Processed foods thesis

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Cooking at home is itself a form of processing. In fact, the majority of foods in the modern diet are processed and they have been for centuries. In most cases, food processing ensures food safety. And beyond that, fortifying foods, which can be defined as strengthening and improving, leads to enhanced nutritional value. On the contrary, processing can actually improve nutritional values. This is why as a standard practice, food processing engineers invest significant energy into minimizing the impact of processing on the nutritional value of food.

Are good intensions misleading consumers? The NOVA classification system and subsequent assertions are particularly troublesome because they make a direct correlation with ultra-processed food being bad for you. When looking at the classifications, I see two fundamental areas creating confusion and misinformation.


How Ultra-Processed Foods Are Killing Us - The Atlantic

First, the distinction of nutrient levels versus degree of processing. Recommendations from the USDA and Department of Health and Human Services on how to make healthy food and beverage choices are based on data that links nutrient intake with the prevention of noncommunicable chronic diseases. On the other hand, the NOVA classification is not based on nutrient intake but rather on the degree of processing. However well-intentioned, that classification is over simplified.

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Second, the way ultra-processed is defined. Such ingredients often include those also used in processed foods, such as sugar, oils, fats, salt, anti-oxidants, stabilizers, and preservatives. Implying that a food product with five or more ingredients is somehow unhealthy and even dangerous is arbitrary and, in many cases simply untrue. A call for clearer classification and communication Processed foods are a valuable part of the modern diet that can provide safe food and a significant amount of nutrients for the global population.

Further studies are needed to better understand the relative effect of the various dimensions of processing nutritional composition, food additives, contact materials, and neoformed contaminants in these associations. Cancer represents a major worldwide burden, with At the same time, during the past decades, diets in many countries have shifted towards a dramatic increase in consumption of ultra-processed foods. This dietary trend may be concerning and deserves investigation.

Several characteristics of ultra-processed foods may be involved in causing disease, particularly cancer. Firstly, ultra-processed foods often have a higher content of total fat, saturated fat, and added sugar and salt, along with a lower fibre and vitamin density. Studying potential effects on health of ultra-processed foods is a very recent field of research, facilitated by the development of the NOVA classification of products according to their degree of food processing. To our knowledge, this prospective study was the first to evaluate the association between the consumption of ultra-processed food products and the incidence of cancer, based on a large cohort study with detailed and up to date assessment of dietary intake.

This cohort has been previously described in detail.

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All questionnaires are completed online using a dedicated website www. Participants are followed using an online platform connected to their email address. Newsletters and alerts about new questionnaires are sent by email. At inclusion, participants completed a set of five questionnaires related to sociodemographic and lifestyle characteristics for example, date of birth, sex, occupation, educational level, smoking status, number of children , 32 anthropometry height, weight , dietary intakes see below , 33 34 physical activity validated seven day International Physical Activity Questionnaire IPAQ , 35 and health status personal and family history of diseases, drug use including use of hormonal treatment for menopause and oral contraceptives, and menopausal status.

Participants were invited to complete a series of three non-consecutive, validated, web based 24 hour dietary records every six months to vary the season of completion , randomly assigned over a two week period two weekdays and one weekend day. We did not exclude participants if they did not complete all optional questionnaires.


Portion sizes were estimated using previously validated photographs or usual containers. Sodium intake was assessed via a specific module included in the 24 hour records, taking into account native sodium in foods, salt added during the cooking, and salt added on the plate. It has been validated against sodium urinary excretion biomarkers.

This group includes mass produced packaged breads and buns; sweet or savoury packaged snacks; industrialised confectionery and desserts; sodas and sweetened drinks; meat balls, poultry and fish nuggets, and other reconstituted meat products transformed with addition of preservatives other than salt for example, nitrites ; instant noodles and soups; frozen or shelf stable ready meals; and other food products made mostly or entirely from sugar, oils and fats, and other substances not commonly used in culinary preparations such as hydrogenated oils, modified starches, and protein isolates.

Industrial processes notably include hydrogenation, hydrolysis, extruding, moulding, reshaping, and pre-processing by frying. Flavouring agents, colours, emulsifiers, humectants, non-sugar sweeteners, and other cosmetic additives are often added to these products to imitate sensorial properties of unprocessed or minimally processed foods and their culinary preparations or to disguise undesirable qualities of the final product.

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As previously described, 44 we identified homemade and artisanal food preparations, decomposed them using standardised recipes, and applied the NOVA classification to their ingredients. Precision and examples are shown in appendix 1. Participants self declared health events through the yearly health status questionnaire, through a specific check-up questionnaire for health events every three months , or at any time through a specific interface on the study website. For each incident cancer declared, a physician from the study team contacted participants and asked them to provide any relevant medical records.

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  4. Afterwards, an expert committee of physicians reviewed all medical data. Our research team was the first in France to obtain the authorisation by decree in the Council of State No to link data from our cohorts to medico-administrative databases of the national health insurance system SNIIRAM databases. We therefore completed declared health events with the information from these databases, thereby limiting any potential bias due to participants with cancer who may not report their disease to the study investigators.

    We classified cancer cases by using the international classification of diseases, 10th revision ICD In this study, we considered all first primary cancers diagnosed between the inclusion date and 1 January to be cases, except for basal cell skin carcinoma, which we did not consider as cancer. The flowchart is in appendix 2. We determined the proportion of ultra-processed foods in the diet by calculating a weight ratio rather than an energy ratio to take into account processed foods that do not provide any energy in particular artificially sweetened drinks and non-nutritional factors related to food processing for example, neoformed contaminants, food additives, and alterations to the structure of raw foods.

    Corresponding values are provided in the footnote to table 1. To avoid massive imputation for a non-negligible number of participants or exclusion of those with missing data and risk of selection bias, we included a missing class into the models for this variable.

    We used Cox proportional hazards models with age as the primary timescale to evaluate the association between the proportion of ultra-processed foods in the diet coded as a continuous variable or as sex specific quarters and incidence of overall, breast, prostate, and colorectal cancer. In these models, cancers at other locations than the one studied were censored at the date of diagnosis that is, we considered them to be non-cases for the cancer of interest and they contributed person years until the date of diagnosis of their cancer.

    We generated log-log survival versus log-time plots to confirm risk proportionality assumptions. We tested for linear trend by using the ordinal score on sex specific quarters of ultra-processed food. Participants contributed person time until the date of diagnosis of cancer, the date of last completed questionnaire, the date of death, or 1 January , whichever occurred first. Breast cancer analyses were additionally stratified by menopausal status. We determined age at menopause by using the yearly health status questionnaires completed during follow-up.

    Values are numbers percentages unless stated otherwise. To test for the potential influence of the nutritional quality of the diet in the relation between intake of ultra-processed food and risk of cancer, this model was additionally adjusted for lipid, sodium, and carbohydrate intakes model 2 , for a Western dietary pattern derived from principal component analysis model 3 details in appendix 3 , or for all these nutritional factors together model 4. In addition, we did mediation analyses according to the method proposed by Lange et al to evaluate the direct and indirect effect of the relation between the exposure and the outcome through the following nutritional mediators: intakes of sodium, total lipids, saturated, mono-unsaturated and poly-unsaturated fatty acids, carbohydrates, and a Western-type dietary pattern.

    We also investigated the association between ultra-processed food and overall cancer risk separately in different strata of the population: men, women, younger adults under 40 years , older adults 40 years or over , smokers, non-smokers, participants with a high level of physical activity, and those with a low to moderate level of physical activity.

    We also tested models after restriction of the study population to the participants with at least six 24 hour dietary records during the first two years of follow-up. Similarly, we tested models including all participants with at least one 24 hour dietary record during the first two years of follow-up. Secondary analyses tested the associations between the proportion in the diet of each of the three other NOVA categories of food processing continuous and risk of cancer, using multivariate Cox models adjusted for model 1 covariates.

    Processed Foods Essay Examples

    We used SAS version 9. The mean age of participants was The mean number of dietary records per participant over their first two years of follow-up was 5. After the launching of the study by the end of May , half of the records were filled between June and November and the other half between December and May.

    Table 1 shows the main baseline characteristics of participants according to quarters of the proportion of ultra-processed foods in the diet. Compared with the lowest quarter, participants in the highest quarter of ultra-processed food intake tended to be younger, current smokers, and less educated, with less family history of cancer and a lower physical activity level. Furthermore, they had higher intakes of energy, lipids, carbohydrates, and sodium, along with lower alcohol intake. Although there was a higher proportion of women than men in this cohort, the contribution of ultra-processed foods to the overall diet was very similar between men and women The distribution of the proportion of ultra-processed food in the diet in the study population is shown in appendix 5.

    Among these cases, 4. Table 2 shows associations between the proportion of ultra-processed foods in the diet and risks of overall, breast, prostate, and colorectal cancer. Figure 2 shows the corresponding cumulative incidence curves. In model 1, ultra-processed food intake was associated with increased risks of overall cancer hazard ratio for a 10 point increment in the proportion of ultra-processed foods in the diet 1. The association with overall cancer risk was statistically significant in all strata of the population investigated, after adjustment for model 1 covariates: in men hazard ratio for a 10 point increment in the proportion of ultra-processed foods in the diet 1.

    Cumulative cancer incidence overall cancer risk according to quarters of proportion of ultra-processed food in diet.

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