statement criteria. Poisson regression was used to assess associations, and interactions with sex were investigated. UPF consumption had no association with MetS (%kcal Adjusted PR: 1.00; 95% CI: 0.99–1.01; %g Adjusted PR: 1.00; 95% CI: 0.99–1.01). However, women with higher UPF consumption, in %kcal and %g, had a higher risk of abdominal obesity (%kcal: p = 0.030; %g: p = 0.003); and women with higher UPF consumption, in %g, had a higher risk of low HDL-cholesterol (p = 0.041). For the other components of MetS, no significant associations were observed in either sex. These findings suggest evidence of no association between UPF consumption and MetS; however, consumption of UPF was associated with increased WC and low HDL-c, but only in women.

BackgroundUltra-processed foods (UPF) are becoming extensively available in the food environments. UPF are industrial formulations that are designed to maximize palatability and consumption through a combination of calorie-dense ingredients and chemical additives. UPFs are also aggressively marketed, which may make them more attractive than unprocessed/minimally processed foods (UMPF). Since consumers' purchase decisions are guided by food-evoked emotions, we aimed to provide evidence that UPF visual cues trigger higher emotional responses and approach motivation than UMPF visual cues, with potential impacts on individuals' intention to consume the UPF over the UMPF.MethodsParticipants (n = 174; 144 women; mean age = 20.7 years; standard deviation = 4.35) performed two tasks. In the first task, 16 pictures of foods (8 UPF and 8 UMPF), and 74 pictures from other affective categories, were presented. After viewing each picture, the participants rated it along two basic dimensions of emotion through the Self-Assessment Manikin scale: pleasantness and arousal. In the second task, the participants viewed the same food pictures, and they rated their intention to consume the foods depicted in the pictures. Each picture was plotted in terms of its mean pleasantness and arousal ratings in a Cartesian plane, which resulted in an affective space.ResultsPictures of UPF and UMPF were positioned in the upper arm of the boomerang-shaped affective space that represents approach motivation. Pictures containing UPF triggered higher approach motivation and intention to consume than pictures containing UMPF. We also found a stronger association between emotional responses and intention to consume UPF relative to UMPF.ConclusionThese results shed new light on the role of ultra-processed foods evoked emotions that contribute to less healthy and sustainable food environments.

Background: Due to changing household types and weakening of family functions, children have fewer opportunities to develop healthy lifestyle patterns from contact with family members compared to the past. In this paper, we evaluate the association between household type and adolescents’ fast-food consumption, focusing on whether they were living with their parents or not, and determine their reasons for not living with their parents. Methods: This cross-sectional study analyzed data from the Korea Youth Risk Behavior web-based survey between 2017 and 2020. The subjects were students in grades 7–12. The outcome variable was a frequency of fast-food intake of ≥5 times per week. The main independent variable was the type of household: (1) living with both parents; (2) living with a single parent (one of father, mother, stepfather, stepmother); (3) not living together, but having parents; and (4) having no parents. Results: Participants without parents were more likely to eat fast food frequently than those living with both parents. Among boys, not having parents and living in a dorm or boarding house or living with other family members or relatives were significantly associated with frequent fast-food intake; among girls, not having parents and living in a dorm or boarding house were significantly associated with frequent fast-food intake. Conclusion: Adolescents having no parents have a higher risk of frequent fast-food intake than those living with both parents. Further studies are needed to address household types in greater detail.

This research examines customers’ intention to buy depending on their use of nutrition labelling (NL) in fast food operations (FFOs) and their intention to visit and recommend these FFOs with nutrition-labelled menus. The research model draws on the theory of planned behaviour (TPB) to examine customers’ intentions to buy from nutrition-labelled menus and their behaviour of visiting and recommending to others FFOs with nutrition-labelled menus. To achieve this purpose, a self-administrated questionnaire was distributed to and collected from a random sample of customers at FFOs in Greater Cairo, Egypt, i.e., McDonald’s and Subway. The results from the structural equation modelling (SEM) using AMOS software indicated positive and direct significant paths from the constructs of the TPB, except for customers’ attitude, to customer intention to buy nutrition-labelled menu items. The results also showed a positive significant impact of customers’ intention on their behaviour of visiting and recommending FFOs featuring nutrition-labelled menus. The findings showed that there is an awaking of nutritional awareness among fast-food customers and that providing nutritional information on fast-food menus will affect their purchasing intention in the future by encouraging them to make healthy food choices. Theoretical implications for scholars and managerial implications for FFOs, especially in relation to public health in general and healthy food choices in particular, are explained and discussed.

Objective Characterize the community food environment through the different types of food outlets in the city of Fortaleza and associate their distribution according to sociodemographic indicators. Methods This is an ecological study carried out in the city of Fortaleza in which data from the Health Surveillance Service were used with the location of all licensed food stores in the city in the years 2018 and 2019. Georeferenced maps were set up to illustrate the spatial distribution of the establishments. Correlation analyses were performed to verify the association between food outlets and socioeconomic data. Values of p≤0.005 were considered significant. Results We identified a greater concentration of food stores in the neighborhoods with better socioeconomic levels. Snack bars (n=2051; 27.7%) and restaurants (n=1945; 26.3%), were in greater quantity and exhibited a positive correlation with the Human Development Index and average income. Supermarkets and hypermarkets (n=288; 3.9%) and street markets (n=81; 1.1%) were in a smaller number and had the worst spatial distribution. Conclusion We observed socioeconomic inequalities in the distribution of different types of food outlets. The little diversity and the limited number of establishments in peripheral neighborhoods, besides the centralization of outlets that sell food that is harmful to health, constitute obstacles for the population to make healthy food choices. RESUMO Objetivo Caracterizar o ambiente alimentar comunitário por meio dos diferentes tipos de estabelecimentos de venda de alimentos existentes na cidade de Fortaleza e relacionar sua distribuição de acordo com indicadores sociodemográficos. Métodos Trata-se de um estudo ecológico realizado na cidade de Fortaleza em que foram utilizados dados da Vigilância Sanitária com a localização de todos os comércios de alimentos licenciados para funcionamento no município nos anos de 2018 e 2019. Foram construídos mapas georreferenciados para ilustrar a distribuição espacial dos estabelecimentos. Análises de correlação foram realizadas para verificar associação entre os estabelecimentos de venda de alimentos e dados socioeconômicos. Consideraram-se significativos valores de p≤0,005. Resultados Foi possível identificar maior concentração de comércios de alimentos nos bairros com melhores níveis socioeconômicos. Lanchonetes (n=2051; 27,7%) e restaurantes (n=1945; 26,3%) apresentaram-se em maior quantidade e obtiveram correlação positiva com o Índice de Desenvolvimento Humano e a renda média. Supermercados e hipermercados (n = 288; 3,9%) e feiras livres (n=81; 1,1%) existiam em menor proporção e apresentaram a pior distribuição espacial. Conclusão Desigualdades socioeconômicas foram observadas na distribuição dos diferentes tipos de pontos de venda de alimentos. A pouca diversidade e a limitada quantidade de estabelecimentos em bairros periféricos, além da centralização da oferta de comércios que vendem alimentos prejudiciais à saúde, constituem-se obstáculos para que a população faça escolhas alimentares saudáveis.

Numerous association studies and findings from a controlled feeding trial have led to the suggestion that “processed” foods are bad for health. Processing technologies and food formulation are essential for food preservation and provide access to safe, nutritious, affordable, appealing and sustainable foods for millions globally. However, food processing at any level can also cause negative health consequences that result from thermal destruction of vitamins; formation of toxins such as acrylamide; or excessive intakes of salt, sugar, and fat. Research on ultraprocessed foods centers on food composition and formulation. In addition, many modern food formulations can have poor nutritional quality and higher energy density. We outline the role of processing in the provision of a safe and secure food supply and explore the characteristics of processed foods that promote greater energy intake. Despite the potential for negative health effects, food processing and formulation represent an opportunity to apply the latest developments in technology and ingredient innovation to improve the food supply by creating foods that decrease the risk of overeating.

Objective\ud To synthesize peer-reviewed literature that utilize co-creation principles in healthy food retail initiatives.\ud \ud Methods\ud Systematic review of six databases from inception to September 2021. Screening and quality assessment were carried out by two authors independently. Studies were included if they were conducted in food retail stores, used a collaborative model, and aimed to improve the healthiness of the food retail environment. Studies excluded were implemented in restaurants, fast food chains, or similar or did not utilize some form of collaboration. Extracted data included the type of stakeholders engaged, level of engagement, stakeholder motivation, and barriers and enablers of the co-creation process.\ud \ud Findings\ud After screening 6951 articles by title and abstract, 131 by full text, 23 manuscripts that describe 20 separate studies from six countries were included. Six were implemented in low-income communities and eight among Indigenous people groups. A common aim was to increase access to, and availability of, healthy products. A diverse range of co-creation approaches, theoretical perspectives, and study designs were observed. The three most common stakeholders involved were researchers, corporate representatives or store owners, and governments.\ud \ud Conclusions\ud Some evidence exists of the benefits of co-creation to improve the healthiness of food retail environments. The field may benefit from structured guidance on the theory and practice of co-creation.

Objective:Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde – PAS).Design:A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis.Setting:Belo Horizonte – Brazil.Participants:3372 adults (≥20 years).Results:Users in the third tertile of PAS (24·4–61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1–24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0–10 months).Conclusions:Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.

Objective:Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city.Design:Cross-sectional study.Setting:Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil.Participants:Totally, 3372 participants.Results:UPF were found to contribute to 27·7 % of the diet’s total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population.Conclusions:Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.

Objective:To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality.Design:Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income.Setting:Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012.Participants:Participants aged 45–84 years were followed for 10 years (n 3567).Results:Median HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46).Conclusions:Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

Objective:To estimate the proportion of products meeting Fiji government labelling regulations, assess compliance with national Na reformulation targets and examine the Na and total sugar levels in packaged foods sold in selected major supermarkets.Design:We selected five major supermarkets in 2018 and collected the product information and nutritional content from the labels of all packaged foods sold. We organised 4278 foods into fourteen major food categories and thirty-six sub-categories and recorded the proportion of products labelled in accordance with the Fiji labelling regulations. We looked at the levels of Na and total sugar in each food category and assessed how many products complied with the Fiji reformulation targets set for Na. We also listed the companies responsible for each product.Setting:Suva, Fiji.Results:Fourteen percentage of packaged foods in fourteen major categories met Fiji national labelling regulations. Na was labelled on 95·4 % products, and total sugar labelled on 92·4 %. The convenience foods category had the highest Na levels (1699 mg/100 g), while confectionery had the highest content of total sugar (52·6 g/100 g). Forty percentage of eligible products did not meet the proposed voluntary Na reformulation targets.Conclusions:Our findings indicate significant room for improvement in nutrient labelling, as well as a need for further enforcement of reformulation targets and monitoring of changes in food composition. Through enacting these measures and establishing additional regulations such as mandatory front-of-pack labelling, government and food industry can drive consumers towards healthier food choices and improve the nutritional quality of packaged foods in Fiji.

Burden, due to foodborne diseases, particularly Salmonella infection, is high in developing countries like Bangladesh. This research aimed at the molecular characterization of Salmonella spp., isolated from selected school canteen’s fast foods in Dhaka city, Bangladesh, and to evaluate the antibiotic resistance patterns of isolated foodborne pathogens. The school cafeterias were selected by the convenience sampling method. The samples were collected aseptically, and serial dilutions were made. The bacterial colonies were isolated by spread plate technique using appropriate media, and bacterial identification was carried out using gram staining and biochemical tests such as MIU, KIA, Oxidase, and Catalase test. The strain of Salmonella spp. was confirmed by molecular characterization employing the 16S rRNA gene sequencing method. The susceptibility of the isolates to various antibiotics was observed by modified Kirby-Bauer disk diffusion method. Most of the samples were found to contain an unacceptable level of a total aerobic count, which ranged from 5.6×105 to 6.1×107 and 3.4×104 to 7.2×107 for burger and sandwich samples, respectively. Significant isolates from the pathogenic strains were Salmonella spp., Shigella, Klebsiella, Proteus, E. coli, Vibrio spp., Clostridium spp., Staphylococcus spp., and others. The further molecular characterization of isolated Salmonella spp. suggests the similarity with Salmonella enterica serovar Rissen SeqrSC0091. Most isolates were resistant against Ampicillin (100%), Azithromycin (60.87%), Tetracycline (39.43%), Colistin (32.61%), while were highly sensitive to Gentamycin and Chloramphenicol. The presence of multidrug-resistant foodborne pathogens at this high level in the school cafeteria’s fast foods signifies an increased risk for the children’s health.

Background & aims Regular consumption of fast-food (FF) as a form of typical Western style diet is associated with obesity and the metabolic syndrome, including its hepatic manifestation nonalcoholic fatty liver disease. Currently, it remains unclear how intermittent excess FF consumption may influence liver metabolism. The study aimed to characterize the effects of a single FF binge on hepatic steatosis, inflammation, bile acid (BA), glucose and lipid metabolism. Methods Twenty-five healthy individuals received a FF meal and were asked to continue eating either for a two-hour period or until fully saturated. Serum levels of transaminases, fasting BA, lipid profile, glucose and cytokine levels as well as transient elastography and controlled attenuation parameter (CAP; to assess hepatic steatosis) were analyzed before (day 0) and the day after FF binge (day 1). Feces was collected prior and after the FF challenge for microbiota analysis. Results The FF meal induced a modest increase in CAP, which was accompanied by a robust increase of fasting serum BA levels. Surprisingly, levels of cholesterol and bilirubin were significantly lower after the FF meal. Differentiating individuals with a relevant delta BA (>1 μmol/l) increase vs. individuals without (delta BA ≤1 μmol/l), identified several gut microbiota, as well as gender to be associated with the BA increase and the observed alterations in liver function, metabolism and inflammation. Conclusion A single binge FF meal leads to a robust increase in serum BA levels and alterations in parameters of liver injury and metabolism, indicating a novel metabolic aspect of the gut–liver axis.

This study aimed to investigate the association of perceived stress and salivary cortisol levels with the snack and fast-food dietary pattern in a sample of women shift workers. We conducted a cross-sectional study of 539 women aged 18-53 years working in the production line of a poultry processing plant. Stress was assessed with the 10-item Perceived Stress Scale (PSS-10) and by salivary cortisol levels (immediately after waking and upon returning home from work). Dietary patterns were identified by principal component analysis. We used linear and Poisson regression models to assess multivariable-adjusted associations of perceived stress and salivary cortisol levels with the snack and fast-food dietary pattern. After adjustments, women with higher PSS-10 scores had a 28% higher probability (95% confidence interval, 1.04-1.56) of consuming snacks/fast food. Mean (SD) waking cortisol levels were inversely associated with quartiles of the dietary pattern: Q1, 6.63 (0.43) nmol/L; Q2, 6.00 (0.38) nmol/L; Q3, 5.62 (0.40) nmol/L; and Q4, 5.29 (0.35) nmol/L (

Objective:To assess the frequency with which soft drinks and premiums are available with children’s meals marketed on the top restaurant chains’ websites worldwide.Design:Cross-sectional structured observational assessment of secondary information about top international restaurant chain children’s meals.Setting:Websites of top restaurant chains for 193 countries and five regions of the United Nations.Participants:Top restaurant chains (including McDonald’s, Subway, Burger King and KFC) across 193 countries. Children’s meal images and descriptions were reviewed to determine if the meal was marketed with a soft drink as a beverage option and whether the meal offered a premium.Results:Children’s meals were marketed online on restaurant websites by at least one of the four chains in a total of seventy eight of the 193 countries (40·4 %). Overall, 56·3 % of countries with any online children’s meal marketing by the four chains included at least one chain that marketed soft drinks and 92·3 % marketed premiums with the meal.Conclusions:Every region in the world includes marketing of children’s meals on the websites of the top restaurant chains. The high prevalence of premiums marketed online with children’s meals is of concern. Similarly, with over 50 % of countries with online children’s meal marketing having at least one chain that offers soft drinks as part of the meals, additional regulation and education may be warranted.

Background: Ready-to-use therapeutic foods (RUTF) are designed to cover the daily nutrient requirements of children with severe acute malnutrition (SAM). However, with the transfer of uncomplicated SAM care from the hospital environment to the community level, children will be able to consume complementary and family foods (CFF) in addition to RUTF, and this might decrease the quantity of RUTF needed for recovery. Objectives: Using an individually randomized clinical trial, we investigated the effects of a reduced RUTF dose on the daily energy and macronutrient intakes, the proportion of energy coming from CFF, and the mean probability of adequacy (MPA) of intake in 11 micronutrients of 516 children aged 6–59 mo who were treated for SAM in Burkina Faso. Methods: The data were collected using a single 24-h multipass dietary recall, 1 mo after starting treatment, from December 2016 to August 2018, repeated on a subsample of 66 children. Differences between children receiving the reduced RUTF (intervention arm) and those receiving standard RUTF (control arm) were assessed by linear mixed models. Results: Daily energy intake was lower (P < 0.01) in the intervention arm (mean ± SD 1321 ± 339 kcal) than in the control arm (1467 ± 319 kcal). CFF contributed to 40% of the daily energy intake in the intervention and 35% in the control arm. The MPA for 11 micronutrients was 0.89 ± 0.1 in the intervention arm and 0.95 ± 0.07 in the control arm (P = 0.06). Conclusions: Reducing the dose of RUTF during SAM treatment had a negative impact on daily energy intake of the children. Despite this, children covered their recommended energy intake. The energy intake coming from CFF was similar between arms, suggesting that children’s feeding practices did not change due to the reduction in RUTF in this context. This trial was registered at the IRSCTN registry as ISRCTN50039021

Objective: This study examined the food consumption pattern and dietary diversity of a vegetarian population in the Greater Accra Region of Ghana.Methods: A cross-sectional study was employed to examine the nutritional status of four (4) vegetarian groups in the Greater Accra Region of Ghana. One hundred and twenty-two (122) vegetarians were recruited using the total enumeration technique. Food consumption pattern and dietary diversity were assessed using a validated qualitative food frequency questionnaire and a 24-hour dietary recall, respectively. Dietary diversity was calculated using the FAO guidelines.Results: Sixty eight percent (68%) of the vegetarians reported daily intakes of vegetable protein. Majority of the vegetarians (80.6%) reported daily intakes of cereals and grains while 54% reported daily intakes of tubers. Eighty two percent (82%) and 72% of the vegetarians consumed vegetables and fruits on daily basis respectively. A few ofthe vegetarians (29%) reported daily intakes of fruit juices. Soft drinks, deep fried foods and fast foods were occasionally consumed. About 40.3% of the vegetarians obtained a dietary diversity score of four (4). Majority of them (68.9%) had low dietary diversity.Conclusion: The vegetarians had low dietary diversity which may lead to inadequate nutrient intakes. Thus, there is the need for nutrition-related professionals to give appropriate information on a vegetarian diet and educate vegetarians to include a variety of foods in their diet.

European Snacks Association (ESA) data on acrylamide in potato crisps from 2002 to 2019 (99704 observations) were analysed. Acrylamide levels have plateaued since 2011, although the lowest mean so far was attained in 2018 at 353 ± 2.7 ng g-1: a 54% reduction since 2002. The 85th, 90th and 95th quantiles did show evidence of continued downward progress, the 90th quantile being lower than the 750 ng g-1 European Benchmark Level from 2017 to 2019. A smaller dataset from the European Food Safety Authority (2124 observations) for 2011-2018, was also analysed. The yearly means were higher than those of the ESA data, but showed a fall in average acrylamide from 715 ± 40.5 ng g-1 in 2015 to 505 ±28.5 ng g-1 in 2018, as well as steep falls in the 85th, 90th and 95th quantiles. Nevertheless, even the 85th quantile remained above the 750 ng g-1 Benchmark Level. The ESA data showed a reduction in the proportion of samples with acrylamide exceeding 750 ng g-1, from over 40 % in 2002 to 7.75 % in 2019. Seasonality was evident, with highest acrylamide levels from November to May. Crisp type had little effect except that thicker types had a higher proportion of samples containing >750 ng g-1 acrylamide. Analysis of the region of origin in Europe of the final product revealed improvements in the east and north. Geographical factors combined with seasonality continued to be problematic but was also an aspect in which progress was most evident. The findings show that improvements have been made in reducing the number of samples with very high levels of acrylamide, but do not suggest that mean acrylamide levels could be reduced substantially below where they have been since 2011, or that levels could be kept consistently below the current Benchmark Level.

Objective:To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March–3 May 2020).Design:Retrospective observational study.Setting:Italy.Participants:We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005–2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, −1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.Results:Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = −1·94; 95 % CI −2·72, −1·17 for individuals aged >75 years as compared with 18–39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = −1·32; 95 % CI −1·80, −0·84), while UPF lowering associated with increased exercise (β = −0·90; 95 % CI −1·46, −0·35) and weight loss (β = −1·05; 95 % CI −1·51, −0·59) during confinement.Conclusions:During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

Resumo O objetivo foi avaliar a disponibilidade da informação sobre quantidade de açúcar e identificar sua posição na lista de ingredientes em alimentos industrializados. Este estudo caracteriza-se como transversal, com análise de todos os alimentos industrializados tradicionais, diet, light e zero comercializados em um hipermercado de grande porte, que contivessem na lista de ingredientes as palavras açúcar ou sacarose. A declaração da quantidade e a posição do açúcar na lista de ingredientes foram registrados após observação do rótulo. A informação de quantidade de açúcar também foi solicitada às indústrias de alimentos, por e-mail ou telefone. Foram analisados 2200 alimentos, sendo 2164 (98,4%) tradicionais e 36 (1,6%) diet, light e zero, nos quais a declaração da quantidade de açúcar foi observada em apenas 14,4% e 13,9% dos alimentos, respectivamente (p=0,84). Das 156 empresas contatadas, apenas 7,7% (n=12) disponibilizaram as informações solicitadas. Dentre os alimentos tradicionais, 75,8% apresentam o açúcar nas três primeiras posições da lista de ingredientes, enquanto nos diet, light e zero, 77,8% (p=0,93). Conclui-se que o açúcar é o principal ingrediente em grande parte dos alimentos analisados e que a disponibilidade de informação de sua quantidade é baixa.

Background: Globally, ready-to-use therapeutic food (RUTF) with peanut and milk as the primary source of protein is used to treat children having severe acute malnutrition (SAM). Valid Nutrition in collaboration with Ajinomoto Co., Inc has developed a nonmilk RUTF from soybean, maize, and sorghum (SMS-RUTF) and demonstrated its efficacy. Objective: To pilot SMS-RUTF in treatment of SAM within Community-Based Management of Acute Malnutrition (CMAM) program in Malawi, Africa. Methods and Findings: This was implemented from January to July 2018 and its performance was based on the SPHERE criteria and Ministry of Health CMAM guidelines. A total of 742 children were treated with SMS-RUTF. Of these, 94.5% (95% CI: 92.6-96.0) were successfully discharged to supplementary feeding program (SFP) with middle upper arm circumference (MUAC) ≥115 mm or directly to their homes with MUAC ≥125 mm; 3.6% (95% CI: 2.4-5.3) defaulted, 1.9 % (95% CI: 1.0-2.1) died, and 0.0% nonresponders. Analysis of 222 children who were discharged home with MUAC ≥125 mm gave a recovery rate of 88.3% (95% CI: 88.3-92.2), a defaulter rate of 6.8 % (95% CI: 3.8-10.9), a mortality rate of 1.3% (95% CI: 0.3-3.9), and a nonresponders rate of 1.8% (95% CI: 0.5-4.5). These outcomes exceed SPHERE minimum performance standards. The mean (standard deviation) length of stay of children discharged to SFP and discharged directly home were 42.0 (20.9) and 46.1 (21.1) days, respectively. These outcomes are within the recommended average duration of Conclusion: The pilot CMAM program using SMS-RUTF recipe that contains no milk or peanuts achieved SPHERE minimum standards. Based on this evidence, SMS-RUTF should be encouraged for treatment of SAM in children between 6 and 59 months in routine CMAM programs in Malawi and globally.

US schools have fast-food restaurants nearby, encouraging student patronage, unhealthy consumption, and weight gain. Geographers have developed an activity space framework which suggests this nearby location effect will be moderated by whether people perceive the location as their activity space. Therefore, we study whether students perceive a fast-food restaurant near school as their activity space, and whether social marketing messages can change that perception. We conducted six studies: a secondary data analysis with 5986 students, a field experiment with 188 students, and four lab experiments with 188, 251, 178, and 379 students. We find that students who strongly identify with their student community patronize a fast-food restaurant near school (vs. farther away) because they view it as their activity space, while students who weakly identify do not. For example, in our field experiment, 44% vs. 7% of students who strongly identified with the student community patronized the near versus farther restaurant, while only 28% versus 19% of students who weakly identified patronized the near and farther restaurants comparably. We also find that to deter the strong identifiers, messages should convey that patronage is a social liability, e.g., portray student activism against fast food. We show that standard health messages do not change perceptions of restaurants as social activity spaces. Thus, to combat the problem of fast-food restaurants near schools causing unhealthy consumption, policy and educational interventions should focus on students who strongly identify with their student community and find ways to weaken their perceptions that fast-food restaurants near schools are their activity spaces.

A liquid chromatography-mass spectrometry bottom-up proteomic approach was applied for the detection and identification of proteins from liver tissues. We identified 74 unique pork liver peptide markers that are resistant to the thermal processing of food. These peptides are derived from 43 proteins, which perform various functions in the liver. Roasted and sterilised pâté-type products with a pork liver content ranging from 6% to 51% were examined to select the most reliable pork liver peptide markers that survive unmodified in complex processed food matrices. Of the 74 specific heat-stable peptides detected in pure liver tissue, five (GDAPEEEVSLSK, ALTAELEAVGK, TFYLNVLNEEER, AQFGQPEILLGTIPGTGGTQR and VIAPGFNALEQILQSTAGK) were the best candidates to confirm the presence of liver tissue in highly processed meat products. We have identified unique tissue-specific markers that enable rapid and specific identification of pork liver in processed food and may contribute to the development of new methods for testing food authenticity.

The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother's and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child's age (T2: OR = 1.17

Aim: Hypertension is a major public health problem worldwide and is associated with high mortality and morbidity. The main aim of this study is to assess obesity and overweight in school children and their relationship to hypertension and associated risk factors. Study Design: Population based cross sectional study. Results and Discussion: A total number of 712 students with age group between 7-12 years from different school were screened for their height, weight and body mass index. The present study was aimed to assess obesity and overweight in school children and their relationship to hypertension and associated risk factors. Under weight and healthy weight children are engaged in physical activities like playing in ground and thus they are healthy where the children who found as overweight and obese were not engaged in physical activities regularly and thus this might be the reason for their overweight and obesity. At the same time the children who found as obese and overweight were said that they were having fast foods twice a day. Conclusion: In order to get rid of these risks and their associated cardiovascular risks, their food habits must be changed and physical activities needs to be improved.

Ultraprocessed foods provide the majority of energy content in the American diet, yet little is known regarding consumption trends over time. We determined trends in diet processing level and diet quality from 1991 to 2008 within the prospective Framingham Offspring Cohort. Dietary intakes were collected by FFQ quadrennially 1991–2008 (total of four examinations). The analytical sample included 2893 adults with valid dietary data for ≥3 examinations (baseline mean age = 54 years). Based on the NOVA framework, we classified foods as: unprocessed/minimally processed foods; processed culinary ingredients (salt/sugar/fats/oils); and processed foods and ultraprocessed foods. We evaluated diet quality using the Dietary Guidelines for Americans Adherence Index (DGAI) 2010. Trends in consumption of foods within each processing level (servings/d) and diet quality over the four examinations were evaluated using mixed effects models with subject-specific random intercepts. Analyses were stratified by sex, BMI (2, 25–29·9 kg/m2, ≥30 kg/m2) and smoking status. Over 17 years of follow-up, ultraprocessed food consumption decreased from 7·5 to 6·0 servings/d and minimally processed food consumption decreased from 11·9 to 11·3 servings/d (Ptrend < 0·001). Changes in intakes of processed foods, culinary ingredients and culinary preparations were minimal. Trends were similar by sex, BMI and smoking status. DGAI-2010 score increased from 60·1 to 61·5, P < 0·001. The current study uniquely describes trends in diet processing level in an ageing US population, highlighting the longstanding presence of ultraprocessed foods in the American diet. Given the poor nutritional quality of ultraprocessed foods, public health efforts should be designed to limit their consumption.

OBJECTIVE To assess whether proportional contribution of unprocessed or minimally processed, processed or ultra-processed foods to daily energy intake is associated with dental caries in US adults. METHODS This secondary cross-sectional analysis included adults aged 20 to 59 years old with complete oral examinations, using data gathered from cycles 2011-2012 and 2013-2014 of the continuous National Health and Nutrition Examination Survey (NHANES). Dietary recall data were categorized according to the NOVA classification into four groups: unprocessed or minimally processed foods (Group 1), processed culinary ingredients (Group 2), processed foods (Group 3) and ultra-processed foods (Group 4). The proportional contribution of each of these groups to mean daily energy intake was calculated and then cut into quartiles (Group 1, Group 3 and Group 4) or tertiles (Group 2). Two separate measures were used to assess dental caries: the decayed, missing, filled teeth (DMFT) index and, after exclusion of edentulous participants, prevalence of untreated caries. Poisson regression was used to model DMFT, while logistic regression was used to model the prevalence of untreated dental caries. Models were calculated for each NOVA group. All models were controlled for age, gender, race/ethnicity, level of education, income, access to oral health services, body mass index, smoking status and total energy intake. Analyses took into account NHANES sampling weights. RESULTS We analysed data from 5720 individuals, of whom 123 (2.2%) were edentulous. Mean DMFT was 9.7 (± 0.2), while the prevalence of untreated dental caries was 26.0%. Mean daily energy intake was 2170 kcal (± 17). Mean contribution to overall daily energy intake was 28.6% (± 0.5) for G1 foods, 4.3% (± 0.1) for G2 foods, 10.1% (± 0.2) for G3 foods and 56.9% (± 0.5) for G4 foods. A higher intake of G3 was associated with lower DMFT at the fourth quartile (0.89; 95%: CI 0.81-0.96), while a higher intake of G4 was associated with a higher DMFT at the fourth quartile (1.10; 95% CI: 1.04-1.16). In the adjusted models for untreated dental caries, no statistically significant associations were found with any of the NOVA groups. CONCLUSION Higher proportional intake of NOVA groups is only weakly associated with dental caries. Widespread exposure to a highly ultra-processed diet may explain these weak associations.

BACKGROUND For decades, Americans have increasingly relied on food away from home (FAFH) despite its association with negative health outcomes. Little is known about FAFH frequency and expenditures of adults with lower food security (FS) and their association with health outcomes, such as BMI. OBJECTIVES We evaluated patterns of adults' FAFH purchases by FS status and other demographic characteristics, and examined the association between FAFH frequency and BMI in adults of varying levels of FS. METHODS This cross-sectional study used data from the Consumer Behavior Survey, Food Security Survey, and anthropometric measurements to assess FAFH frequency and expenditures, FS, and calculated BMI of adults (≥18 y) who participated in the NHANES 2007-2014 (n = 20,733). We used multinomial logistic regression to examine the association between FAFH frequency quartiles (quartile 1: 0 n/wk; quartile 2: 1-2 n/wk; quartile 3: 3-4 n/wk; quartile 4: ≥5 n/wk) and BMI by FS category. RESULTS Although FAFH frequency was similar across FS levels, adults with high FS spent more dollars (${\$}$213.60) and a greater proportion (29.4%) of their food budget on FAFH compared with adults with marginal, low, and very low FS (${\$}$133.00, ${\$}$116.20, ${\$}$103.30 and 21.4%, 19.7%, 20.0%, respectively). Obesity prevalence was highest in adults with low FS (42.9%) and very low FS (41.5%), and lowest in adults with high FS (33.7%). FAFH frequency and BMI were positively associated in adults with high (P

Background Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods A population-based cohort of 91,891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results After an average follow-up of 13.5 years (1,236,049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36–1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50–1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76–1.17). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity Pinteraction Conclusions High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.

Nugget and crackers are fast foods that are widely consumed and favored by the public, usually used as dishes or snacks. Banana tubers is a local food commodities which contains of high fiber can be processed as an ingredients nuggets and crackers. The purpose ofthis reseach was to determine the fiber content of nuggets and crackers with the basic ingredients of kepok banana hump (Musa paradisiaca Var. Balbisina Colla). This study was experimental design. The nugget formulation consisted of 3 comparisons, the ratio of banana hump : wheat flour (25%: 75%) (F1), (50%: 50%) (F2), and (75%: 25%) (F3). The cracker formulation consists of 3 comparisons, the ratios of banana hump: tapioca flour (25%: 75%) (F1), (50%: 50%) (F2), and (75%: 25%) (F3). Test the fiber containt by the gravimatry method which is then described. The results in this study was analyzed of the fiber value of nuggets and crackers kepok banana hump every (100g). The highest fiber content of nuggets was F3: 0.514g, F2: 0.322g and F1: 0.186g. The highest fiber content of Kepok banana hump crackers is F3: 0.861g, F2: 0.747g and F1: 0.727g. The fiber value of the kepok banana hump crackers is higher than the kepok banana hump nugget.

espanolEn la etapa universitaria se presenta un cambio en habitos de vida y, en la mayoria de casos, las conductas adquiridas en esta epoca se mantienen en edad adulta. El objetivo fue identificar la relacion entre la composicion corporal y el consumo de alimentos ricos en fibra y grasa, entre los estudiantes de Cultura Fisica, Deporte y Recreacion en Bogota, Colombia. La investigacion tuvo un enfoque cuantitativo, no experimental, transversal. A una muestra de 91 estudiantes se les evaluo la composicion corporal y se les aplico un cuestionario de alimentos. Los resultados indicaron un porcentaje graso optimo, un IMC y grasa visceral dentro del rango saludable. El promedio de puntuacion para la ingesta de grasa de 22.2 revelo un consumo moderado de grasa, con relacion al consumo de fibra el puntaje fue bajo; no se encontro una relacion estadisticamente significativa entre la composicion corporal y el consumo de alimentos. Se sugiere aumentar consumo de frutas y verduras, disminuir la ingesta de alimentos fritos y comidas rapidas pues, como futuros profesionales que tienen que promover habitos de vida saludable, deben iniciar la generacion de esos habitos en el ambito personal. EnglishIn the university stage there is a change in life habits and, in most cases, the behaviors acquired at this time are maintained in adulthood. The aim was to identify the relationship between body composition and the consumption of foods rich in fiber and fat, in students of Physical Culture, Sports and Recreation of Bogota, Colombia. The research had a quantitative approach, non-experimental, transversal. The sample consisted of 91 students; body composition was evaluated and a food questionnaire was applied to them. The results showed an optimal fat percentage, a BMI and visceral fat within the healthy range. The average score for fat intake of 22.2 revealed a moderate consumption of fat, in relation to fiber consumption the score was low; no statistically significant relationship was found between body composition and food consumption. It is suggested to increase the consumption of fruits and vegetables, and decrease the intake of fried foods and fast foods, since being future professionals who promote healthy lifestyle habits, they must start the generation of those habits in the personal sphere.

Objective:To evaluate energetic contribution according to the degree of industrial food processing and its association with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics in adolescents.Design:Cross-sectional study (Adolescent Lifestyle Study). Food consumption was assessed using 24-h dietary recalls, with foods classified by degree of industrial progressing. The usual diet was estimated using the Multiple Source Method. In a linear regression model, the energy percentage (E %) was associated with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics, after adjustment for sex and age.Setting:Juiz de Fora, Brazil.Participants:Eight hundred and four adolescents, of both sexes, 14–19 years of age, enrolled in public schools.Results:The E % of unprocessed or minimally processed foods corresponded to 43·1 %, processed foods to 11·0 % and the ultraprocessed foods to 45·9 %. E % of unprocessed foods was associated with socio-economic stratum (adjusted β = −0·093; P = 0·032), neck circumference (adjusted β = 0·017; P = 0·049), screen time (adjusted β = −0·247; P = 0·036) and HDL-cholesterol (adjusted β = −0·156; P = 0·003). E % of ultraprocessed foods was associated with socio-economic stratum (adjusted β = 0·118; P = 0·011), screen time (adjusted β = 0·375; P = 0·003), BMI (adjusted β = −0·029; P = 0·025), neck circumference (adjusted β = −0·017; P = 0·028) and HDL-cholesterol (adjusted β = 0·150; P = 0·002).Conclusions:There was a high E % of ultraprocessed foods in the diet of the adolescents. Actions are needed to raise the awareness of adopting healthy eating habits.

Eating disorder (ED) is a common complication with disturbance of eating or eating-related behaviors that lead to physical and psychosocial disorders. The purpose of this study was to evaluate the association between eating disorders and daily fast food consumption, family size, weight-caused stress, and sleep quality in teenagers in Zanjan, Iran. Adolescent girl students aged 12–15 years (n = 370), selected in a cross-sectional study, completed the Eating Attitude Test-26 and Pittsburgh Sleep Quality Index questionnaires. The cluster random sampling method was used. Statistical analysis was performed using R software version 3.6.3. Logistic regression modeling was used for investigating the relationship between factors and odds of EDs. A p value of less than 0.05 was considered significant. A significant relationship was found between family size (OR = 0.77, p = 0.049), fast food-daily consumption (OR = 5.42, p = 0.043), weight-caused stress (OR = 12.47, p

The objective was to evaluate the influence of individual and contextual determinants on infant’s consumption of fruits and vegetables (FV), and ultra-processed foods (UPF). The data was obtained from the Survey of Prevalence of Breastfeeding in Brazilian Municipalities, 2008. A representative sample of 14,326 infants 6-11.9 months old, from seventy-five municipalities of São Paulo state was evaluated. The influence of determinants on FV and UPF consumption was analyzed using Poisson multilevel regression. Mother’s educational level and maternal age had positive dose-response effect for the consumption of FV (p trend < 0.001) and negative for UPF (p trend < 0.001). Infants of multiparous women and those who received outpatient care in public medical system showed lower prevalence of FV (p < 0.001 for both) and higher prevalence of UPF (respectively, p < 0.001 and p = 0.001). Moreover, the contextual variable related to population size indicated that the prevalence of consumption of FV decreased (p < 0.001) and UPF increased (p = 0.081) with decreased population size. Therefore, infants born to women with low education levels, who received outpatient care in the public health network, and who reside in small municipalities should be prioritized for educational programs related to feeding practices. Resumo O objetivo foi analisar a influência de determinantes individuais e contextuais sobre o consumo de frutas, legumes e verduras (FLV) e de alimentos ultraprocessados (AUP) entre lactentes. Estudo com amostra representativa de 14.326 lactentes com idade entre 6-11,9 meses de 75 municípios do estado de São Paulo participantes da Pesquisa de Prevalência de Aleitamento Materno em Municípios Brasileiros, de 2008. A influência dos determinantes sobre o consumo de FLV e de AUP foi avaliada por regressão de Poisson multinível. A escolaridade e faixa etária maternas mostraram efeito dose-resposta positivo para o consumo de FLV (p de tendência < 0,001), e negativo para AUP (p de tendência < 0,001). O consumo de FLV foi menos prevalente entre filhos de multíparas (p < 0,001) e entre aqueles acompanhados no sistema público de saúde (p < 0,001); porém, estes dois grupos apresentaram maiores prevalências de consumo de AUP (respectivamente: p < 0,001 e p = 0,001). Ainda, a variável contextual referente ao porte populacional mostrou relação dose-resposta positiva para FLV (p < 0,001), e negativa para AUP (p = 0,081). Destacam-se grupos que deveriam ser priorizados nas ações nutricionais educativas sobre alimentação de lactentes.

While all groups are affected by the COVID-19 pandemic, the aged people as well as those with underlying chronic medical conditions are at the greatest risk. The higher adherence to refined carbohydrate diets, sweats, and saturated fats contributes to the prevalence of obesity and type 2 diabetes; these disorders increase the risk for severe COVID-19 morbidity and mortality. Fast food consumption activates the intrinsic immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defence against viruses. Furthermore, inflammatory responses caused by COVID-19 may have long-term costs in survived individuals, leading to chronic disorders such as dementia and neurodegenerative disease through neuroinflammatory mechanisms that are related to an unhealthy diet. Therefore, now more than ever, wider access to healthy foods should be a main concern and individuals should be aware of healthy eating habits to reduce COVID-19 complications.

Aims: The aim of this study was to investigate the microbiological quality and the presence of pathogens in sandwiches from different snack bars. Study Design: Foods ready for consumption present a composition which facilitates their deterioration and care from production to consumption ensures its quality. The sandwich is a product of high consumption for its easy acquisition and despite its immediate consumption the sandwich can be considered a food offering risk to the consumers because it is composed of different ingredients that require excessive manipulation. Place and Duration of Study: Food Microbiology Laboratory - University of Uberaba. Methodology: For this study, 30 samples of this product were collected from the popular snack bars, street-foods and reputable fast-foods chains in Uberaba trade. The samples were transported to the Laboratory of Food Microbiology of the University of Uberaba in isotherm boxes filled with ice where they were kept under refrigeration until the time of analysis. The microbiological analyses were done according to the methods proposed by Vanderzant and Splittstoesser (1999) and Silva et al. (2007). Results: From the total of the samples analyzed, 36.6% presented fecal coliforms and Salmonella sp.; 46.6% presented coagulase-positive Staphylococcus and 30% Bacillus cereus. There was no presence of sulphite-reducing clostridium. Conclusion: The presence of coagulase-positive Staphylococcus aureus indicates the lack of hygiene by food handlers because it is a living microorganism from the nasopharynx and the presence of Salmonella sp. and fecal coliforms indicate poor hygiene and sanitary handling. The improper handling and lack of care in relation to good practices favor the food poisoning.

Objective:To examine the association between urban food environment and regular consumption of fruits and vegetables (FV) by older adults from a medium-sized Brazilian city.Design:Cross-sectional study based on data related to (1) objective assessment of establishments with predominant sale of unprocessed/minimally processed foods, mixed establishments and establishments with predominant sale of ultra-processed foods; (2) regular consumption of FV (≥ 5 times/week), health and socio-demographic variables of community-dwelling older adults. Tertiles of proximity between food establishments and older adults’ residence were calculated. Poisson generalised estimating equations with robust variance, adjusted for individual and contextual variables, were used to estimate the independent association between the proximity of establishments and regular consumption of FV.Setting:Medium-sized Brazilian city.Subjects:Representative sample of community-dwelling older adults (n 549).Results:Older adults travelled the longest distances to establishments with predominant sale of unprocessed/minimally processed foods. The longer the distance to establishments with predominant sale of unprocessed/minimally processed foods, the lower the prevalence of regular consumption of FV (tertile 2: prevalence ratio (PR) = 0·86; 95 % CI = 0·74, 0·99; tertile 3: PR = 0·84; 95 % CI = 0·72, 0·97). Older adults living larger distance tertiles from establishments with predominant sale of ultra-processed foods, mixed establishments or all categories of establishments had 16 % (PR = 0·84; 95 % CI = 0·73, 0·96), 19 % (PR = 0·81; 95 % CI = 0·71, 0·93) and 19 % (PR = 0·81; 95 % CI = 0·70, 0·94) lower prevalence of regular consumption of FV, respectively.Conclusion:The food environment is associated with regular consumption of FV among older adults. Longer distances from the residence of older adults to food establishments are independently associated with lower prevalence of regular consumption of FV.

Production and world consumption of spices are constantly increasing. Although the antimicrobial properties of some spices are well documented, their use in the agri-food industry is also responsible for microbial contamination and spoilage. Bacterial spores introduced by spices can withstand different preparation processes, particularly thermal treatments, leading to food alterations during storage. This review brings together data from the literature about the prevalence and concentrations of spore-forming bacteria in all commercially available spices. The sporeformers found in spices belong mainly to the genera Bacillus and Clostridium. Such contaminations are very common and sometimes reach high levels, as in pepper and turmeric. Bacillus licheniformis and Bacillus cereus are the most frequently detected species. Studying the harvesting, processing, and storage procedures for spices provides elements to explain why high prevalence and concentrations are observed. Spices are mostly produced in developing countries on small farms using traditional production methods. Spices become contaminated by bacterial spores in two main ways: by contact with soil during harvesting or drying, as for pepper, or by cross-contamination during the water-cooking step, as for turmeric. From these observations, we propose some recommendations. Different methods that can be used to eliminate bacterial spores from spices are presented indicating their efficiency and the limitations of their use.

Purpose of review Ultra-processed foods (UPF) have been associated with poor diet quality and adverse health outcomes. Our aim in this review is to summarize recent research assessing the impact of UPF consumption, classified according to the NOVA system, on outcomes related to metabolic health. Recent findings Thirty recent studies with different design, quality and target population have investigated the impact of UPF consumption on parameters related to metabolic health, which were organized into: metabolic syndrome; body weight change and obesity indicators; blood pressure and hypertension; glucose profile, insulin resistance and type 2 diabetes; other metabolic risks and cardiovascular diseases and mortality. Most of the studies demonstrated adverse associations between high UPF consumption and metabolic health, mainly those with robust design and involving adults. Summary Most of the latest findings have revealed an adverse impact of high UPF consumption on metabolic health, including cardiovascular diseases and mortality. Scientific evidence is accumulating towards the necessity of curbing UPF consumption worldwide at different life stages. Nevertheless, other studies are needed to confirm the causality between UPF consumption and metabolic health in diverse scenarios and to better elucidate all likely mechanisms involved in this relationship.

Background Calorie labeling is mandated in restaurant chains with ≥20 locations nationwide, but the effect of labeling on the nutritional quality of purchased meals in fast-food settings is unclear, especially for adolescents and children. Objective To estimate the effect of calorie menu labeling on the nutrient content and composition of fast-food meal purchases in McDonald’s restaurants vs control restaurants. Design From 2010 to 2014, customers were sampled during repeated visits to McDonald’s restaurants, which voluntarily labeled menus with calorie information in 2012, and 5 control fast-food restaurant chains that had not labeled their menus over the study period. Participants/setting Restaurant receipts and questionnaires were collected from 2883 adults, 2131 adolescents, and 433 children in 4 New England cities. Main outcome measures Saturated fat, sugar, sodium, and fiber content of purchased meals, as well as nutrient densities (ie, nutrient content adjusted for total calories), were calculated after linking purchases to nutrition data from restaurant websites. Statistical analyses Difference-in-differences analyses and linear mixed models were used to examine whether calorie labeling in McDonald’s was associated with changes in nutrient content and nutrient density of purchased meals separately in adults, adolescents, and children. Results After implementation of calorie labeling at McDonald’s, adult meals contained on average 4.0% fewer calories from sugar (95% confidence interval: −7.5 to −0.5), but 1.8% more calories from saturated fat (95% confidence interval: 0.7 to 2.9) compared with control chains. The fiber content of children’s purchased meals was lower at McDonald’s after calorie labeling (change = −1.4 g, 95% confidence interval: −2.5 to −0.3). Calorie labeling was not associated with changes in nutrient quality of adolescent meals. Conclusions Calorie labeling at McDonald’s was associated with a possibly small positive change in the nutritional quality of meals in adults but not in adolescents or children. Efforts are needed to improve the nutritional quality of restaurant meals.

Background: Kebab is one of the popular ready-to-eat foods in Indonesia and sold as a street food. The purpose of this study was to determine occurrence and antibiotic resistance of Escherichia coli in street-vended kebab in Dramaga, Bogor, Indonesia. Methods: Totally, 43 samples of kebab meat were collected from street food kebab vendors. Examinations on Total Plate Count (TPC), and total E. coli using Most Probable Number (MPN) method were referred to the Indonesia National Standard. The antibiotic resistance test was carried out using the Kirby-Bauer disk diffusion method. Results: The mean of TPC in kebab samples was 5.3 log10 Colony Forming Unit (CFU)/g. Based on TPC, 13 out of 43 (30.2%) of kebab samples did not comply with the Indonesia National Standard with maximum acceptable level of 5 log10 CFU/g. E. coli was identified in 5 out of 43 samples (11.6%) with mean of 39.2 MPN/g ranged from 7.4 to 150 MPN/g which were higher than standard level (0.5 log10 CFU/g). Four out of 5 E. coli isolated from kebab samples were resistant to gentamycin. All E. coli isolates were susceptible to amoxicillin/clavulanate and chloramphenicol. Conclusion: The occurrence of antibiotic resistant E. coli in ready-to-eat kebab in this area of Indonesia could cause the health problem in consumers. The local government should conduct the monitoring and surveillance on the occurrence of pathogens and the antibiotic resistance in food chain.