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      Dietary fibre intake and its association with ultraprocessed food consumption in the general population of Switzerland: analysis of a population-based, cross-sectional national nutrition survey

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          Abstract

          Objectives

          The objective of this study was to describe the compliance to dietary fibre recommendations of the Swiss population and to investigate the association between dietary fibre intake and ultraprocessed food (UPF) consumption.

          Methods

          Data were obtained from the cross-sectional Swiss National Nutrition Survey menuCH. We summarised the sociodemographic, lifestyle and anthropometric parameters as well as dietary data collected with two 24-hour dietary recalls for the whole population and subgroups according to absolute and relative dietary fibre intake. We analysed the associations between dietary fibre intake and UPF consumption by fitting multinomial logistic regression models. Data were weighted according to the menuCH weighting strategy to achieve a representation of the Swiss population.

          Results

          Data obtained from 2057 adults were included in the analysis, of which 87% had a dietary fibre intake of <30 g/day. Participants with high UPF consumption had lower odds of being in the medium or high dietary fibre intake groups than participants with low UPF consumption. The odds of being in the medium or high dietary fibre intake groups decreased linearly across quartiles of UPF consumption ( p for trend ≤0.004).

          Conclusions

          Dietary fibre intake is insufficient in all population groups in Switzerland. UPF consumption is inversely and dose dependently associated with dietary fibre intake. To increase dietary fibre intake, public health measures should discourage UPF consumption and increase dietary fibre intake via unprocessed or minimally processed foods.

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          Most cited references40

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          R: A Language and Enviroment for Statistical Computing

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            Ultra-processed foods: what they are and how to identify them

            The present commentary contains a clear and simple guide designed to identify ultra-processed foods. It responds to the growing interest in ultra-processed foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-processed foods are defined within the NOVA classification system, which groups foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-processed foods include the fractioning of whole foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-processed foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unprocessed or minimally processed foods. A practical way to identify an ultra-processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).
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              Alternative dietary indices both strongly predict risk of chronic disease.

              The Healthy Eating Index-2005 (HEI-2005) measures adherence to the 2005 Dietary Guidelines for Americans, but the association between the HEI-2005 and risk of chronic disease is not known. The Alternative Healthy Eating Index (AHEI), which is based on foods and nutrients predictive of chronic disease risk, was associated inversely with chronic disease risk previously. We updated the AHEI, including additional dietary factors involved in the development of chronic disease, and assessed the associations between the AHEI-2010 and the HEI-2005 and risk of major chronic disease prospectively among 71,495 women from the Nurses' Health Study and 41,029 men from the Health Professionals Follow-Up Study who were free of chronic disease at baseline. During ≥24 y of follow-up, we documented 26,759 and 15,558 incident chronic diseases (cardiovascular disease, diabetes, cancer, or nontrauma death) among women and men, respectively. The RR (95% CI) of chronic disease comparing the highest with the lowest quintile was 0.84 (0.81, 0.87) for the HEI-2005 and 0.81 (0.77, 0.85) for the AHEI-2010. The AHEI-2010 and HEI-2005 were most strongly associated with coronary heart disease (CHD) and diabetes, and for both outcomes the AHEI-2010 was more strongly associated with risk than the HEI-2005 (P-difference = 0.002 and <0.001, respectively). The 2 indices were similarly associated with risk of stroke and cancer. These findings suggest that closer adherence to the 2005 Dietary Guidelines may lower risk of major chronic disease. However, the AHEI-2010, which included additional dietary information, was more strongly associated with chronic disease risk, particularly CHD and diabetes.
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                Author and article information

                Journal
                BMJ Nutr Prev Health
                BMJ Nutr Prev Health
                bmjnph
                bmjnph
                BMJ Nutrition, Prevention & Health
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2516-5542
                2024
                16 January 2024
                : 7
                : 1
                : 26-37
                Affiliations
                [1 ] departmentDepartment of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM) , Ringgold_27252University Hospital and University of Bern , Bern, Switzerland
                [2 ] departmentDepartment of Pharmaceutical Sciences, Division of Clinical Pharmacy and Epidemiology , Ringgold_27209University of Basel , Basel, Switzerland
                [3 ] departmentHealth Department, Nutrition Group , Ringgold_370340Swiss Distance University of Applied Sciences (FFHS) / University of Applied Sciences and Arts of Southern Switzerland (SUPSI) , Zurich, Switzerland
                [4 ] departmentEpidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology , Ringgold_27217University of Zurich , Zurich, Switzerland
                [5 ] departmentHealth Department , Ringgold_69477Bern University of Applied Sciences , Bern, Switzerland
                Author notes
                [Correspondence to ] Professor David Faeh; david.faeh@ 123456bfh.ch

                GP and DF are joint senior authors.

                Author information
                http://orcid.org/0000-0002-2122-4746
                http://orcid.org/0000-0002-0357-6887
                http://orcid.org/0000-0001-8799-2708
                http://orcid.org/0000-0002-8471-7513
                http://orcid.org/0000-0002-8630-2477
                http://orcid.org/0000-0002-5933-7439
                http://orcid.org/0000-0003-2630-8102
                Article
                bmjnph-2023-000727
                10.1136/bmjnph-2023-000727
                11221279
                38966099
                ead452e9-edbd-44e3-aaa1-73ffcd6c0ffb
                © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 09 July 2023
                : 23 November 2023
                Funding
                Funded by: Division of Clinical Pharmacy and Epidemiology, University of Basel;
                Award ID: FO119900
                Funded by: Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital;
                Award ID: WFE-012
                Funded by: SV Foundation;
                Categories
                Original Research
                1506
                Custom metadata
                unlocked

                dietary patterns,nutrient deficiencies
                dietary patterns, nutrient deficiencies

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