By: Junaida Astina, S.Gz., Ph.D, Widya Indriani, S.T.P., M.Sc (MedSci)
We live in an era where time is limited and is forcing us to consume a more convenient food that is quick to prepare, less expensive, and palatable. These attributes are included in ultra-processed food (UPF). UPF is defined as formulated food with at least five ingredients that include salt, sugar, oil, fats, and food ingredients that are rarely used in culinary preparations. In the industrial manufacturing process, many UPFs use food additives, such as hydrogenated fats, sweeteners, flavor enhancers, texture modifiers, colorants, emulsifiers, and preservatives to improve the quality of the food products. Those ingredients can easily be found in products available in the market and are not limited to foods classified as junk foods such as instant noodles, industrially manufactured white bread, sausages, or nuggets. Other foods perceived as beneficial for health, such as breakfast cereals, low-fat products, or low-sugar products are also included as UPFs.
The association between their consumption and adverse health outcomes has become an emerging public health concern due to the increasing trend of non-communicable diseases (NCDs). Many published articles showed that UPF consumption increased the risk of NCDs, such as obesity, cardiovascular disease (CVD), cancers, and diabetes mellitus4-7. Many studies tried to find the link between UPF consumption and the incidence of NCDs, and whether it is related to poor nutritional quality or not. A randomized crossover-controlled trial was carried out to compare the dietary intake between ultra-processed diets and unprocessed diets consumed for 14 days1. The study involved 20 healthy adults receiving an ultra-processed diet or unprocessed diet that matched for energy, fat, fiber, and macronutrient. The volunteers were asked to eat as they want (ad libitum) at each mealtime. The results showed that the ultra-processed diet raised the intake of energy up to 508 kcal/day compared to the unprocessed diet1. Consequently, the volunteer gained more body weight following the ultra-processed diet (0.9 kg), in contrast to the volunteer with the unprocessed diet who lost 0.9 kg during the trial. The increased energy intake was possibly due to the lower PYY level, an appetite-suppressing hormone, following the ultra-processed diet.
The roadmap to lower the incidence of NCDs in Indonesia is not without effort. The Indonesian government has encouraged the food industry to produce healthier products through fat, sugar, and sodium content reformulation. Many food industries are trying to act in accordance with the government’s policy as pictured through the recent growth of less-sugar beverages, less-sodium noodles, or fat-free dairy products in the market. Nevertheless, a review study carried out by Dicken and Batterham (2022) revealed that obesity and other NCDs were associated with UPF consumption even after dietary adjustment was made8. It means that the effect of UPF consumption on obesity is independent of dietary quality, indicating the nutritional quality of the foods is not the only contributing factor to the incidence of UPF-related NCDs. The altered satiety mechanism as a response to consuming highly palatable, convenient, and affordable traits of ultra-processed foods may lead to a poor dietary pattern that eventually contributes to excessive energy intake. These findings encour- age us to consume more unprocessed or minimally processed foods instead of ultra-processed ones.
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1. Hall et al., Cell metab, 30(1), 67-77 (2019) |
2. Steele, et al., BMJ open, 6(3), e009892 (2016)
3. Monteiro et al., Public HealthNutr, 22(5), 936-941 (2019)
4. Beslay, et al., PLoS med, 17(8), e1003256 (2020) |
5. Fiolet, et al., BMJ, 360, k322 (2018)
6.Schnabel, et al., JAMA intern med, 179(4), 490-498 (2019)
7. Srour, et al., JAMA intern med, 180(2), 283-291 (2020)
8.Dicken, S. J., & Batterham, R. L., Nutrients, 14(1), 23 (2022)
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