Facile synthesis of magnetic ionic covalent organic framework and dispersive magnetic solid phase extraction of aromatic amino acid oxidation products in thermally processed foods.

Aromatic amino acid oxidation products (AAAOPs) are newly discovered risk substances of thermal processes. Due to its significant polarity and trace level in food matrices, there are no efficient pre-treatment methods available to enrich AAAOPs. Herein, we proposed a magnetic cationic covalent organic framework (Fe3O4@EB-iCOF) as an adsorbent for dispersive magnetic solid-phase extraction (DMSPE). Benefiting from the unique charged characteristics of Fe3O4@EB-iCOF, AAAOPs can be enriched through electrostatic interaction and π-π interactions. Under the optimal DMSPE conditions, the combined HPLC-MS/MS method demonstrated good linearity (R2 ≥ 0.990) and a low detection limit (0.11-7.5 µg·kg-1) for AAAOPs. In addition, the method was applied to real sample and obtained satisfactory recoveries (86.8 % âˆ¼ 109.9 %). Especially, we applied this method to the detection of AAAOPs in meat samples and conducted a preliminarily study on its formation rules, which provides a reliable basis for assessing potential dietary risks.

Role of ultra-processed foods in modulating the effect of Mediterranean diet on human and planet health-study protocol of the PROMENADE randomized controlled trial.

BACKGROUND: The Mediterranean diet (MD), globally recognized for its sustainability and health benefits, traditionally emphasizes the consumption of plant-based foods in raw or minimally processed forms. However, shifting lifestyles, even in Mediterranean regions, have led to an increasing consumption of ultra-processed foods (UPF). Epidemiological evidence suggests that UPF consumption may be detrimental to human health, but there is only one clinical trial on this topic which is largely debated in the scientific community. This study aims to investigate the impact of the inclusion of UPF within a Mediterranean-based dietary pattern on cardiometabolic markers, gut microbiota, and other markers of human and planet health. METHODS: Fifty clinically healthy individuals showing overweight and presenting a low-to-moderate cardiovascular risk profile will be recruited for a 7-month randomized, open, cross-over dietary trial. Eligible participants will be randomly assigned to a 3-month high-UPF MD (intervention group) or a low-UPF MD (control group), with a 1-month wash-out period. Both intervention diets will have identical food group compositions, with the intervention group consuming 5 servings/day of selected UPF items, and the control group consuming raw/minimally processed items from the same food group. Blood, urine, and fecal samples, alongside food/lifestyle diaries, will be collected from each participant before and after the dietary interventions. The primary endpoint will be the change in plasma LDL-cholesterol levels from baseline. Additional markers include blood pressure, anthropometric parameters, chemical parameters, glucose and lipid-related metabolic markers, incretins, inflammatory and oxidative stress markers, fecal microbiota composition, and short-chain fatty acids. Finally, food waste production will be evaluated through specific validated food diaries. The study has been approved by the Ethical Committee of the University of Milan and the Tuscany Regional Ethics Committee of the Azienda Ospedaliera Universitaria (AOU) - Careggi, Florence. DISCUSSION: Results from the PROMENADE study will improve knowledge about the impact of UPF consumption on human and planet health and will contribute to the scientific debate on this topic. TRIAL REGISTRATION: ClinicalTrials.gov NCT06314932. Registered on March 13, 2024.

Adherence to the EAT-Lancet sustainable diet and ultra-processed food consumption: findings from a nationwide population-based study in Brazil.

OBJECTIVE: To evaluate the association between ultra-processed food consumption and adherence to the EAT-Lancet diet in a representative sample of the Brazilian population. DESIGN: The study used data from the Brazilian National Dietary Survey 2017-2018 and employed linear regression models to evaluate the association between ultra-processed food consumption and adherence to the EAT-Lancet diet, as measured by the Nova food system and Planetary Health Diet Index (PHDI), respectively. SETTING: Nationally representative sample of the Brazilian population. PARTICIPANTS: The study included 46 164 Brazilians ≥ 10 years old. RESULTS: The average PHDI total score was 45·9 points (95 % CI 45·6, 46·1). The ultra-processed food consumption was, with dose-response, inversely associated with the adherence to the EAT-Lancet diet. The PHDI total score was 5·38 points lower (95 % CI -6·01, -4·75) in individuals in the highest quintile of consumption of ultra-processed foods, as compared to those in the first quintile. The PHDI score was also inversely associated with the share of processed culinary ingredients and processed foods and positively associated with the share of unprocessed or minimally processed foods. CONCLUSIONS: Our study showed an inverse relationship between the consumption of ultra-processed foods and the adherence to a healthy and sustainable diet.

Ultra-processed Food Intake During Pregnancy and its Impact on Maternal Diet Quality and Weight Change: A Systematic Review of Observational Studies.

PURPOSE OF REVIEW: Adequate and balanced nutrition during pregnancy is essential for both the mother's and fetus's health. The increased dietary intake of ultra-processed foods (UPFs) and their significant share in the diet negatively affects diet quality and gestational weight gain during pregnancy. The aim of this systematic review was to examine the association of UPFs consumption with diet quality and gestational weight change among healthy pregnant women, using data from observational studies (PROSPERO Identifier: CRD42023468269) from the last 10 years. RECENT FINDINGS: A search was performed in Pubmed, Wiley, Scopus, and Web of Science, and studies published in english language were selected. Study selection and data extraction were made by determining the exclusion and eligible inclusion criterias according to the PECOS framework. Of the 12 studies included, 5 were longitudinal cohort studies and 7 were cross-sectional studies. On average, half of the energy in the participants' daily diets came from UPFs in 3 studies, but the energy share of UPFs was about 20-30% in the remainder studies. UPFs-enriched maternal diet was associated with less dietary intake of legumes, vegetables, fruits and protein sources (seafood and plant protein, total protein) and greater consumption of refined grains compared to those who consume less UPFs. In parallel, UPFs consumption was negatively associated with Healthy Eating Index. UPF intake during pregnancy has a negative impact on diet quality and gestational weight gain. Increasing awareness of UPFs during this period may reduce potential complications during pregnancy and fetal growth.

Nutritional value and environmental aspects of high-protein ultra-processed foods on the German market.

OBJECTIVE: To compare nutritional value and aspects with environmental impact of high-protein (HP) and 'normal-protein' (NP) ultra-processed foods (UPF). DESIGN: 299 HP and 286 NP products were evaluated regarding aspects of nutritional value, energy density, Nutri-Score, number of additives as well as hyper-palatability and price. Environmental impact of HP UPF was addressed by analysing protein sources and the use of environmentally persistent non-nutritive artificial sweeteners. SETTING: Cross-sectional market analysis in German supermarkets and online shops. PARTICIPANTS: 299 HP and 286 NP UPF products. RESULTS: HP compared to NP UPF had a lower energy density, a lower content of sugar, total and saturated fat, whereas fibre and protein content (62·2 % animal protein) were higher (all P < 0·001). HP products therefore had a higher prevalence of Nutri-Score A (67·2 % v. 21·7 %) and a lower prevalence of Nutri-Score E (0·3 % v. 11·2 %) labelling (both P < 0·001). By contrast, salt content and the number of additives (environmentally persistent sweeteners, sugar alcohols, flavourings) were higher in HP compared to NP UPF (P < 0·001). When compared to HP products, twice as many NP were identified as hyper-palatable (82·5 % v. 40·5 %; P < 0·001). The price of HP was on average 132 % higher compared to NP UPF (P < 0·001). CONCLUSIONS: While major adverse aspects of UPF regarding nutritional profile and hyper-palatability are less pronounced in HP compared to NP products, higher salt content, increased number of additives and negative environmental effects from frequent use of animal protein and environmentally persistent sweeteners are major drawbacks of HP UPF.

Ultra-processed foods intake in relation to metabolic health status, serum brain-derived neurotrophic factor and adropin levels in adults.

BACKGROUND: In recent years, there has been a lot of discussion over the impact of ultra-processed foods (UPFs) intake on overall health of subjects. However, the association between UPFs intake and metabolic unhealthy (MU) status is still in a state of ambiguity. The current study assessed the relationship between UPFs intake and MU status with regard to brain-derived neurotrophic factor (BDNF) and adropin levels. METHODS: A sample of Iranian adults (aged 20-65 years) was selected to participate in this cross-sectional study using a multistage cluster random-sampling method. UPFs intake was assessed by a validated food frequency questionnaire and NOVA classification. Concentrations of metabolic parameters, BDNF and adropin were determined through fasting blood samples. MU status was assessed according to the criteria proposed by Wildman. RESULTS: The overall prevalence of MU phenotype among study participants (n = 527) was 42.5%. Higher intake of UPFs was associated with elevated odds of MU status in multivariable-adjusted model (ORT3 vs. T1=1.88; 95%CI: 1.02-3.45). Moreover, a positive association was observed between UPFs intake and hypertriglyceridemia after controlling all confounders (ORT3 vs. T1=2.07; 95%CI: 1.15-3.73). However, each tertile increase in UPFs intake was not significantly associated with serum BDNF ([Formula: see text]=0.15; 95%CI: -0.05, 0.34; P = 0.14) and adropin ([Formula: see text]=-1.37; 95%CI: -6.16, 3.42; P = 0.58) levels in multivariable-adjusted linear regression models. CONCLUSION: Our findings suggested that higher consumption of UPFs was related to increased likelihood of MU status among a sample of Iranian adults. Further longitudinal studies are needed to verify the directionality and generalizability of the results to all adult populations.

Association between processed and ultra-processed food intake and the risk of breast cancer: a case-control study.

BACKGROUND: Results from studies investigating the association between ultra-processed foods (UPFs) and breast cancer are scarce and, in some cases, contradictory. Therefore, we aimed to evaluate the association between the intake of processed foods (PFs) and UPFs with the risk of breast cancer in Iranian women. METHODS: The present case (n = 133) - control (n = 266) study was carried out at two general hospitals in Tehran, Iran. A 168-item semi-quantitative food frequency questionnaire was used to assess the participants' dietary intake. Also, the NOVA classification was used to identify PFs and UPFs. The association between PFs and UPFs with the odds of breast cancer was analyzed using logistic regression models. RESULTS: According to Model 1 of conditional logistic regression, the odds of breast cancer were higher in the last tertile of UPFs than in the first tertile (odds ratio (OR) = 1.930; 95% confidence interval (CI): 1.080-3.449). In Model 2, no significant association was observed between the second and last tertiles of PFs and UPFs with the odds of breast cancer compared to the reference tertile. Also based on menopause status, the odds of breast cancer increased in the last tertile only among premenopausal women in Model 2 (OR = 3.656; 95% CI: 1.326-10.079). CONCLUSIONS: This study demonstrated that higher consumption of UPFs is associated with higher odds of breast cancer in premenopausal women.

Ultra-processed food consumption and renal cell carcinoma incidence and mortality: results from a large prospective cohort.

BACKGROUND: Growing evidence shows that ultra-processed food consumption is associated with the risk of cancer. However, prospective evidence is limited on renal cell carcinoma (RCC) incidence and mortality. In this study, we aimed to examine the association of ultra-processed food consumption and RCC incidence and mortality in a large cohort of US adults. METHODS: A population-based cohort of 101,688 participants were included from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Ultra-processed food items were confirmed by using the NOVA food classification system. The consumption of ultra-processed food was expressed as a percentage of total food intake (g/day). Prospective associations were calculated using Cox regression. Restricted cubic spline regression was used to assess nonlinearity. Subgroup analyses were performed to investigate the potential effect modifiers on the incidence and mortality of RCC. RESULTS: A total of 410 participants developed RCC during a total of 899,731 person-years of follow-up (median 9.41 years) and 230 RCC deaths during 1,533,930 person-years of follow-up (median 16.85 years). In the fully adjusted model, participants in the highest compared with the lowest quintiles of ultra-processed food consumption had a higher risk of RCC (HR quartile 4 vs 1:1.42; 95% CI: 1.06-1.91; Ptrend = 0.004) and mortality (HR quartile 4 vs. quartile 1: 1.64; 95% CI: 1.10-2.43; Ptrend = 0.027). Linear dose-response associations with RCC incidence and mortality were observed for ultra-processed food consumption (all Pnonlinearity > 0.05). The reliability of these results was supported by sensitivity and subgroup analyses. CONCLUSION: In conclusion, higher consumption of ultra-processed food is associated with an increased risk of RCC incidence and mortality. Limiting ultra-processed food consumption might be a primary prevention method of RCC.

Carnes processadas: por que tributar?

Assim como o tabaco, as carnes processadas - salsichas, linguiças, mortadelas, dentre outras - causam câncer e não existe limite seguro de consumo. Assim, promover a taxação e política de preços tem potencial para reduzir o consumo dessas carnes processadas.

How can advocates leverage power to advance comprehensive regulation on ultra-processed foods? learning from advocate experience in Argentina.

BACKGROUND: The use of corporate power to undermine public health policy processes is increasingly well understood; however, relatively little scholarship examines how advocates can leverage power to promote the successful adoption of public health policies. The objective of this paper is to explore how advocates leveraged three forms of power - structural, instrumental and discursive - to promote the passage of the Promotion of Healthy Eating Law (Ley 27,642) in Argentina, one of the most comprehensive policies to introduce mandatory front-of-package (FOP) warning labels and regulate the marketing and sales of ultra-processed foods (UPFs) adopted to date. METHODS: We conducted seventeen semi-structured interviews with advocates from different sectors, including civil society, international agencies, and government. Both data collection and analysis were guided by Milsom's conceptual framework for analyzing power in public health policymaking, and the data was analyzed using hybrid deductive and inductive thematic analysis. RESULTS: Advocates harnessed structural power through the leveraging of revolving doors, informal alliances, and formal coalitions, enabling them to convene discussion spaces with decision-makers, make strategic use of limited resources, and cultivate the diverse expertise (e.g., research, nutrition science, advocacy, law, political science, activism and communications) needed to support the law through different phases of the policy process. Advocates wielded instrumental power by amassing an armada of localized evidence to promote robust policy design, building technical literacy amongst themselves and decision-makers, and exposing conflicts of interest to harness public pressure. Advocates exercised discursive power by adopting a rights-based discourse, including of children and adolescents and of consumers to transparent information, which enabled advocates to foster a favorable perception of the law amongst both decision-makers and the public. Key contextual enablers include a political window of opportunity, the COVID-19 pandemic, and the ability to learn from the regional precedent of similar policies. CONCLUSIONS: Public health policymaking, particularly when encroaching upon corporate interests, is characterized by stark imbalances of power that hinder policy decisions. The strategies identified in the case of Argentina provide important insights as to how advocates might harness and exercise structural, instrumental, and discursive power to counter corporate influence and promote the successful adoption of comprehensive UPF regulation.

Association of ultra-processed food intake with severe non-alcoholic fatty liver disease: a prospective study of 143073 UK Biobank participants.

BACKGROUND: Previous studies indicate a link between non-alcoholic fatty liver disease (NAFLD) and unhealthy dietary patterns or nutrient intake. However, it remains unclear whether ultra-processed foods (UPF) contribute to an increased risk of NAFLD. This study aimed to explore how ultra-processed food consumption correlates with severe NAFLD using the UK Biobank data. METHODS: This prospective cohort study included 143,073 participants from the UK Biobank. UPF consumption levels were determined using the NOVA classification and quantified from 24-h dietary recall data. The association between UPF consumption and severe NAFLD (hospitalization or death) was initially examined using Cox proportional hazards models with intake quartiles. Nonlinear associations were investigated using penalized cubic splines fitted in the Cox proportional hazards models. Adjustments were made for general characteristics, sociodemographic factors, body mass index (BMI), and lifestyle. RESULTS: Throughout the median follow-up period of 10.5 years, 1,445 participants developed severe NAFLD. The adjusted models indicated a significant increase in severe NAFLD risk in higher UPF intake groups compared to the lowest quartile (HR: 1.26 [95% CI: 1.11-1.43]). Subgroup analysis revealed that individuals with a BMI of 25 or higher were at greater risk in the highest quartile of UPF consumption. Sensitivity analyses yielded results consistent with these findings. CONCLUSION: Higher consumption of UPF is associated with an increased risk of severe NAFLD. Reducing the intake of UPF can be a potential approach to lower the risk of NAFLD.

Ultra-processed foods cause weight gain and increased energy intake associated with reduced chewing frequency: A randomized, open-label, crossover study.

AIM: To elucidate the effects of ultra-processed foods (UPFs) on body weight and ad libitum energy intake compared with non-UPFs. MATERIALS AND METHODS: In this randomized, open-label crossover study conducted at the University of Tokyo Hospital, overweight/obese Japanese male participants were randomly assigned (1:1) to start the study with consumption of either UPFs or non-UPFs for 1 week, followed by a 2-week washout period, before crossing over to the alternate food diet for 1 week. Individuals with diabetes, hypertension or any other medical conditions who visited a hospital regularly were excluded. The meals were designed to be matched for the total energy and macronutrient levels. The primary outcome was the difference in the body weight change between the UPF and non-UPF periods. The differences in the average daily energy intake and chewing frequency were assessed as one of the prespecified secondary outcomes. RESULTS: Nine eligible participants were randomly assigned to start the study with either UPFs or non-UPFs. All participants completed the study. During the UPF period, participants gained 1.1 kg more weight (95% confidence interval 0.2 to 2.0; P = .021) and consumed 813.5 kcal more per day (342.4 to 1284.7; P = .0041) compared with during the non-UPF period. Regarding the chewing frequency, the number of chews per calorie was significantly lower during the UPF period (P = .016). CONCLUSIONS: Consumption of UPFs causes significant weight gain. Medical nutritional therapy focused on reducing the consumption of UPFs could be an effective strategy for preventing obesity.

North American considerations, strategies, and practices in reducing the sodium content in processed foods.

Most Americans exceed the recommended limit for sodium in their diet, a risk factor for hypertension and cardiovascular disease. Efforts have been made by the food industry and government agencies to reduce the sodium content in foods and encourage the consumption of lower sodium diets. Such efforts, however, are not successful in improving public health when consumers do not accept and consume lower sodium foods. This review article provides an overview of the strategies that have been used by the US food industry to reduce and replace sodium in consumer packaged goods, as well as future sodium reduction strategies and approaches for replacing sodium with potassium salts. Challenges in consumer acceptance regarding the reduction of sodium in foods are also discussed. Because of the widespread consumption of numerous sodium-containing consumer packaged goods, implementing future strategies in various aspects of salt reduction and potassium replacement in foods should have a profound impact on the health of Americans. PRACTICAL APPLICATION: New information is provided herein as it discusses the most current and collective perspectives of major food industry successes and challenges, as well as government strategies to decrease sodium intake. The information provided also addresses future strategies for reducing sodium content in foods, increasing potassium intake, and consumer acceptance of lower sodium foods.

Socio-demographic correlates of ultra-processed food consumption in Canada.

OBJECTIVE: To characterise consumption of ultra-processed foods and drinks (UPF) across a range of socio-demographic characteristics of Canadians. DESIGN: Cross-sectional study. The national-level 2015 Canadian Community Health Survey-Nutrition provided data on all foods and drinks consumed on the previous day via a 24-hour dietary recall. All food items were classified according to the type of industrial processing using the NOVA system. Multivariable linear regression models examined associations between a range of socio-demographic characteristics and the mean energy contribution (% of total daily energy intake) from total UPF and UPF subgroups. SETTING: The ten Canadian provinces. PARTICIPANTS: Canadians aged 2 or older (n 20 103). RESULTS: UPF contributed, on average, nearly half (44·9 %) of total daily energy intake of Canadians. Children aged 6-12 and adolescents aged 13-18 consumed over half of total daily energy from UPF (adjusted means of 51·9 % and 50·7 %, respectively). Recent and long-term immigrants consumed a significantly lower share of energy from UPF (adjusted means of 42·2 % and 45·1 %, respectively) compared with non-immigrants (54·4 %), as did the food secure (42·8 %) v. those in moderately (48·1 %) or severely food-insecure households (50·8 %). More modest differences were observed for intake of total UPF and UPF subgroups by sex, education, income adequacy and region of residence. CONCLUSION: Levels of UPF consumption in 2015 in Canada were pervasive in all socio-demographic groups and highest among children and adolescents, non-immigrants and those living in food-insecure households. These findings can inform public health interventions to reduce UPF consumption and promote healthier diets in various socio-demographic groups.

Patterns of ultra-processed foods consumption throughout childhood and trajectories of growth and adiposity.

BACKGROUND & AIMS: Ultra-processed foods (UPF) consumption has been associated with unhealthy outcomes. However, the literature lacks robust longitudinal studies considering its cumulative effect, particularly in young populations. This study aimed to evaluate the relationship between UPF consumption patterns throughout childhood with growth and adiposity trajectories. METHODS: Generation XXI population-based birth cohort (Porto, Portugal) participants were included. Food frequency questionnaire items at 4, 7 and 10 years were classified according to the processing degree using NOVA. UPF consumption patterns based on total quantity were identified using a probabilistic Gaussian mixture model using participants with complete data and predicting for the total sample (n = 8647). To assess whether the outcome trajectories from 4 to 13 years [body weight (kg), height (cm), body mass index (BMI) z-score, waist circumference (WC) (cm) and fat mass (FM) (%)] depend on UPF patterns, a mixed-effects model with linear and quadratic terms for age adjusted for confounders was used. Participants with at least 2 measurements at 4, 7, 10 or 13 years were included in this study (n range: 5885-6272). RESULTS: Four UPF consumption patterns were identified: constantly lower consumption (15.4%), constantly intermediate consumption (56.4%), transition from low to high consumption (11.2%), and constantly higher consumption (17.1%). Compared to the constantly lower UPF consumption, the constantly higher consumption pattern was associated with greater acceleration in body weight (ß: 0.119; 95%CI: 0.027; 0.212), BMI z-score (ß: 0.014; 95%CI: 0.004; 0.023), WC (ß: 0.232; 95%CI: 0.144; 0.319) and FM% (ß: 0.200; 95%CI: 0.092; 0.308) and with lower acceleration in height (ß: -0.063; 95%CI: -0.111;-0.015). The constantly intermediate UPF consumption pattern was associated with greater acceleration in body weight (ß: 0.123; 95%CI: 0.043; 0.203), WC (ß: 0.120; 95%CI: 0.045; 0.195) and FM% (ß: 0.146; 95%CI: 0.054; 0.238). CONCLUSION: Constantly higher and constantly intermediate UPF consumption throughout childhood were associated with worse growth and adiposity trajectories until adolescence.

Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report.

BACKGROUND: Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. METHODS: We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. RESULTS: Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. CONCLUSION: More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.

Phase angle is inversely related to the consumption of ultra-processed foods and positively related to the consumption of minimally processed foods by university students: a cross-sectional study.

OBJECTIVE: Ultra-processed foods (UPF) and minimally processed foods (MPF) consumption are differentially connected to adiposity and possibly body composition. Phase angle (PhA) originates from bioelectrical impedance analysis (BIA) and is connected to cellular health. This study is the first to investigate associations between UPF/MPF consumption and PhA. DESIGN: A cross-sectional study was conducted. Anthropometrical and BIA were performed. The Hellenic Physical Activity Questionnaire was used for physical activity evaluation, while a validated FFQ was used for dietary assessment. UPF and MPF intake (% energy) were determined according to the NOVA system. Partial correlation coefficients of PhA and dietary variables were assessed after multi-adjustment. PARTICIPANTS: Students were recruited (n 151, 114 women). SETTING: University. RESULTS: Median and interquartile range (IQR) of PhA were 5·5° (5·1-6·4°) in the total sample, 6·8° (6·1-7·3°) in men and 5·3° (5·1-5·9°) in women (P < 0·001). The median and IQR for UPF consumption was 13·7 (8·1-33·4) % in the total sample, 23·8 (8·1-70·5) % in men and 12·9 (8·1-27·5) % in women (P < 0·001). The mean (sd) of MPF consumption was 60·2 (sd 15·7) % for the total sample, 59·1 (sd 16·4) % for men and 60·5 (sd 15·6) % for women (P = 0·720). The consumption of UPF was negatively (rho = -0·267, P = 0·002), while the consumption of MPF was positively (rho = 0·218, P = 0·010) associated with the PhA, after adjustment for age, sex, BMI and physical activity. CONCLUSION: PhA relates inversely to UPF and positively to MPF consumption. The observed associations possibly reflect the effects of diet on cellular health and in turn PhA.