@misc{10481/70300,
year = {2021},
month = {7},
url = {http://hdl.handle.net/10481/70300},
abstract = {The 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 PREDIMEDPlus
(“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.},
organization = {European Research Council (ERC)
European Commission	#340918},
organization = {Centro de Investigacion Biomedica en Red-Fisiopatologia de la Obesidad y Nutricion	PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441	
PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471	
PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332},
publisher = {MDPI},
keywords = {Cardiometabolic risk},
keywords = {Classification systems},
keywords = {Diet},
keywords = {Food processing},
keywords = {IARC},
keywords = {IFIC},
keywords = {NOVA},
keywords = {PREDIMED-Plus},
keywords = {Ultra-processed food},
keywords = {UNC},
title = {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)},
doi = {10.3390/nu13072471},
author = {Martínez Pérez, Celia and Bueno Cavanillas, Aurora},
}