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)

Martinez-Perez, CeliaSan-Cristobal, RodrigoGuallar-Castillon, PilarMartínez-González, Miguel ÁngelSalas-Salvadó, JordiCorella, DoloresCastañer, OlgaMartinez, Jose AlfredoAlonso-Gómez, Ángel M.Wärnberg, JuliaVioque, JesúsRomaguera, DoraLópez-Miranda, JoséEstruch, RamonTinahones, Francisco J.Lapetra, JoséSerra-Majem, LluisBueno-Cavanillas, AuroraTur, Josep A.Martín Sánchez, VicentePintó, XavierGaforio, José J.Matía-Martín, PilarVidal, JosepVázquez, ClotildeRos, EmilioBabio, NancySorlí, Jose V.Lassale, CamillePérez-Sanz, BeatrizVaquero-Luna, JessicaAjejas Bazán, María JuliaBarceló-Iglesias, María ConcepciónKonieczna, JadwigaRíos, Antonio GarcíaBernal-López, María RosaSantos-Lozano, José ManuelToledo, EstefaníaBecerra-Tomás, NereaPortoles, OlgaZomeño, María DoloresAbete, ItziarMoreno-Rodriguez, AnaiLecea-Juarez, OscarNishi, Stephanie K.Muñoz-Martínez, JúliaOrdovás, José M.Daimiel, Lidia2024-02-192024-02-192021-07-20Martinez-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.http://hdl.handle.net/10668/4560https://hdl.handle.net/20.500.13003/19890http://hdl.handle.net/20.500.12105/18408The 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.engVoRhttp://creativecommons.org/licenses/by/4.0/Cardiometabolic riskClassification systemsDietFood processingIARCIFICNOVAPREDIMED-PlusUltra-processed foodUNCOverweightMediterranean dietMetabolic syndromeBody mass indexObesityFactores de riesgo cardiometabólicoClasificaciónDietaManipulación de alimentosAlimentos ultraprocesadosSobrepesoDieta mediterráneaSíndrome metabólicoÍndice de masa corporalObesidadAgedCohort StudiesDietDiet SurveysDiet, MediterraneanFast FoodsFemaleFood HandlingHumansIncidenceLinear ModelsMaleMetabolic Syndrome XMiddle AgedSpainOverweightBody Mass IndexObesityInternational AgenciesCardiovascular DiseasesQuestionnairesUse 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)Attribution 4.0 International3437198210.3390/nu130724712072-6643Nutrientsopen accessModelos LinealesEstudios de CohortesDieta MediterráneaIncidenciaComida RápidaSíndrome MetabólicoFactores de Riesgo CardiometabólicoFemeninoDietaMasculinoManipulación de AlimentosEncuestas sobre DietasHumanosPersona de Mediana EdadAncianoEspaña2-s2.0-85110436190676567800001L2007850108