A new study published in the American Journal of Preventive Medicine showed that ultra-processed-food (UPF) consumption precipitated premature deaths in Brazil. Thus, discouraging the consumption of ultra-processed foods would promote considerable health gains in this population and may also aid in reducing premature mortality.
The Global Burden of Diseases approximated that inappropriate diet and malnutrition claimed an estimated 188 million disability-adjusted life-years and nearly eight million lives.
There is a global rise in processed food consumption, especially in developing and developed countries. Processing of foods increases their availability, transportability, shelf-life, and digestibility. These foods have high energy density and low nutritional value.
Processed foods have been categorized as ultra-processed (UPFs) foods; the extreme category is derivatives from other foods (with very little whole food, if present) with added colors, flavors, and emulsifiers. These additives make foods palatable, affordable, and convenient.
UPFs are rich in salt, fats, and sugars and may be contaminated during biological, physical, and chemical processing while the food item is prepared with additives and packaging substances.
Poor dietary intake is a leading cause of global economic and health burdens. Recent studies have demonstrated that consumption of UPFs is associated with a high risk of developing non-communicable diseases (NCDs), like obesity, cardiovascular diseases, diabetes, and even cancer. This is due to the lesser nutritional quality of such foods, the high glycemic loads of such foods, low satiety potential, higher additive quantities, and the presence of contaminants.
However, studies depicting the effects of increased ultra-processed food consumption remain lacking. According to a survey, the contribution of ultra-processed food to the total energy intake in Brazil increased by 5.1% within 16 years.
This recent study estimated premature death occurrences in Brazil due to ultra-processed food intake. A macrosimulation model was developed for comparative risk assessment to estimate the number and proportion of premature deaths due to any cause. These fatalities could likely be prevented by decreasing UPFs’ contribution to the entire energy uptake to a minimum risk level (theoretically; no intake of UPF) and by decreasing UPFs contribution to various counterfactual consumption scenarios.
The approach comprised three stages, the baseline UPFs intake was estimated by age group and sex using the Brazil dietary survey (POF-National Household Budget Survey 2017-18), the reduction in UPFs intake in every counter-facial scenario according to the patient’s gender and age group and using comparative risk assessment analysis to estimate the effects of reduced intake of UPFs.
The Brazilian adults were divided into eight age groups based on their gender. The beverage and food consumption were collected through two episodes of 24-hour recollection of food intake from the Personal Food intake module of POF 2017-18. All the beverages and foods were classified into four categories according to the NOVA classification. The proportions of ultra-processed food to the whole energy intake were analyzed.
It was observed that the UPF consumption habit decreased with age. On average, UPFs contributed at least 13% of whole energy intake in every age group. While 541,160 people between 30 to 69 years of age died prematurely in the year 2019, out of which 261,061 deaths occurred from preventable noncommunicable diseases (NCDs).
Meanwhile, 62% of the mortality occurred among males. In the same year, nearly 57,000 deaths were attributed to UPFs consumption.
Adults of the age-range 50-69 years suffered the highest mortality rate – 66% in males and 73% in females. The population attributable fractions (PAF) were relatively higher among the youngsters and younger adults of both sexes.
It was projected that a reduction in the percentage of UPFs to total energy consumption by 50%, 20%, and 10% could postpone or prevent annual premature deaths by 29300, 12000, and 5900 respectively. In fact, if UPF consumption was curtailed such that it is below the fourth quartile of the baseline contribution of UPF to total energy intake, nearly 19,900 deaths could be averted; out of this 60% would be males.
The authors also pointed out that reducing UPF consumption multiple interventions and public health awareness programs and planning. Promoting healthy food environments – which may include regulating food marketing and implementing nutritional labeling, is key to discouraging UPF intake.
The findings may project the impact of processed food consumption on preventable deaths. Regulatory policies should be implemented to limit the consumption of UPFs, together with spreading awareness amongst the general population about the side effects of processed foods and implementing dietary guidelines.
Considering the numerous impacts of ultra-processed foods on health, a disease-specific approach would not specify the total disease burden of UPFs. Further studies are warranted to explore the impacts of UPFs on public health so that proper food guidelines can be strictly implemented.
- Nilson, E. A. F., Ferrari, G., Louzada, M. L., et al. (2022). Premature deaths attributable to the consumption of ultraprocessed foods in Brazil. American Journal of Preventive Medicine. doi: https://doi.org/10.1016/j.amepre.2022.08.013.