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00925njm 22002777a 4500 dc Martinez-Perez, Celia author San-Cristobal, Rodrigo author Guallar-Castillon, Pilar author Martínez-González, Miguel Ángel author Salas-Salvadó, Jordi author Corella, Dolores author Castañer, Olga author Martinez, Jose Alfredo author Alonso-Gómez, Ángel M. author Wärnberg, Julia author Vioque, Jesús author Romaguera, Dora author López-Miranda, José author Estruch, Ramon author Tinahones, Francisco J. author Lapetra, José author Serra-Majem, Lluis author Bueno-Cavanillas, Aurora author Tur, Josep A. author Martín Sánchez, Vicente author Pintó, Xavier author Gaforio, José J. author Matía-Martín, Pilar author Vidal, Josep author Vázquez, Clotilde author Ros, Emilio author Babio, Nancy author Sorlí, Jose V. author Lassale, Camille author Pérez-Sanz, Beatriz author Vaquero-Luna, Jessica author Ajejas Bazán, María Julia author Barceló-Iglesias, María Concepción author Konieczna, Jadwiga author Ríos, Antonio García author Bernal-López, María Rosa author Santos-Lozano, José Manuel author Toledo, Estefanía author Becerra-Tomás, Nerea author Portoles, Olga author Zomeño, María Dolores author Abete, Itziar author Moreno-Rodriguez, Anai author Lecea-Juarez, Oscar author Nishi, Stephanie K. author Muñoz-Martínez, Júlia author Ordovás, José M. author Daimiel, Lidia author 2021-07-20 The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers. Martinez-Perez C, San-Cristobal R, Guallar-Castillon P, Martinez-Gonzalez MA, Salas-Salvado J, Corella D, et al. Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort). Nutrients. 2021 Jul;13(7):2471. 10.3390/nu13072471 2072-6643 Nutrients http://hdl.handle.net/10668/4560 https://hdl.handle.net/20.500.13003/19890 34371982 L2007850108 2-s2.0-85110436190 http://hdl.handle.net/20.500.12105/18408 676567800001 Cardiometabolic risk Classification systems Diet Food processing IARC IFIC NOVA PREDIMED-Plus Ultra-processed food UNC Overweight Mediterranean diet Metabolic syndrome Body mass index Obesity Factores de riesgo cardiometabólico Clasificación Dieta Manipulación de alimentos Alimentos ultraprocesados Sobrepeso Dieta mediterránea Síndrome metabólico Índice de masa corporal Obesidad Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort)