A new study published in the American Journal of Preventive Medicine showed that the consumption of ultra-processed foods (UPF) precipitated premature deaths in Brazil. Therefore, discouraging the consumption of ultra-processed foods would promote considerable health benefits for this population and could also help reduce premature mortality.
Background
The Global Burden of Disease approximated that inadequate diet and undernutrition claimed an estimated 188 million disability-adjusted life years and nearly eight million lives.
There is a global increase in the consumption of processed foods, especially in developing and developed countries. Food processing increases its availability, transportability, shelf life and digestibility. These foods have a high energy density and low nutritional value.
Processed foods have been categorized as ultra-processed foods (UPFs); the extreme category is those derived from other foods (with very little whole grain, if present) with added colors, flavors, and emulsifiers. These additives make foods tasty, affordable, and convenient.
UPFs are high in salt, fats, and sugars and can become contaminated during biological, physical, and chemical processing as the food is prepared with additives and packaging substances.
Poor dietary intake is one of the main causes of global health and economic burdens. Recent studies have shown that UPF consumption is associated with a high risk of developing noncommunicable diseases (NCDs), such as obesity, cardiovascular disease, diabetes, and even cancer. This is due to the lower nutritional quality of these foods, the high glycemic loads of these foods, the low satiety potential, the higher amounts of additives, and the presence of contaminants.
However, studies describing the effects of increased consumption of ultra-processed foods are still lacking. According to a survey, the contribution of ultra-processed foods to total energy intake in Brazil increased by 5.1% in 16 years.
The study
This recent study estimated the occurrence of premature deaths in Brazil due to the intake of ultra-processed foods. A macrosimulation model for comparative risk assessment was developed to estimate the number and proportion of premature deaths from any cause. It is likely that these deaths could be prevented by lowering the UPF contribution to total energy absorption to a minimal risk level (theoretically, no UPF intake) and by lowering the UPF contribution to various counterfactual consumption scenarios.
The approach comprised three stages, the baseline intake of UPF was estimated by age group and sex using the Brazilian dietary survey (POF-Encuesta Nacional de Presupuestos Familiares 2017-18), the reduction in intake of UPF in each counterfacial scenario according to patient gender and age group and using comparative risk assessment analyzes to estimate the effects of reducing UPF intake.
Brazilian adults were divided into eight age groups based on their gender. Food and beverage consumption was collected through two 24-hour recall episodes of food intake from the 2017-18 POF Personal Food Intake Module. All beverages and foods were classified into four categories according to the NOVA classification. The proportions of ultra-processed foods with respect to total energy intake were analyzed.
Results
It was observed that the consumption habit of UPF decreased with age. On average, FPUs contributed at least 13% of total energy intake in each age group. While 541,160 people between 30 and 69 years old died prematurely in 2019, of which 261,061 deaths occurred due to preventable non-communicable diseases (NCDs).
Meanwhile, 62% of mortality occurred among men. In the same year, about 57,000 deaths were attributed to UPF consumption.
Adults in the age range of 50 to 69 years had the highest mortality rate: 66% in men and 73% in women. Population attributable fractions (PAF) were relatively higher among youth and young adults of both sexes.
A 50%, 20%, and 10% reduction in the percentage of UPF in total energy consumption was projected to postpone or prevent annual premature deaths by 29,300, 12,000, and 5,900, respectively. In fact, if UPF consumption were reduced to below the fourth quartile of UPF’s reference contribution to total energy intake, nearly 19,900 deaths could be averted; of this 60% would be men.
The authors also noted that reducing UPF consumption includes multiple interventions and public health awareness programs and planning. The promotion of healthy food environments, which can include the regulation of food marketing and the implementation of nutrition labeling, is key to discouraging the intake of UPF.
conclusion
The findings may project the impact of processed food consumption on preventable deaths. Regulatory policies to limit UPF consumption should be implemented, along with raising awareness of the general population about the side effects of processed foods and implementing dietary guidelines.
Considering the many health impacts of ultra-processed foods, a disease-specific approach would not specify the full disease burden of UPFs. Further studies are warranted to explore the public health impacts of UPFs so that proper dietary guidelines can be strictly implemented.
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