Hochverarbeitete Lebensmittel und ihre Bedeutung für die Genese ernährungsmitbedingter Erkrankungen

Svenja Fedde; Gerald Rimbach; Karin Schwarz; Anja Bosy-Westphal

doi:10.1055/a-1683-3983

DMW - Deutsche Medizinische Wochenschrift, Inhaltsverzeichnis

Dtsch Med Wochenschr 2022; 147(01/02): 46-52
DOI: 10.1055/a-1683-3983

Review

Hochverarbeitete Lebensmittel und ihre Bedeutung für die Genese ernährungsmitbedingter Erkrankungen

What is ultra-processed food and how is it related to diet-related diseases?

Svenja Fedde

¹Institut für Humanernährung und Lebensmittelkunde, Abteilung Humanernährung, Christian-Albrechts-Universität zu Kiel

,

Gerald Rimbach

²Institut für Humanernährung und Lebensmittelkunde, Abteilung Lebensmittelwissenschaften, Christian-Albrechts-Universität zu Kiel

,

Karin Schwarz

³Institut für Humanernährung und Lebensmittelkunde, Abteilung Lebensmitteltechnologie, Christian-Albrechts-Universität zu Kiel

,

Anja Bosy-Westphal

¹Institut für Humanernährung und Lebensmittelkunde, Abteilung Humanernährung, Christian-Albrechts-Universität zu Kiel

› Institutsangaben

Abstract

Zusammenfassung

Hochverarbeitete Lebensmittel sind Teil eines modernen Lebensstils und machen in Deutschland ca. 46 % der täglichen Energieaufnahme aus. Querschnitts- und Kohortenstudien belegen Assoziationen zwischen dem Verzehr hochverarbeiteter Lebensmittel und nichtübertragbaren Erkrankungen (Übergewicht, Diabetes, Krebs, Herz-Kreislauf-Erkrankungen sowie Depressionen). Als Ursache für diesen Zusammenhang werden neben einer hohen Energiedichte und einer veränderten Lebensmittelmatrix eine ernährungsphysiologisch unausgewogene Zusammensetzung, ein hoher glykämischer Index, sowie abträgliche Zusatzstoffe und Kontaminanten durch Verarbeitung und Verpackung diskutiert. Um die anteilige Bedeutung dieser potenziellen Mechanismen zu verstehen und eine wissenschaftlich begründete, risikoassoziierte Definition hochverarbeiteter Lebensmittel zu geben, sind sowohl Interventionsstudien als auch eine bessere Erfassung der Zusammensetzung der verzehrten verarbeiteten Lebensmittel in prospektiven Kohortenstudien nötig.

Abstract

Ultra-processed food is part of a modern lifestyle and accounts for about 46 % of daily energy intake in Germany. Cross-sectional and cohort studies indicate associations between consumption of ultra-processed food and a range of non-communicable diseases (obesity, diabetes, cancer, cardiovascular disease, and depression). As underlying mechanisms, a high energy density, altered food matrix, an unbalanced nutritional composition, high glycemic index, adverse additives, processing- and packaging contaminants are discussed. In order to understand the role of these potential mechanisms and to provide a scientifically based and risk-associated definition of ultra-processed food it is important to conduct appropriate intervention studies and to improve dietary assessment of processed food in prospective cohort studies.

Schlüsselwörter

Hochverarbeitete Lebensmittel - Lebensmittelklassifizierung - Übergewicht - ernährungsmitbedingte Erkrankungen

Keywords

ultra-processed food - food classification - overweight - diet-related diseases

Volltext

Referenzen

Literatur
1 Monteiro CA, Moubarac J-C, Cannon G. et al. Ultra-processed products are becoming dominant in the global food system: Ultra-processed products: global dominance. Obes Rev 2013; 14: 21-28
2 Weaver CM, Dwyer J, Fulgoni VL. et al. Processed foods: contributions to nutrition. Am J Clin Nutr 2014; 99: 1525-1542
3 Monteiro CA, Cannon G, Levy RB. et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr 2019; 22: 936-941
4 Fardet A, Rock E. Ultra-processed foods: A new holistic paradigm?. Trends Food Sci Tech 2019; 93: 174-184
5 Hall KD, Ayuketah A, Brychta R. et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab 2019; 30: 67-77
6 Krüger J, Schebek L, Ellrott T. Die Beschleunigung der Ernährung und die Folgen für Umwelt und Gesundheit. Ernahrungs Umschau 2014; 01: 36-42
7 Monteiro CA, Moubarac J-C, Levy RB. et al. Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr 2018; 21: 18-26
8 Sadler CR, Grassby T, Hart K. et al. Processed food classification: Conceptualisation and challenges. Trends Food Sci Tech 2021; 112: 149-162
9 Chen X, Zhang Z, Yang H. et al. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J 2020; 19: 1-10
10 Gibney MJ, Forde CG, Mullally D. et al. Ultra-processed foods in human health: a critical appraisal. Am J Clin Nutr 2017; 106: 717-724
11 Davidou S, Christodoulou A, Frank K. et al. A study of ultra-processing marker profiles in 22,028 packaged ultra-processed foods using the Siga classification. J Food Compos Anal 2021; 99: 103848
12 Silva FM, Giatti L, de Figueiredo RC. et al. Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008–2010). Public Health Nutr 2018; 21: 2271-2279
13 Juul F, Martinez-Steele E, Parekh N. et al. Ultra-processed food consumption and excess weight among US adults. Br J Nutr 2018; 120: 90-100
14 Rauber F, Steele EM, Louzada da C ML. et al. Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016). PLOS ONE 2020; 15
15 Canhada SL, Luft VC, Giatti L. et al. Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr 2020; 23: 1076-1086
16 Mendonça de D 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. Am J Clin Nutr 2016; 104: 1433-1440
17 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 Medicine 2020; 17: e1003256
18 World Health Organisation(WHO). Obesity and overweight. 2020 Im Internet (Stand: 11.11.2020): https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
19 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: 283-291
20 Srour B, Fezeu LK, Kesse-Guyot E. et al. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ 2019; 365
21 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
22 Schnabel L, Buscail C, Sabate J-M. et al. Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort. Am J Gastroenterol 2018; 113: 1217-1228
23 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: 78
24 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
25 Dinu M, Bonaccio M, Martini D. et al. Reproducibility and validity of a food-frequency questionnaire (NFFQ) to assess food consumption based on the NOVA classification in adults. Int J Food Sci Nutr 2021; 1-8
26 Lafay L, Mennen L, Basdevant A. et al. Does energy intake underreporting involve all kinds of food or only specific food items? Results from the Fleurbaix Laventie Ville Sante (FLVS) study. Int J Obes Relat Metab Disord 2000; 24: 1500-1506
27 Johnson L, Wilks DC, Lindroos AK. et al. Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?. Obes Rev 2009; 10: 681-692
28 Rolls BJ. The relationship between dietary energy density and energy intake. Physiol Behav 2009; 97: 609-615
29 Poti JM, Mendez MA, Ng SW. et al. Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households?. Am J Clin Nutr 2015; 101: 1251-1262
30 Bundesministerium für Ernährung und Landwirtschaft (BMEL). Nationale Reduktions- und Innovationsstrategie für Zucker, Fette und Salz in Fertigprodukten. 2018 Im Internet: https://www.bmel.de/SharedDocs/Downloads/DE/Broschueren/NationaleReduktionsInnovationsstrategie-Layout.html
31 Schulte EM, Avena NM, Gearhardt AN. Which Foods May Be Addictive? The Roles of Processing, Fat Content, and Glycemic Load. PLOS ONE 2015; 10
32 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
33 Fardet A. Characterization of the Degree of Food Processing in Relation With Its Health Potenzial and Effects. In: Advances in Food and Nutrition Research. Elsevier 2018; 79-129
34 Miclotte L, Van de Wiele T. Food processing, gut microbiota and the globesity problem. Crit Rev Food Sci Nutr 2020; 60: 1769-1782
35 Verordnung (EU) 2019/649 der Kommission vom 24. April 2019 zur Änderung des Anhangs III der Verordnung (EG) Nr. 1925/2006 des Europäischen Parlaments und des Rates betreffend anderer Trans-Fettsäuren als solcher, die auf natürliche Weise in Fett tierischen Ursprungs vorkommen. Im Internet (Stand: 28.07.2021): http://data.europa.eu/eli/reg/2019/649/oj
36 Verordnung (EU) 2017/2158 der Kommission vom 20. November 2017 zur Festlegung von Minimierungsmaßnahmen und Richtwerten für die Senkung des Acrylamidgehalts in Lebensmitteln. 2017 Im Internet (Stand: 28.07.2021): http://data.europa.eu/eli/reg/2017/2158/oj/deu
37 Bundesinstitut für Risikobewertung. Gesundheitliche Risiken durch hohe Gehalte an 3-MCPD- und Glycidyl-Fettsäureestern in bestimmten Lebensmitteln möglich: Stellungnahme Nr. 020/2020 des BfR vom 20. April 2020. 2020.
38 Leonarduzzi G, Sottero B, Poli G. Oxidized products of cholesterol: dietary and metabolic origin, and proatherosclerotic effects (review). J Nutr Biochem 2002; 13: 700-710
39 Buckley JP, Kim H, Wong E. et al. Ultra-processed food consumption and exposure to phthalates and bisphenols in the US National Health and Nutrition Examination Survey, 2013–2014. Environ Int 2019; 131: 105057
40 Gore AC, Chappell VA, Fenton SE. et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015; 36: 1-150
41 Fardet A, Rock E. Ultra-Processed Foods and Food System Sustainability: What Are the Links?. Sustainability 2020; 12: 6280
42 Nisbett N, Buse K, Collin J. et al UN food systems summit leaders must not remain silent on its inadequate rules of engagement with commercial actors. The BMJopinion. 2021 Im Internet (Stand: 12.10.2021): https://blogs.bmj.com/bmj/2021/09/01/un-food-systems-summit-leaders-must-not-remain-silent-on-its-inadequate-rules-of-engagement-with-commercial-actors/