Ultra-spracované potraviny – hrozba pre zdravie pečene

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Authors: M. Rác ¹; M. Janičko ²; T. Koller ³; L. Skladaný ⁴
Authors‘ workplace: Department of Internal Medicine, Teaching Hospital Nitra ¹; 2nd Department of Internal Medicine, P. J. Safarik University, Faculty of Medicine and L. Pasteur University Hospital Košice ²; 5th Department of Internal Medicine, University Hospital Bratislava, Comenius University, Faculty of Medicine, Bratislava ³; 2nd Department of Internal Medicine, HEGITO, F. D. Roosevelt University Hospital, Banská Bystrica ⁴
Published in: Gastroent Hepatol 2023; 77(2): 123-129
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doi: https://doi.org/10.48095/ccgh2023123

Overview

Ultra-spracované potraviny (UPF) sa často vyznačujú nízkou nutričnou kvalitou, vysokou energetickou hustotou a prítomnosťou prídavných látok, látok z obalov a zlúčenín, ktoré vznikajú počas výroby, spracovania a skladovania. UPF zahŕňa priemyselné receptúry a zvyčajne obsahuje mnoho zložiek. UPF obsahuje cukor, oleje, tuky, soľ, antioxidanty, stabilizátory a konzervačné látky, potravinárske prísady a emulgátory. Okrem nízkej výživovej hodnoty spracovanie potravín podporuje tvorbu škodlivých zlúčenín v potravinách. Potravinové prísady v rámci UPF, podporujú zápaly, poruchy funkcie pečene a metabolický syndróm, ktoré sú založené na zmenách mikrobiómu. Obezogény sú látky z prostredia, ktoré menia rovnováhu medzi príjmom a výdajom energie. Obezogény sú podskupinou environmentálnych chemických látok, ktoré pôsobia ako endokrinné disruptory ovplyvňujúce koncové metabolické ukazovatele. V posledných desaťročiach sa na celom svete dramaticky zvýšila spotreba ultra-spracovaných výrobkov. UPF sa na priemernom energetickom príjme podieľali viac ako 60 %. Priemerný obsah bielkovín, vlákniny, vitamínov a vápnika v strave výrazne klesá. Energetický príspevok UPF, zatiaľ čo obsah sacharidov, pridaného cukru a nasýtených tukov sa zvyšuje. Ultra-spracované potraviny sa podieľajú na väčšine pridaných cukrov v západnej strave. Fruktóza – najčastejší obezogén, sa spája so zvýšeným rizikom fibrózy pečene. V posledných rokoch pribúdajú dôkazy o škodlivom vplyve UPF. Konzumácia UPF sa spája s metabolickými zmenami, výskytom chronických ochorení a nadmernou úmrtnosťou. Existujú aj dôkazy o súvislosti s NAFLD, NASH a fibrózou. Vysoká spotreba UPF súvisí so škodlivými metabolickými a hepatálnymi parametrami v populácii NAFLD. Okrem toho kombinácia fajčenia a vysokého príjmu UPF môže zosilniť poškodenie pečene. Na základe dôkazov zo štúdií by sa vo výživových usmerneniach malo zvážiť odporúčanie znížiť príjem ultra- -spracovaných potravín na minimum a implementovať opatrenia v oblasti verejného zdravotníctva.

Klíčová slova:

metabolický syndrom – nealkoholová tuková choroba pečene (NAFLD) – ultra-spracované potraviny (UPF) – obezogény – chemické látky narúšajúce endokrinný systém (EDC)

Sources

1. Monteiro CA, Moubarac JC, Cannon G et al. Ultra-processed products are becoming dominant in the global food system. Obes Rev 2013; 14 (S2): 21–28. doi: 10.1111/obr.12107.

2. Popkin BM, Reardon T. Obesity and the food system transformation in Latin America. Obes Rev 2018; 19 (8): 1028–1064. doi: 10.1111/ obr.12694.

3. Dawber TR, Kannel WB. The Framingham Study An Epidemiological Approach to Coronary Heart Disease. Circulation 1966; 34 (4): 553–555. doi: 10.1161/01.CIR.34.4.553.

4. Pagliai G, Dinu M, Madarena MP et al. Consumption of ultra-processed foods and health status: A systematic review and meta-analysis. Br J Nutr 2021; 125 (3): 308–318. doi: 10.1017/ S0007114520002688.

5. Lane MM, Davis JA, Beattie S et al. Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta-analysis of 43 observational studies. Obes Rev 2021; 22 (3): 1–19. doi: 10.1111/obr.13146.

6. Phillips JA. Dietary Guidelines for Americans, 2020–2025. Work Heal Saf 2021; 69 (8): 395. doi: 10.1177/21650799211026980.

7. Lustig RH. Processed food-an experiment that failed. JAMA Pediatr 2017; 171 (3): 212–214. doi: 10.1001/jamapediatrics.2016.4136.

8. Jin J. Dietary guidelines for Americans. JAMA 2016; 315 (5): 528. doi: 10.1001/jama.2016. 0077.

9. Chassaing B, Koren O, Goodrich JK et al. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature 2015; 519 (7541): 92–96. doi: 10.1038/nature14232.

10. Lustig RH, Mulligan K, Noworolski SM et al. Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity 2016; 24 (2): 453–460. doi: 10.1002/oby.21371.

11. Monteiro CA, Cannon G, Lawrence M et al. The NOVA Food Classification System and Its Four Food Groups. 2019 [online]. Dostupné z: https: //www.wipo.int/amc/en/mediation/rules.

12. Monteiro CA, Cannon G, Levy RB et al. Ultra-processed foods: What they are and how to identify them. Public Health Nutr 2019; 22 (5): 936–941. doi: 10.1017/S1368980018003762.

13. Schulte EM, Gearhardt AN. Attributes of the food addiction phenotype within overweight and obesity. Eat Weight Disord 2021; 26 (6): 2043–2049. doi: 10.1007/s40519-020-01055-7.

14. Garber AK, Lustig RH. Is Fast Food Addict- ive? Curr Drug Abuse Rev 2011; 4 (3): 146–162. doi: http: //dx.doi.org/10.2174/1874473711104030146.

15. Baraldi LG, Martinez Steele E, Canella DS et al. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: Evidence from a nationally representative cross-sectional study. BMJ Open 2018; 8 (3). doi: 10.1136/bmjopen- 2017-020574.

16. Rauber F, Louzada MLDC, Martinez Steele E et al. Ultra-processed foods and excessive free sugar intake in the UK: A nationally representative cross-sectional study. BMJ Open 2019; 9 (10): 1–11. doi: 10.1136/bmjopen-2018-027546.

17. Monteiro CA, Cannon G, Moubarac JC et al. The un Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr 2018; 21 (1): 5–17. doi: 10.1017/S1368980017000234.

18. Luiten CM, Steenhuis IHM, Eyles H et al. Ultra-processed foods have the worst nutrient profile, yet they are the most available packaged products in a sample of New Zealand supermarkets. Public Health Nutr 2016; 19 (3): 530–538. doi: 10.1017/S1368980015002177.

19. Martínez Steele E, Popkin BM, Swinburn B et al. The share of ultra-processed foods and the overall nutritional quality of diets in the US: Evidence from a nationally representative cross-sectional study. Popul Health Metr 2017; 15 (1): 1–11. doi: 10.1186/s12963-017-0119-3.

20. Harris JM, Shiptsova R. Consumer Demand for Convenience Foods: Demographics and Expenditures. J Food Distrib Res 2007; 38 (3): 22–36.

21. Bellisle F. Meals and snacking, diet quality and energy balance. Physiol Behav 2014; 134: 38–43. doi: https: //doi.org/10.1016/j.physbeh. 2014.03.010.

22. Small DM, DiFeliceantonio AG. Neuroscience: Processed foods and food reward. Science 2019; 363 (6425): 346–347. doi: 10.1126/science.aav 0556.

23. Fardet A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: A preliminary study with 98 ready-to-eat foods. Food Funct 2016; 7 (5): 2338–2346. doi: 10.1039/c6fo00107f.

24. Forde CG, Mars M, De Graaf K. Ultra-Processing or Oral Processing? A Role for Energy Density and Eating Rate in Moderating Energy Intake from Processed Foods. Curr Dev Nutr 2020; 4 (3): 1–7. doi: 10.1093/cdn/nzaa019.

25. Guimarães JS, Mais LA, Leite FHM et al. Ultra-processed food and beverage advertising on Brazilian television by International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support benchmark. Public Health Nutr 2020; 23 (15): 2657–2662. doi: 10.1017/S1368980020000518.

26. Pulker CE, Scott JA, Pollard CM. Ultra-processed family foods in Australia: Nutrition claims, health claims and marketing techniques. Pub- lic Health Nutr 2018; 21 (1): 38–48. doi: 10.1017/ S1368980017001148.

27. Abt E, Robin LP, McGrath S, et al. Acrylamide levels and dietary exposure from foods in the United States, an update based on 2011–2015 data. Food Addit Contam – Part A Chem Anal Control Expo Risk Assess 2019; 36 (10): 1475–1490. doi: 10.1080/19440049.2019.1637548.

28. Gibis M. Heterocyclic Aromatic Amines in Cooked Meat Products: Causes, Formation, Occurrence, and Risk Assessment. Compr Rev Food Sci Food Saf 2016; 15 (2): 269–302. doi: 10.1111/1541-4337.12186.

29. Miclotte L, Van de Wiele T. Food processing, gut microbiota and the globesity problem. Crit Rev Food Sci Nutr 2020; 60 (11): 1769–1782. doi: 10.1080/10408398.2019.1596878.

30. Heindel JJ, Newbold R, Schug TT. Endocrine disruptors and obesity. Nat Rev Endocrinol 2015; 11 (11): 653–661. doi: 10.1038/nrendo.2015. 163.

31. Steele EM, Khandpur N, da Costa Louzada ML, Monteiro CA. Association between dietary contribution of ultra-processed foods and urinary concentrations of phthalates and bisphenol in a nationally representative sample of the US population aged 6 years and older. PLoS One 2020; 15: 1–21. doi: 10.1371/journal.pone.0236738.

32. Griffin MD, Pereira SR, DeBari MK et al. Mechanisms of action, chemical characteristics, and model systems of obesogens. BMC Biomed Eng 2020; 2 (1): 1–13. doi: 10.1186/s424 90-020-00040-6.

33. Heindel JJ, Howard S, Agay-Shay K et al. Obesity II: Establishing causal links between chemical exposures and obesity. Biochem Pharmacol 2022; 199: 115015. doi: 10.1016/j.bcp.2022.115015.

34. de Deus Mendonça R, Pimenta AM, Gea A et al. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study 1,2. Am J Clin Nutr 2016; 104 (5): 1433–1440. doi: 10.3945/ajcn.116.135004.

35. Beslay M, Srour B, Méjean C et al. Ultra-processed food intake in association with BMI change and risk of overweight and obesity: A prospective analysis of the French NutriNet-Santé cohort. PLoS Med 2020; 17 (8): 1–19. doi: 10.1371/JOURNAL.PMED.1003256.

36. Levy RB, Rauber F, Chang K et al. Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study. Clin Nutr 2021; 40 (5): 3608–3614. doi: 10.1016/j.clnu.2020.12.018.

37. Llavero-Valero M, Escalada-San Martín J, Martínez-González MA et al. Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study. Clin Nutr 2021; 40 (5): 2817–2824. doi: 10.1016/j.clnu.2021.03. 039.

38. Adjibade M, Julia C, Allès B et al. Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Santé cohort. BMC Med 2019; 17 (1): 78. doi: 10.1186/s12916-019-1312-y.

39. Juul F, Vaidean G, Lin Y et al. Ultra-Processed Foods and Incident Cardiovascular Disease in the Framingham Offspring Study. J Am Coll Cardiol 2021; 77 (12): 1520–1531. doi: 10.1016/j.jacc.2021.01.047.

40. Rico-Campà A, Martínez-González MA, Alvarez-Alvarez I et al. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ 2019; 365. doi: 10.1136/bmj.l1949.

41. Chang K, Gunter MJ, Rauber F et al. Articles Ultra-processed food consumption, cancer risk and cancer mortality : a large-scale prospective analysis within the UK Biobank. EClinicalMedicine 2023; 56: 101840. doi: 10. 1016/j.eclinm.2023.101840.

42. Elizabeth L, Machado P, Zinöcker M et al. Ultra-processed foods and health outcomes: A narrative review. Nutrients 2020; 12 (7): 1–36. doi: 10.3390/nu12071955.

43. Scaranni PO, Cardoso LO, Chor D et al. Ultra-processed foods, changes in blood pressure and incidence of hypertension: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr 2021; 24 (11): 3352–3360. doi: 10.1017/S136898002100094X.

44. Rauber F, Campagnolo PDB, Hoffman DJ et al. Consumption of ultra-processed food products and its effects on children’s lipid profiles: A longitudinal study. Nutr Metab Cardiovasc Dis 2015; 25 (1): 116–122. doi: 10.1016/ j.numecd.2014.08.001.

45. Srour B, Fezeu LK, Kesse-Guyot E et al. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. JAMA Intern Med 2020; 180 (2): 283–291. doi: 10.1001/jama internmed.2019.5942.

46. Gómez-Donoso C, Sánchez-Villegas A, Martínez-González MA et al. Ultra-processed food consumption and the incidence of depression in a Mediterranean cohort: the SUN Project. Eur J Nutr 2020; 59 (3): 1093–1103. doi: 10.1007/s00394-019-01970-1.

47. Fiolet T, Srour B, Sellem L et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 2018; 360: k322. doi: 10.1136/bmj.k322.

48. Rey-García J, Donat-Vargas C, Sandoval-Insausti H et al. Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study. Nutrients 2021; 13 (2): 428. doi: 10.3390/nu13020428.

49. Sandoval-Insausti H, Blanco-Rojo R, Graciani A et al. Ultra-processed Food Consumption and Incident Frailty: A Prospective Cohort Study of Older Adults. Journals Gerontol Ser A. 2020; 75 (6): 1126–1133. doi: 10.1093/gerona/glz140.

50. Schnabel L, Kesse-Guyot E, Allès B, et al. Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France. JAMA Intern Med 2019; 179 (4): 490–498. doi: 10.1001/jamaintern med.2018.7289.

51. Zhong GC, Gu HT, Peng Y et al. Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study. Int J Behav Nutr Phys Act 2021; 18 (1): 21. doi: 10.1186/s12966-021-01081-3.

52. Rodriguez-Palacios A, Harding A, Menghini P et al. The Artificial Sweetener Splenda Promotes Gut Proteobacteria, Dysbiosis, and Myeloperoxidase Reactivity in Crohn’s Disease-Like Ileitis. Inflamm Bowel Dis 2018; 24 (5): 1005–1020. doi: 10.1093/ibd/izy060.

53. Narula N, Wong ECL, Dehghan M et al. Association of ultra-processed food intake with risk of inflammatory bowel disease: Prospective cohort study. BMJ 2021; 374. doi: 10.1136/bmj.n1554.

54. Mosca A, Nobili V, De Vito R et al. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. J Hepatol 2017; 66 (5): 1031–1036. doi: 10.1016/j.jhep.2016.12.025.

55. Abdelmalek MF, Suzuki A, Guy C et al. Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease. Hepatology 2010; 51 (6): 1961–1971. doi: 10.1002/hep.23535.

56. Ivancovsky-Wajcman D, Fliss-Isakov N, Webb M et al. Ultra-processed food is asso- ciated with features of metabolic syndrome and non-alcoholic fatty liver disease. Liver Int 2021; 41 (11): 2635–2645. doi: https: //doi.org/10.11 11/liv.14996.