FERNANDA RAUBER
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
47 resultados
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- Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: application of the Nova classification and validation using selected biomarkers of food processing (vol 9, 1035580 , 2022)(2023) HUYBRECHTS, Inge; RAUBER, Fernanda; NICOLAS, Genevieve; CASAGRANDE, Corinne; KLIEMANN, Nathalie; WEDEKIND, Roland; BIESSY, Carine; SCALBERT, Augustin; TOUVIER, Mathilde; ALEKSANDROVA, Krasimira; JAKSZYN, Paula; SKEIE, Guri; BAJRACHARYA, Rashmita; BOER, Jolanda M. A.; BORNE, Yan; CHAJES, Veronique; DAHM, Christina C.; DANSERO, Lucia; GUEVARA, Marcela; HEATH, Alicia K.; IBSEN, Daniel B.; PAPIER, Keren; KATZKE, Verena; KYRO, Cecilie; MASALA, Giovanna; MOLINA-MONTES, Esther; ROBINSON, Oliver J. K.; PABLOS, Carmen Santiuste de; SCHULZE, Matthias B.; SIMEON, Vittorio; SONESTEDT, Emily; TJONNELAND, Anne; TUMINO, Rosario; SCHOUW, Yvonne T. van der; VERSCHUREN, W. M. Monique; VOZAR, Beatrice; WINKVIST, Anna; GUNTER, Marc J.; MONTEIRO, Carlos A.; MILLETT, Christopher; LEVY, Renata Bertazzi
- Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: Application of the Nova classification and validation using selected biomarkers of food processing(2022) HUYBRECHTS, Inge; RAUBER, Fernanda; NICOLAS, Genevieve; CASAGRANDE, Corinne; KLIEMANN, Nathalie; WEDEKIND, Roland; BIESSY, Carine; SCALBERT, Augustin; TOUVIER, Mathilde; ALEKSANDROVA, Krasimira; JAKSZYN, Paula; SKEIE, Guri; BAJRACHARYA, Rashmita; BOER, Jolanda M. A.; BORNE, Yan; CHAJES, Veronique; DAHM, Christina C.; DANSERO, Lucia; GUEVARA, Marcela; HEATH, Alicia K.; IBSEN, Daniel B.; PAPIER, Keren; KATZKE, Verena; KYRO, Cecilie; MASALA, Giovanna; MOLINA-MONTES, Esther; ROBINSON, Oliver J. K.; PABLOS, Carmen Santiuste de; SCHULZE, Matthias B.; SIMEON, Vittorio; SONESTEDT, Emily; TJONNELAND, Anne; TUMINO, Rosario; SCHOUW, Yvonne T. van der; VERSCHUREN, W. M. Monique; VOZAR, Beatrice; WINKVIST, Anna; GUNTER, Marc J.; MONTEIRO, Carlos A.; MILLETT, Christopher; LEVY, Renata BertazziBackground: Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) ""Ultra-processed"" foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements. Methods: After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25-p75: 58-66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF). Results: Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were -0.07 and -0.37 for elaidic acid and 4-methyl syringol sulfate, respectively). Conclusion: These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods.
- Food Processing and Risk of Crohn's Disease and Ulcerative Colitis: A European Prospective Cohort Study(2023) MEYER, Antoine; DONG, Catherine; CASAGRANDE, Corinne; CHAN, Simon S. M.; HUYBRECHTS, Inge; NICOLAS, Genevieve; RAUBER, Fernanda; LEVY, Renata Bertazzi; MILLETT, Christopher; OLDENBURG, Bas; WEIDERPASS, Elisabete; HEATH, Alicia K.; TONG, Tammy Y. N.; TJONNELAND, Anne; KYRO, Cecilie; KAAKS, Rudolf; KATZKE, Verena A.; BERGMAN, Manuela M.; PALLI, Domenico; MASALA, Giovanna; TUMINO, Rosario; SACERDOTE, Carlotta; COLORADO-YOHAR, Sandra M.; SANCHEZ, Maria-Jose; GRIP, Olof; LINDGREN, Stefan; LUBEN, Robert; GUNTER, Marc J.; MAHAMAT-SALEH, Yahya; BOUTRON-RUAULT, Marie-Christine; CARBONNEL, FranckBACKGROUND & AIMS: Industrial foods have been associated with increased risks of several chronic conditions. We investigated the relationship between the degree of food processing and risks of Crohn's dis-ease (CD) and ulcerative colitis (UC) in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Analyses included 413,590 participants (68.6% women; mean baseline age, 51.7 y) from 8 European countries. Dietary data were collected at baseline from validated country-specific dietary ques-tionnaires. Associations between proportions of unprocessed/minimally processed and ultra -processed food intake and CD and UC risks were estimated using Cox models to obtain hazard ratios (HRs) and 95% CIs. Models were stratified by center, age, and sex, and adjusted for smoking status, body mass index, physical activity, energy intake, educational level, and alcohol consumption.RESULTS: During a mean follow-up period of 13.2 years, 179 incident cases of CD and 431 incident cases of UC were identified. The risk of CD was lower in people consuming high proportions of un-processed/minimally processed foods (adjusted HR for the highest vs lowest quartile: 0.57; 95% CI, 0.35-0.93; P trend < .01), particularly fruits and vegetables (adjusted HRs, 0.54; 95% CI, 0.34-0.87 and 0.55; 95% CI, 0.34-0.91, respectively). There was no association between un-processed/minimally processed food intake and the risk of UC. No association was detected between ultraprocessed food consumption and CD or UC risks.CONCLUSIONS: In the European Prospective Investigation into Cancer and Nutrition cohort, consumption of unprocessed/minimally processed foods was associated with a lower risk of CD. No association between UC risk and food processing was found.
- Ultra-Processed Food Consumption and Chronic Non-Communicable Diseases-Related Dietary Nutrient Profile in the UK (2008-2014)(2018) RAUBER, Fernanda; LOUZADA, Maria Laura da Costa; STEELE, Euridice Martinez; MILLETT, Christopher; MONTEIRO, Carlos Augusto; LEVY, Renata BertazziWe described the contribution of ultra-processed foods in the U.K. diet and its association with the overall dietary content of nutrients known to affect the risk of chronic non-communicable diseases (NCDs). Cross-sectional data from the U.K. National Diet and Nutrition Survey (2008-2014) were analysed. Food items collected using a four-day food diary were classified according to the NOVA system. The average energy intake was 1764 kcal/day, with 30.1% of calories coming from unprocessed or minimally processed foods, 4.2% from culinary ingredients, 8.8% from processed foods, and 56.8% from ultra-processed foods. As the ultra-processed food consumption increased, the dietary content of carbohydrates, free sugars, total fats, saturated fats, and sodium increased significantly while the content of protein, fibre, and potassium decreased. Increased ultra-processed food consumption had a remarkable effect on average content of free sugars, which increased from 9.9% to 15.4% of total energy from the first to the last quintile. The prevalence of people exceeding the upper limits recommended for free sugars and sodium increased by 85% and 55%, respectively, from the lowest to the highest ultra-processed food quintile. Decreasing the dietary share of ultra-processed foods may substantially improve the nutritional quality of diets and contribute to the prevention of diet-related NCDs.
- Social inequality in food consumption between 2008 and 2019 in Brazil(2022) CREPALDI, Barbara Virginia Caixeta; OKADA, Leticia Martins; RAUBER, Fernanda; LEVY, Renata Bertazzi; AZEREDO, Catarina MachadoObjective: To analyse the trend of social inequality in food consumption among Brazilians from 2008 to 2019. Design: Time series analyses using cross-sectional annual data from the Telephone Surveillance System (VIGITEL 2008-2019). Food consumption was evaluated through: (1) consumption of five or more portions of fruits and vegetables in >= 5 d/week; (2) consumption of beans in >= 5 d/week and (3) consumption of soft drinks or artificial juices in >= 5 d/week. Absolute inequality was assessed by the slope index of inequality (SII) and relative inequality by the concentration index (CIX). SII and CIX positive values indicate higher prevalence among more educated citizens and negative among less educated ones. Time trend was assessed by linear regression using weighted least squares. Setting: 26 Brazilian state capitals and the Federal District. Participants: 621 689 individuals >= 18 years. Results: Fruits and vegetable consumption was more prevalent among the more educated citizens, while beans were mostly consumed by the less educated, and soft drinks or artificial juices was more prevalent among individuals with intermediate education. The highest absolute inequality was found for beans (SII2019 -25 center dot 9). In 12 years, the absolute inequality increased for fruit and vegetable consumption (from SII2008 12 center dot 8 to SII2019 16 center dot 2), remained for beans (SII2008 -23 center dot 1 to SII2019 -25 center dot 9) and reduced for soft drinks or artificial juices (SII2008 8 center dot 7 to SII2019 0 center dot 4). Relative inequality was low and constant. Conclusion: Despite the advances reducing inequalities in soft drinks or artificial juice consumption, the increase in the social gap for adequate consumption of fruits and vegetables is troublesome.
- Best practices for applying the Nova food classification system(2023) MARTINEZ-STEELE, Euridice; KHANDPUR, Neha; BATIS, Carolina; BES-RASTROLLO, Maira; BONACCIO, Marialaura; CEDIEL, Gustavo; HUYBRECHTS, Inge; JUUL, Filippa; LEVY, Renata B.; LOUZADA, Maria Laura da Costa; MACHADO, Priscila P.; MOUBARAC, Jean-Claude; NANSEL, Tonja; RAUBER, Fernanda; SROUR, Bernard; TOUVIER, Mathilde; MONTEIRO, Carlos A.The assignment of foods to one of four categories proposed by the Nova framework may be challenging in the absence of information on how these foods were prepared and their specific composition. A three-step iterative approach can make the categorization process more efficient and transparent, thereby increasing the accuracy of Nova estimates.
- Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health(2022) STRATAKIS, Nikos; SISKOS, Alexandros P.; PAPADOPOULOU, Eleni; NGUYEN, Anh N.; ZHAO, Yinqi; MARGETAKI, Katerina; LAU, Chung-Ho E.; COEN, Muireann; MAITRE, Lea; FERNANDEZ-BARRES, Silvia; AGIER, Lydiane; ANDRUSAITYTE, Sandra; BASAGANA, Xavier; BRANTSAETER, Anne Lise; CASAS, Maribel; FOSSATI, Serena; GRAZULEVICIENE, Regina; HEUDE, Barbara; MCEACHAN, Rosemary R. C.; MELTZER, Helle Margrete; MILLETT, Christopher; RAUBER, Fernanda; ROBINSON, Oliver; ROUMELIOTAKI, Theano; BORRAS, Eva; SABIDO, Eduard; URQUIZA, Jose; VAFEIADI, Marina; VINEIS, Paolo; VOORTMAN, Trudy; WRIGHT, John; V, David Conti; VRIJHEID, Martine; KEUN, Hector C.; CHATZI, LedaUrinary metabolic profiling is a promising powerful tool to reflect dietary intake and can help understand metabolic alterations in response to diet quality. Here, we used H-1 NMR spectroscopy in a multicountry study in European children (1147 children from 6 different cohorts) and identified a common panel of 4 urinary metabolites (hippurate, N-methylnicotinic acid, urea, and sucrose) that was predictive of Mediterranean diet adherence (KIDMED) and ultra-processed food consumption and also had higher capacity in discriminating children's diet quality than that of established sociodemographic determinants. Further, we showed that the identified metabolite panel also reflected the associations of these diet quality indicators with C-peptide, a stable and accurate marker of insulin resistance and future risk of metabolic disease. This methodology enables objective assessment of dietary patterns in European child populations, complementary to traditional questionary methods, and can be used in future studies to evaluate diet quality. Moreover, this knowledge can provide mechanistic evidence of common biological pathways that characterize healthy and unhealthy dietary patterns, and diet-related molecular alterations that could associate to metabolic disease.
- Food and Nutrition Surveillance System markers predict diet quality(2023) LOUZADA, Maria Laura da Costa; COUTO, Vanessa Del Castillo Silva; RAUBER, Fernanda; TRAMONTT, Claudia Raulino; SANTOS, Thanise Sabrina Souza; LOURENCO, Barbara Hatzlhoffer; JAIME, Patricia ConstanteOBJECTIVE: To investigate the performance of food consumption markers of the Food and Nutrition Surveillance System (Sisvan) in assessing the overall dietary quality.METHODS: The study was carried out based on the reproduction of responses to markers in 24-hour recall data from 46,164 individuals aged >= 10 years, from the 2017-2018 Household Budget Survey (POF). Seven Sisvan markers were evaluated, and two scores were calculated for each participant, based on the sum of the number of healthy food markers (beans, fruits, and vegetables, ranging from 0 to 3) and unhealthy (hamburgers/sausages, sweetened beverages, instant noodles/salt snacks/crackers, stuffed cookies/sweets/candies, ranging from 0 to 4) consumed. Linear regression analyses were used to assess the association between scores and diet quality indicators (ultra-processed foods, dietary diversity, and levels of saturated and trans fat, added sugar, sodium, potassium, and fiber in the diet).RESULTS: The score of healthy eating markers increased significantly with increasing dietary diversity and potassium and fiber contents in the diet, while the opposite trend was observed for the densities of added sugar, sodium, saturated and trans fat (p < 0.001). The score of unhealthy eating markers increased significantly with the increase in the consumption of ultra-processed foods and densities of added sugar, saturated and trans fat levels in the diet, while an inverse trend was observed for potassium and fiber (p < 0.001). The joint analysis of the combination of the two marker scores showed that individuals with better performance (3 in the healthy food score, and 0 in the unhealthy food score) have a lower number of inadequacies in nutrient consumption.CONCLUSION: Sisvan food consumption markers, quickly and easily applied and already incorporated into the Brazilian public health system, have good potential to reflect the overall dietary quality.
- The burden of excessive saturated fatty acid intake attributed to ultra-processed food consumption: a study conducted with nationally representative cross-sectional studies from eight countries(2021) STEELE, Euridice Martinez; BATIS, Carolina; CEDIEL, Gustavo; LOUZADA, Maria Laura da Costa; KHANDPUR, Neha; MACHADO, Priscila; MOUBARAC, Jean-Claude; RAUBER, Fernanda; JEDLICKI, Marcela Reyes; LEVY, Renata Bertazzi; MONTEIRO, Carlos A.Cross-sectional nutritional survey data collected in eight countries were used to estimate saturated fatty acid intakes. Our objective was to estimate the proportion of excessive saturated fatty acid intakes (>10 % of total energy intake) that could be avoided if ultra-processed food consumption was reduced to levels observed in the first quintile of each country. Secondary analysis was performed of 24 h dietary recall or food diary/record data collected by the most recently available nationally representative cross-sectional surveys carried out in Brazil (2008-9), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011-12), the UK (2008-16), Canada (2015) and the US (2015-16). Population attributable fractions estimated the impact of reducing ultra-processed food consumption on excessive saturated fatty acid intakes (above 10 % of total energy intake) in each country. Significant relative reductions in the percentage of excessive saturated fatty acid intakes would be observed in all countries if ultra-processed food consumption was reduced to levels observed in the first quintile's consumption. The reductions in excessive intakes ranged from 10.0 % (95 % CI 6.2-13.6 %) in Canada to 35.0 % (95 % CI 28.7-48.0 %) in Mexico. In all eight studied countries, all presenting more than 30 % of intakes with excessive saturated fatty acids, lowering the dietary contribution of ultra-processed foods to attainable, context-specific levels was shown to be a potentially effective way to reduce the percentage of intakes with excessive saturated fatty acids, which may play an important role in the prevention of non-communicable diseases, particularly cardiovascular diseases.
- Degree of food processing and breast cancer risk in black urban women from Soweto, South African: the South African Breast Cancer study(2022) JACOBS, Inarie; TALJAARD-KRUGELL, Christine; WICKS, Mariaan; CUBASCH, Herbert; JOFFE, Maureen; LAUBSCHER, Ria; ROMIEU, Isabelle; LEVY, Renata B.; RAUBER, Fernanda; BIESSY, Carine; RINALDI, Sabina; HUYBRECHTS, IngeThis study aimed to investigate the association between consumption of ultra-processed foods, whole foods and breast cancer risk in black women from Soweto, South Africa. A population-based case (n 396)-control (n 396) study matched on age and residence, using data from the South African Breast Cancer study. Dietary intake was assessed using a validated quantified FFQ. Food items were categorised using the NOVA system ((1) unprocessed/minimally processed foods, (2) culinary ingredients, (3) processed foods and (4) ultra-processed foods). Conditional logistic regression models were used to estimate OR and 95 % CI of dietary contributions from each NOVA food group (as a percentage of total energy intake (EI)) and adjusting for potential confounders. Considering contributions to total EI per day, ultra-processed food consumption contributed to 44 center dot 8 % in cases and 47 center dot 9 % in controls, while unprocessed/minimally processed foods contributed to 38 center dot 8 % in cases and 35 center dot 2 % in controls. Unprocessed/minimally processed food consumption showed an inverse association with breast cancer risk overall (OR = 0 center dot 52, 95 % CI 0 center dot 35, 0 center dot 78), as well as in pre- and postmenopausal women separately (OR = 0 center dot 52, 95 % CI 0 center dot 27, 0 center dot 95 and OR = 0 center dot 55, 95 % CI 0 center dot 35, 0 center dot 89, respectively) and in women with progesterone positive breast cancer (OR = 0 center dot 23, 95 % CI 0 center dot 06, 0 center dot 86). There was no heterogeneity in association with breast cancer when analyses were stratified according to BMI. No significant associations were observed for the consumption of other NOVA food groups. Intake of unprocessed/minimally processed foods may reduce the risk of developing breast cancer in black women from Soweto, South Africa.