food processing and reformulation

Question 1

food processing

Answer 1

processed food generally described as any food that has been altered from its natural state
integral to providing safe, edible, nutritious foods to population
useful for increasing shelf life of foods, optimising nutrient availability and food quality as well as to reduce food losses and waste
around 75% of food sales globally are processed
food processing is important to keep up with demand for food + to eradicate hunger

Question 2

benefits of food processing

Answer 2

preservation
food safety
variety
nutrition
convenience

Question 3

preservation

Answer 3

pasteurisation- treated with mild heat to eliminate pathogens + extend shelf life
pickling or canning
salting

who benefits?
- distributors cna ship products over greater distancez
- retailers can stock products for longer
- consuners can keep foods for longer
- combats food waste

Question 4

food safety

Answer 4

wasting, pastuering, cooking, drying, freezing

who benefits?
- consumers are at lower risk of foodborne illness

Question 5

variety

Answer 5

milling grains, mixing ingredients, adding flavours, colours or fortifications

who benefits?
- manufacturers may gain higher profit and traction in a competitive market
- consumers have access to wider variety

Question 6

nutrition- fortification

Answer 6

fortifying milk with vitD, salt with iodine and grains with B vitamins, iron and folic acid

who benefits?
- manufactureres can use fortification as a selling point
- consumers are at lower risk for certain nutrition deficiences
- tailoring to certain dietary needs

Question 7

convenience

Answer 7

fast foods and convenience foods

who benefits?
- manufacturers can higher sales by responding to demand for convenience food

Question 8

drawbacks of food processing

Answer 8

nutrient loss and structural changes
additives and preservatives
increased sodium, sugar and unhealthy fats
risk of contamination
environmental impact
chemicals in food packaging

Question 9

nutrient loss and structural changes

Answer 9

processing can lead to degradation of heat sensitive vitamins and minerals
refining process may strip away essential nutrients
processing induces significant changes to food matrix

Question 10

additives and preservatives

Answer 10

potential health concerns or issues for individuals with sensitivities or allergies

Question 11

sodium, sugar and fats

Answer 11

excessive consumption of these often found in processed food is linked to health issues

Question 12

risk of contamination

Answer 12

contaminants such as bacteria, moulds, toxins and chemicals can pose health risks if not properly controlled

Question 13

environmental impact

Answer 13

food packaging poses an enviornmental concern- air and water pollution, greenhouse gas emmisions

Question 14

**

chemicals in food packaging

Answer 14

BPA (bisphenol A)- used in food containers
the molecules can migrate into food and drink that we consume
possible ink between BPA exposure and adverse health outcomes eg CVD, T2D, certain cancers and changes to immune functions and child behaviour

Question 15

food processing spectrum

Answer 15

NOVA- diet classification system
group 1- unprocessed or minimally processed foods eg fresh, fry orn forzen veg, fruit, grains, legumes, meat, fish, eggs, nuts and seedsn

group 2- processed culinary ingredients
eg plant oils, animal fats, maple syrup, sugar, honey and salt

group 3- processed foods
eg canned/pickled vegetables, meat, fish or fruit, artisinal bread, cheese, salted meats, wine, beer and dier

group 4- ultra processed foods
eg sugar sweetened beverages, sweet and savoury reconsituted meat, pre prepared frozen dishes, ice cream etc
formulations made from a series of processes including extraction and chemical modification- very little group 1 foods

Question 16

UPF and chronic noncommunicable diseases

Answer 16

systematic review
43 studies including cross section, prospective and case control
- meta analysis showed higher intake UPF was associated with greater risk of overweight/onesity, all cause mortality, metabolic syndrome and depression in adults
- positive association with T2D, frailty, IBS, CVD risk and breast/overall cancer

Question 17

limitations of observational studies

Answer 17

many use FFQs that have not been validated to assess intake of UPF- eg sourdough bread vs packaged bread (different sections of nova processing)
association is not causation; no indication of mechanisms
- dietary patterms high in UPF have been associated with higher intake of calories, added sugars, sodium, sat fat, low consumption of non UPF , sedentary behaviour and socioeconomic status

Question 18

study -UPF (inpatient trial)

Answer 18

UPF diets cause excess calorie intake and weight gain- an impatient randomised controlled trial

results - mean energy intake 500kcal higher on UPF diet
mean body weight increased (+0.9kg) following 2wk UPF diet- opposite on unprocessed diet
no reported differences in pleasantness or appetite sensations

conclusions- limiting upf may be effective strategy for obesity and prevention treatmemnt

limitations- not a real world study so doednt consider the element of choice and other factors that are involved

Question 19

UPF and CVD risk

Answer 19

potential mechanisms linking UPF to CVD risk
further research is needed to assess whether UPFs increase chronic disease risk beyond traditionally recognised individual nutrients

direct effects- high refined CH + added sugar, high total fat (incl saturated and trans), additives

energy mediated effects - high energy density, high ghrelin + reduced PYY, eating habits, timing, frequency

indirect effects- low fibre intake, smoking + alcohol intake

all lead to factors leading to CVD- oxidative stress, obesity, hypertension, inflammation, endothelial dysfunction

Question 20

not all UPFs are equal

Answer 20

some foods in category 4 may contribute to a balanced diet and we are encouraged to consume eg wholemeal bread and low fat yogurts
may be oversimplistic to pool all of the UPF together as they do contribute to other macronutrients

Question 21

UPF and cancer cardiometabolic multimorbidity

Answer 21

artificially sugar sweetened beverages, animal based products and sauces, spreads and condiments but notnother subgroups, were associated with increased risk
more nuanced subgroup anaylses of UPF are warranted

Question 22

processed foods and international policies

Answer 22

• brazil- make natural or minimally processed fofoods the basis of your diet - avoiding consumption of ultra processed diets
• israel- the diet must be varied and based mainly upon unprocessed food and food that has gone undergone minimal processing
• canada- limit highly processed foods- if you choose these foods, eat them less often and in small amounts
• french govt has set target of reducing UPF in the national diet by 20% between 2018 and 2022

Question 23

UPF as a proportion of foods purchased and consumed

Answer 23

consumed
- UPF=57%
- processed=9%
- culinary ingredients=4%
- unprocessed= 30%

countries
in europe, UK has highest % of UPF as a % of household purchases (50.7)
germany- 46.2%
spain- 20.3%
portugal- 10.2%

in UK it is cheapest to buy UPF as they are frequently on promotion, making it very easy and cheap to overconsume on these types of food
countries like france do not offer promotions on these types of foods

Question 24

SACN statement on processed foods and health

Answer 24

• consumption of UPF may be an indicator of other unhealthy dieatary patterns and lifestyle behaviours and diets high in UPF are often energy dense, high sat fat, salt or free sugars, high in processed meat, and or low in fruit and vegetables and dibre
• opbserved associations between higher consumptions of UPF and the adverse health outcomes are concerning, but the limitations in the NOVA classification system, potenntial for confounding and the possibility that the observed advrse associations with UPF are covered by existing UK dietary recommendations mean that evidence should be treated with caution

Question 25

food reform strategies

Answer 25

potential to improve dietary intakes by changing the composition of foods without changing consumer’s eating habits or food choices
consumer acceptance- key driver of effectiveness in changing dietary intakes

Question 26

food reformulation

Answer 26

redesigning an existing processed food product with the objective of making it healthier
can target specific nutrients in processed foods
goal to contribute to a better environment for consumers

Question 27

food environment

Answer 27

non commicable diseases are leading cause of death worldwide
largely caused by lifestyle factors incl unhealthy diet
exposure to a healthy food environment has been shown to be a stronger driver of healthy eating than health promotion and education efforts
food environments can be changed by reformulation of packaged and processed foods

Question 28

successful reformulation strategies

Answer 28

food refom strategies have been successfully utilised to improve the salt and trans fatty acid profile of commonly consumed processed foods
silent product reformulation/gradual step reduction - modification of food products, without making the consumer explicitly aware, may be an effective strategy for project reformulation
help to maintain consumers’ acceptance of products

Question 29

sodium (salt) reduction

Answer 29

recommended 5g per day but most adults in the UK will eat 7g/day
~4/5s of salt we consume is already in foods we buy
salt is leading cause of HBP (hypertension)

Question 30

trans fats

Answer 30

produced through the process of hydrogenation- hydrogen atoms are added to make them more solid at room temp
raises LDL and reduces HDL, increases of heart disease
some evidence thought that trans fats were better for individuals than saturated fat, however evidence isnt completely true
WHO have a goal of eliminating trans fats from all food production

studies show that reformulation led to a sig decrease in trans fatty acid intake

Question 31

reformulation + CVD

Answer 31

empirical impact of reformultion intitiatives on overall CVD morbidity and mortality
- food reformulation has potential to improve people’s diet and health
- changes in the nutrient composition of food products translates into changes in balance of nutrients from food purchased by consumers
- decrease in sodium and TFA contents in foods results in changes in intakes of those nutrients
- decreased TFA content in foods tends to be associated with decreased mortality from CVD at population level