RENATA BERTAZZI LEVY
Projetos de Pesquisa
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LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
13 resultados
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- Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada(2013) MOUBARAC, Jean-Claude; MARTINS, Ana Paula Bortoletto; CLARO, Rafael Moreira; LEVY, Renata Bertazzi; CANNON, Geoffrey; MONTEIRO, Carlos AugustoObjective: To investigate consumption of ultra-processed products in Canada and to assess their association with dietary quality. Design: Application of a classification of foodstuffs based on the nature, extent and purpose of food processing to data from a national household food budget survey. Foods are classified as unprocessed/minimally processed foods (Group 1), processed culinary ingredients (Group 2) or ultra-processed products (Group 3). Setting: All provinces and territories of Canada, 2001. Subjects: Households (n 5643). Results: Food purchases provided a mean per capita energy availability of 8908 (SE 81) kJ/d (2129 (SE 19) kcal/d). Over 61.7% of dietary energy came from ultra-processed products (Group 3), 25.6% from Group 1 and 12.7% from Group 2. The overall diet exceeded WHO upper limits for fat, saturated fat, free sugars and Na density, with less fibre than recommended. It also exceeded the average energy density target of the World Cancer Research Fund/American Institute for Cancer Research. Group 3 products taken together are more fatty, sugary, salty and energy-dense than a combination of Group 1 and Group 2 items. Only the 20% lowest consumers of ultra-processed products (who consumed 33.2% of energy from these products) were anywhere near reaching all nutrient goals for the prevention of obesity and chronic non-communicable diseases. Conclusions: The 2001 Canadian diet was dominated by ultra-processed products. As a group, these products are unhealthy. The present analysis indicates that any substantial improvement of the diet would involve much lower consumption of ultra-processed products and much higher consumption of meals and dishes prepared from minimally processed foods and processed culinary ingredients.
conferenceObject TIME TRENDS CHANGES IN THE CONSUMPTION OF PROCESSED AND ULTRA-PROCESSED FOOD AND DRINK PRODUCTS DURING THE 20TH CENTURY IN CANADA(2013) MOUBARAC, J. C.; BATAL, M.; MARTINS, A. P. Bortoletto; CLARO, R.; LEVY, R. B.; CANNON, G.; MONTEIRO, C.- Ultra-processing. An odd 'appraisal'(2018) MONTEIRO, Carlos A.; CANNON, Geoffrey; MOUBARAC, Jean-Claude; LEVY, Renata B.; LOUZADA, Maria Laura C.; JAIME, Patricia C.It is now generally agreed that the impact of the current nature, purpose and extent of food processing on human well-being, health and disease needs to be better understood and explained, in order to improve public health. The special issue of Public Health Nutrition devoted to the concept of ultra-processing of food, and the NOVA classification of which ultra-processed foods are one category, is a great step forward in this work. Coincidentally, a polemical 'critical appraisal' of ultra-processing was recently published in another journal. Debate and discussion are an essential part of the scientific endeavour. In this commentary, we correct inaccurate statements made about NOVA in the 'appraisal,' rebut points raised, and discuss the larger issue of scientific responsibility for publishing opposing views on controversial topics.
- The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing(2018) MONTEIRO, Carlos Augusto; CANNON, Geoffrey; MOUBARAC, Jean-Claude; LEVY, Renata Bertazzi; LOUZADA, Maria Laura C.; JAIME, Patricia ConstanteGiven evident multiple threats to food systems and supplies, food security, human health and welfare, the living and physical world and the biosphere, the years 2016-2025 are now designated by the UN as the Decade of Nutrition, in support of the UN Sustainable Development Goals. For these initiatives to succeed, it is necessary to know which foods contribute to health and well-being, and which are unhealthy. The present commentary outlines the NOVA system of food classification based on the nature, extent and purpose of food processing. Evidence that NOVA effectively addresses the quality of diets and their impact on all forms of malnutrition, and also the sustainability of food systems, has now accumulated in a number of countries, as shown here. A singular feature of NOVA is its identification of ultra-processed food and drink products. These are not modified foods, but formulations mostly of cheap industrial sources of dietary energy and nutrients plus additives, using a series of processes (hence ultra-processed'). All together, they are energy-dense, high in unhealthy types of fat, refined starches, free sugars and salt, and poor sources of protein, dietary fibre and micronutrients. Ultra-processed products are made to be hyper-palatable and attractive, with long shelf-life, and able to be consumed anywhere, any time. Their formulation, presentation and marketing often promote overconsumption. Studies based on NOVA show that ultra-processed products now dominate the food supplies of various high-income countries and are increasingly pervasive in lower-middle- and upper-middle-income countries. The evidence so far shows that displacement of minimally processed foods and freshly prepared dishes and meals by ultra-processed products is associated with unhealthy dietary nutrient profiles and several diet-related non-communicable diseases. Ultra-processed products are also troublesome from social, cultural, economic, political and environmental points of view. We conclude that the ever-increasing production and consumption of these products is a world crisis, to be confronted, checked and reversed as part of the work of the UN Sustainable Development Goals and its Decade of Nutrition.
- Household availability of ultra-processed foods and obesity in nineteen European countries(2018) MONTEIRO, Carlos Augusto; MOUBARAC, Jean-Claude; LEVY, Renata Bertazzi; CANELLA, Daniela Silva; LOUZADA, Maria Laura da Costa; CANNON, GeoffreyObjective To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-processed foods and prevalence of obesity. Design Ecological, cross-sectional study. Setting Europe. Subjects Estimates of ultra-processed foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Results Across the nineteen countries, median average household availability amounted to 339 % of total purchased dietary energy for unprocessed or minimally processed foods, 203 % for processed culinary ingredients, 196 % for processed foods and 264 % for ultra-processed foods. The average household availability of ultra-processed foods ranged from 102 % in Portugal and 134 % in Italy to 462 % in Germany and 504 % in the UK. A significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-processed foods resulted in an increase of 025 percentage points in obesity prevalence. Conclusions The study contributes to a growing literature showing that the consumption of ultra-processed foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unprocessed or minimally processed foods and make ultra-processed foods less available and affordable.
- 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.
- 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.
- We should eat freshly cooked meals(2018) AUGUSTO, Carlos; CANNON, Geoffrey; MOUBARAC, Jean-Claude; LEVY, Renata Bertazzi; LOUZADA, Maria Laura; JAIME, Patricia Constante
- Potential reductions in ultra-processed food consumption substantially improve population cardiometabolic-related dietary(2022) STEELE, E. Martinez; PONCE, J. A. Marron; CEDIEL, G.; LOUZADA, M. L. C.; KHANDPUR, N.; MACHADO, P.; MOUBARAC, J. -C.; RAUBER, F.; CORVALAN, C.; LEVY, R. B.; MONTEIRO, C. A.Background and aims: The negative effect on dietary nutrient profiles is the most obvious mechanism explaining the higher risk of cardiometabolic diseases associated with increased dietary share of UPF observed in large cohort studies.We estimate the proportion of diets with excessive energy density, excessive free sugars or saturated fat contents and insufficient fiber that could be avoided, if UPF consumption was reduced to levels among lowest consumers across eight countries, as well as the proportion of diets with multiple inadequacies.Methods and results: Using nationally-representative cross-sectional surveys from Brazil (2008-09), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011-12), the UK (2008-16), Can-ada (2015), and the US (2015-16), inadequate energy density (>= 2.25 kcal/g) or contents of free sugars (>10% of total energy intake), saturated fats (>10% of total energy intake) and fiber (<25 g/2000 kcal) population attributable fractions were quantified.Substantial reductions in nutrient inadequacies would be observed ranging from 50.4% in Chile to 76.8% in US for dietary energy density, from 15.5% in Colombia to 68.4% in Australia for free sugars, from 9.5% in Canada to 35.0% in Mexico for saturated fats, and from 10.3% in UK to 37.9% in Mexico for fiber. Higher reductions would be observed for diets with multiple nutrient inadequacies: from 27.3% in UK to 77.7% in Australia for >= 3 and from 69.4% in Canada to 92.1% in US, for 4 inadequacies.Conclusions: Lowering dietary contribution of UPF to levels among country-specific lowest con-sumers is a way to improve population cardiometabolic-related dietary nutrient profiles.(c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the
conferenceObject ULTRA-PROCESSED FOODS AND NUTRIENT PROFILE OF DIETS CONSUMED IN CHILE AND COLOMBIA(2017) UAUY, Ricardo; CEDIEL, Gustavo; PARRA, Diana C.; KHANDPUR, Neha; LOUZADA, da Costa Maria Laura; MOUBARAC, Jean-Claude; LEVY, Bertazzi Renata; REYES, Marcela; CORVALAN, Camila; MONTEIRO, Carlos