Martinez-Perez, CeliaSan-Cristobal, RodrigoGuallar-Castillon, PilarMartínez-González, Miguel ÁngelSalas-Salvadó, JordiCorella, DoloresCastañer, OlgaMartinez, Jose AlfredoAlonso-Gómez, Ángel M.Wärnberg, JuliaVioque, JesúsRomaguera, DoraLópez-Miranda, JoséEstruch, RamonTinahones, Francisco J.Lapetra, JoséSerra-Majem, LluisBueno-Cavanillas, AuroraTur, Josep A.Martín Sánchez, VicentePintó, XavierGaforio, José J.Matía-Martín, PilarVidal, JosepVázquez, ClotildeRos, EmilioBes-Rastrollo, MairaBabio, NancySorlí, Jose V.Lassale, CamillePérez-Sanz, BeatrizVaquero-Luna, JessicaAjejas Bazán, María JuliaBarceló-Iglesias, María ConcepciónKonieczna, JadwigaRíos, Antonio GarcíaBernal-López, María RosaSantos-Lozano, José ManuelToledo, EstefaníaBecerra-Tomás, NereaPortoles, OlgaZomeño, María DoloresAbete, ItziarMoreno-Rodriguez, AnaiLecea-Juarez, OscarNishi, Stephanie K.Muñoz-Martínez, JúliaOrdovás, José M.Daimiel, Lidia2023-01-102023-01-102021-07-20Martinez-Perez C, San-Cristobal R, Guallar-Castillon P, Martínez-González MÁ, Salas-Salvadó J, Corella D, et al. Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort). Nutrients. 2021 Jul 20;13(7):2471http://hdl.handle.net/10668/4560The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Cardiometabolic riskClassification systemsDietFood processingIARCIFICNOVAPREDIMED-PlusUltra-processed foodUNCOverweightMediterranean dietMetabolic syndromeBody mass indexObesityFactores de riesgo cardiometabólicoClasificaciónDietaManipulación de alimentosAlimentos ultraprocesadosSobrepesoDieta mediterráneaSíndrome metabólicoÍndice de masa corporalObesidadMedical Subject Headings::Persons::Persons::Age Groups::Adult::AgedMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort StudiesMedical Subject Headings::Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::DietMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys::Diet SurveysMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, MediterraneanMedical Subject Headings::Technology and Food and Beverages::Food and Beverages::Food::Fast FoodsMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Technology and Food and Beverages::Technology, Industry, and Agriculture::Industry::Food Industry::Food HandlingMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::IncidenceMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Linear ModelsMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hyperinsulinism::Insulin Resistance::Metabolic Syndrome XMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::OverweightMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass IndexMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::ObesityMedical Subject Headings::Health Care::Health Care Economics and Organizations::Organizations::International AgenciesMedical Subject Headings::Diseases::Cardiovascular DiseasesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Questionnairesresearch article34371982open access10.3390/nu130724712072-6643PMC8308804