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Ultra-processed food (UPF) consumption impacts nutrient intake and plays an important role in non-communicable diseases (NCD), even among schoolchildren. This cross-sectional study aimed to characterize the food consumption of this population and its relationship with laboratory and anthropometric aspects. A sample of 190 subjects aged 5 to 19 y was randomly selected for dietary, laboratory, and anthropometric assessment. Statistical inference was calculated using Spearman’s correlation. Excess weight was observed in 34%, a high Waist-to-Height Ratio in 9%, and hypertriglyceridemia in 17% of the subjects, higher among those from urban schools (45%, p = 0.011; 15%, p = 0.015; 24%, p = 0.026, respectively). UPF consumption represented 21% of caloric intake and showed a positive correlation with trans fatty acids (r = 0.70) and sugar (r = 0.59) intake. Unprocessed food consumption showed a weak, but significant, correlation with Body Mass Index (r = 0.22) and Waist Circumference (r = 0.23), while processed meat showed a negative correlation with serum ferritin (r = −0.16) and vitamins D (r = −0.20) and B12 (r = −0.15). These findings highlight the need for public policies to promote Food and Nutritional Security for schoolchildren to prevent NCD and nutritional deficiencies.

Aimed at improving the quality of school meals, the Sustainable School Program (SSP) implemented low-carbon meals, twice a week, in 155 schools of 4 municipalities, reaching more than 32,000 students. This study evaluated the environmental impact and nutritional viability of this intervention for this population. The 15 most repeated meals from the conventional and sustainable menus were selected, and we considered the school age group and number of meals served per student/day. Nutritional information was calculated using validated food composition tables, nutritional adequacy was assessed using National School Feeding Program (PNAE) requirements, the level of processing was considered using NOVA classification, and greenhouse gas emissions (GHGE) were estimated using food life cycle assessment (LCA) validated data. We found both conventional and sustainable food menus are equivalent, in terms of nutrients, except for calcium, iron, and magnesium. Sustainable food menus were cholesterol-free. However, there was a reduction of up to 17% in GHGE, depending on the school age group analysed. Considering the greater energy efficiency and lower environmental impact of these food menus, the SSP, therefore, demonstrates that a substantial reduction in climate impact is feasible, successful, and can be an inspiration to other regions globally. University of Manchester GCRF fellowship, funded through the University of Manchester Internal Research England GCRF QR fund. X. Schmidt was supported through Brunel University Internal Research England GCRF QR fund. During the organisation of this research, J. T. da Silva, S. Bridle, and C. Reynolds were supported, in part, through the STFC GCRF funded project “Trends in greenhouse gas emissions from Brazilian foods using GGDOT” (ST/S003320/1).

The American Heart Association Diet Score (AHA-DS) defines the cardiovascular health, and the Brazilian Cardioprotective Nutritional Program Dietary Index (BALANCE DI) was designed to evaluate diet quality in secondary cardiovascular prevention settings. Our aim was to assess the absolute and relative agreement between both tools in Brazilian adults after a myocardial infarction (MI). In this cross-sectional study, 473 individuals were included and had their diet assessed by a 24 h food recall and a semi-quantitative Food Frequency Questionnaire. The weighted Kappa between BALANCE DI and primary AHA-DS was 0.66 (95% CI: 0.08–0.21), and between BALANCE DI and total AHA-DS was 0.70 (95% CI: 0.20–0.32). To improve the agreement between the tools, modifications were made to the BALANCE DI scoring system. The weighted Kappa between New BALANCE DI and primary AHA-DS was 0.77 (95% CI: 0.36–0.48), and between BALANCE DI and total AHA-DS was 0.76 (95% CI: 0.34–0.46). The mean bias observed between the New BALANCE DI as compared to the primary and total AHA-DS was −16% (−51 to 19) and −8% (−41 to 24), respectively. Our results suggest that the New BALANCE DI may be a useful tool to evaluate diet quality in post MI patients.

Context Recent evidence suggests that modulation of the gut microbiota may contribute to body weight control. Objective This systematic review aimed to assess the effects of oral supplementation with probiotics or synbiotics on body weight, body mass index (BMI), and waist circumference in overweight and obese adults (BMI ≥ 25 kg/m2). Data sources Five electronic databases-PubMed, Embase, Cochrane Library/CENTRAL, LILACS, and Web of Science-were searched from inception to August 2017. No language restrictions were applied. Study selection Randomized and quasi-randomized parallel trials that assessed the effects of oral supplementation with probiotics or synbiotics vs any other intervention but bariatric surgery or fecal transplantation in overweight or obese adults were selected. Data extraction Three teams of 2 authors independently assessed risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Results Nineteen randomized trials (28 publications, 1412 participants) were included. There were no differences in mean body weight change [mean difference (MD), -0.54 kg; 95%CI, -1.09 to 0.01; I2 = 0%; moderate quality of evidence) or mean BMI change (MD, -0.19 kg/m2; 95%CI, -0.43 to 0.04; I2 = 51%; low quality of evidence) between groups who received probiotics or synbiotics and control groups. Oral supplementation with probiotics or synbiotics reduced mean waist circumference compared with control (MD, -0.82 cm; 95%CI, -1.43 to -0.21; I2 = 46%; low quality of evidence). Conclusions The findings suggest that oral supplementation with probiotics or synbiotics has a small effect to reduce waist circumference but no effect on body weight or BMI, although the quality of evidence is low to moderate. Therefore, the current evidence is not definitive. Large-scale trials are needed and may help to better inform clinical practice. Systematic review registration PROSPERO registration number CRD42018075126.

Copyright © 2021 van Erp, Reynolds, Maynard, Starke, Ibáñez Martín, Andres, Leite, Alvarez de Toledo, Schmidt Rivera, Trattner, Brewer, Adriano Martins, Kluczkovski, Frankowska, Bridle, Levy, Rauber, Tereza da Silva and Bosma. In this paper, we discuss the use of natural language processing and artificial intelligence to analyze nutritional and sustainability aspects of recipes and food. We present the state-of-the-art and some use cases, followed by a discussion of challenges. Our perspective on addressing these is that while they typically have a technical nature, they nevertheless require an interdisciplinary approach combining natural language processing and artificial intelligence with expert domain knowledge to create practical tools and comprehensive analysis for the food domain. Research Councils UK, the University of Manchester, the University of Sheffield, the STFC Food Network+ and the HEFCE Catalyst-funded N8 AgriFood Resilience Programme with matched funding from the N8 group of Universities; AHRC funded AHRC US-UK Food Digital Scholarship Network (Grant Reference: AH/S012591/1), STFC GCRF funded project “Trends in greenhouse gas emissions from Brazilian foods using GGDOT” (ST/S003320/1), the STFC funded project “Piloting Zooniverse for food, health and sustainability citizen science” (ST/T001410/1), and the STFC Food Network+ Awarded Scoping Project “Piloting Zooniverse to help us understand citizen food perceptions”; ESRC via the University of Sheffield Social Sciences Partnerships, Impact and Knowledge Exchange fund for “Recipe environmental impact calculator”; and through Research England via the University of Sheffield QR Strategic Priorities Fund projects “Cooking as part of a Sustainable Food System – creating an wider evidence base for policy makers”, and “Food based citizen science in the UK as a policy tool”; N8 AgriFood-funded project “Greenhouse Gas and Dietary choices Open-source Toolkit (GGDOT) hacknights.’; Brunel University internal Research England GCRF QR Fund; The University of Manchester GCRF QR Visiting Researcher Fellowship; National Institute of Informatics, Japan.

Copyright © 2021 The Author(s). Background The consumption of ultra-processed foods has increased worldwide and has been related to the occurrence of obesity and other non-communicable diseases. However, little is known about the environmental effects of ultra-processed foods. We aimed to assess the temporal trends in greenhouse gas emissions (GHGE), water footprint, and ecological footprint of food purchases in Brazilian metropolitan areas, and how these are affected by the amount of food processing. Methods In this time-series study, we used data from five Brazilian Household Budget Surveys (1987–88, 1995–96, 2002–03, 2008–09, 2017–18) to calculate GHGE, water footprint, and ecological footprint per 1000 kcal of food and beverages purchased. Food items were classified into NOVA food groups: unprocessed or minimally processed foods (G1); processed culinary ingredients (G2); processed foods (G3); and ultra-processed foods (G4). We calculated the proportion each NOVA food group contributes to daily kcal per person. Linear regression was performed to evaluate trends of the environmental impacts across the years. Findings Between 1987–88 and 2017–18, diet-related GHGE increased by 21% (from 1538·6 g CO2 equivalent [CO2e] per 1000 kcal [95% CI 1473·3–1604·0] to 1866·0 g CO2e per 1000 kcal [1788·0–1944·0]; ptrend

Summary Background & aims To evaluate the effect of the Brazilian Cardioprotective Diet Program (BALANCE Program) on inflammatory biomarkers, involved in the pathophysiology of the atherosclerosis, on inflammatory biomarkers, cardiovascular risk factors, and on plasma fatty acids in cardiovascular disease secondary prevention patients. Methods In this substudy of the BALANCE Program randomized clinical trial, a total of 369 patients aged 45 years or older, who have experienced cardiovascular disease in the previous 10 years, were included. These patients were randomized into two groups and followed up for six months: BALANCE Program group and control group (conventional nutrition advice). In the initial and six-month final visits, anthropometry (body weight, height and waist circumference), food intake evaluation by 24-h dietary recall, plasma inflammatory biomarkers (IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-α, adiponectin, and C-reactive protein levels), blood pressure, glycemia, insulinemia, lipid profile, and plasma fatty acids levels were evaluated. Results The BALANCE Program group showed increased plasma alpha-linolenic acid levels (P = 0.008), reduction in waist circumference (P = 0.049) and BMI (P = 0.032). No difference was observed among plasma inflammatory biomarkers and clinical data. Conclusion After six months of follow-up, BALANCE Program led to a significant reduction on BMI and waist circumference in individuals in secondary prevention for cardiovascular disease. Although plasmatic alpha-linolenic acid has increased, there was no impact on plasma inflammatory biomarkers. Clinical trial registration NCT01620398.

Background The diet of the Brazilian Cardioprotective Nutritional Program (BALANCE) classifies food into four groups and sets the daily amount to be consumed. The dietary approach of BALANCE is different from other dietary recommendations; therefore, it is not possible to use existing dietary indexes (DI) to assess patient’s adequacy to BALANCE diet. For this reason, it is important to develop a specific dietary index based on BALANCE diet. This study aims to describe the development of the BALANCE DI, evaluate its internal consistency, construct and content validity and population characteristics associated with the index. Methods We analyzed baseline data from the BALANCE randomized clinical trial (https://www.clinicaltrials.gov/; NCT01620398). The four food groups of the diet were adopted as index components. Points ranging from 0 to 10 were given to each index component. Internal consistency was evaluated by correlation coefficients between total score and component scores, as well as Cronbach’s Alpha. Content and construct validity were assessed by checking how nutrients are associated with the index and if the index could distinguish between groups with known differences in diet, respectively. Crude and adjusted linear regression analyses were performed to evaluate population characteristics associated with the index. Results The analysis included 2044 subjects (58.6% men). The average of the total index was higher among women (p 0.40. Cronbach’s alpha coefficient was 0.66. High scores in the index were inversely associated (p

Background Proinflammatory biomarkers levels are increased among patients with cardiovascular disease, and it is known that both the presence of insulin resistance and diet may influence those levels. However, these associations are not well studied among patients with established cardiovascular disease. Our objective is to compare inflammatory biomarker levels among cardiovascular disease secondary prevention patients with and without insulin resistance, and to evaluate if there is any association between plasma fatty acid levels and inflammatory biomarker levels among them. Methods In this cross-sectional sub-study from the BALANCE Program Trial, we collected data from 359 patients with established cardiovascular disease. Plasma fatty acids and inflammatory biomarkers (interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, high sensitive C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor (TNF)-alpha) were measured. Biomarkers and plasma fatty acid levels of subjects across insulin resistant and not insulin resistant groups were compared, and general linear models were used to examine the association between plasma fatty acids and inflammatory biomarkers. Results Subjects with insulin resistance had a higher concentration of hs-CRP (p = 0.002) and IL-6 (p = 0.002) than subjects without insulin resistance. Among subjects without insulin resistance there was a positive association between stearic fatty acid and IL-6 (p = 0.032), and a negative association between alpha-linolenic fatty acid and pro-inflammatory biomarkers (p