HEALTH-DISEASE PROCESS AND NEW FOOD CLASSIFICATION: BRAZUCA NATAL STUDY
NOVA classification. Ultra-processed foods. Cognitive decline. Dementia. Chronic non-communicable diseases.
Thesis objective: To analyze the health-disease process of adults and elderly people from the perspective of nutrition based on the NOVA food classification methodology. This work is being developed in three articles. Article 1: This is a cross-sectional quantitative study that aims to: describe food consumption according to the NOVA classification of the Brazuca Natal Study population and investigate the association between food consumption and anthropometric nutritional status (ANS) in adults and elderly residents of Natal. The study population consists of a sample of 398 individuals with complete data on food consumption and ANS. Data collection took place in 2019-2020 through an interview based on the national health survey, using the Epicollect5 software (for socioeconomic and ANS variables) and Globodiet (for food consumption). We analyzed food consumption according to the NOVA classification into: unprocessed or minimally processed foods (UMP), culinary ingredients, processed foods (PF), and ultra-processed foods (UPF), as well as 34 subgroups. The energy consumption was 1936 kcal (95% CI: 1877.0-1994.0), mostly from UMP (55.70%) and UPF (19.20%). In the multivariate analysis, we found an association between body mass index and the subgroups: fruits, vegetables, vegetable oils, cheeses, and sweets. In the analysis with relative fat mass, we observed an association with UMP (OR: 1.76; 95% CI: 1.04-2.98), PF (OR: 0.51; 95% CI: 0.30-0.86), and UPF (OR: 0.38; 95% CI: 0.23-0.65). When the outcome was waist circumference, there was an association with UMP (OR: 1.90; 95% CI: 1.06-3.41) and UPF (OR: 0.47; 95% CI: 0.26-0.86). Our data reveal the predominance of UMP in the diet of the Brazuca Natal population. However, there is a significant proportion of UPF and PF. We also found that lower consumption of UMP and higher consumption of PF and UPF tend to be risk factors for overweight, metabolic complications, and mortality. Articles 2 and 3: These are being conducted in light of the 2020 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) which aim to investigate whether there is an association between the type of food processing according to NOVA and cognitive decline and dementia in adults and the elderly. The second article is a systematic review protocol that presents an initial literature review partially answering the guiding question. It was possible to perceive that the type of food processing impacts the risk and development of cognitive decline and all-cause dementias. In the third article, the systematic review included 4 studies. Three studies evaluated cognitive decline/performance as the primary outcome and one evaluated dementias. Only one study did not observe an association between UPF consumption and brain health. One study analyzed the association between UMP and all-cause dementia. We concluded that food processing impacts brain health in both adults and the elderly. Furthermore, we emphasize that other chronic conditions, such as diabetes mellitus and overweight, as well as socioeconomic variables, such as age and gender, can directly interfere in the food processing-brain health association.