背景:随着关于超加工食品(UPFs)对健康的负面影响的证据越来越多,以营养为中心的建议存在争议,以食物为基础的饮食指南越来越多地被利用。先前对饮食指南的分析评估了它们对健康和可持续性的潜在影响,但是很少有研究来研究UPFs的概念如何反映在消费者的饮食建议中。本文系统地分析了国际饮食指南中是否以及如何代表UPFs。
方法:基于系统的在线搜索,我们确定了106份膳食指南中的以消费者为目标的关键信息,并进行了定性内容分析.开发了一种编码框架,根据使用的语言将消息分类为\'多吃\'或\'少吃\'(例如,\'选择\'vs\'避免\')并区分对营养素或食物加工的关注。“少吃”指南中提到的特定食品是根据NOVA框架的加工水平进行分类的。
结果:99%的指南使用了某种基于营养的信息,要么促进“阳性”营养素(例如,维生素)或不鼓励摄入“阴性”营养素(主要是盐,糖和脂肪)。45%的“少吃”指南和5%的“多吃”指南中明确提到了食品加工。隐式引用(例如,在43%的“少吃”和75%的“多吃”指南中发现了推广“生”或劝阻“包装”食品)。“少吃”建议中提到的特定食物中有53%是UPFs。
结论:总体而言,基于营养的消息比关于处理级别的消息更常见。大多数沮丧的食物是UPFs,然而,一些最低限度的加工食品被劝阻,这表明基于营养和加工的饮食建议之间存在紧张和矛盾。随着饮食指南开始包括有关食品加工的建议,重要的是要考虑消费者对所使用术语的理解以及他们根据建议采取行动的能力。
As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary
guidelines are increasingly utilised. Previous analyses of dietary
guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally.
Based on a systematic online search, the consumer-targeted key messages of 106 dietary
guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as \'eat more\' or \'eat less\' according to the language used (eg, \'choose\' vs \'avoid\') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in \'eat less\' guidelines were classified according to their level of processing using the NOVA framework.
99% of guidelines utilised some type of nutrient-based message, either promoting \'positive\' nutrients (eg, vitamins) or discouraging the consumption of \'negative\' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of \'eat less\'
guidelines and 5% of \'eat more\'
guidelines. Implicit references (eg, promoting \'raw\' or discouraging \'packaged\' foods) were found in 43% of \'eat less\' and 75% of \'eat more\'
guidelines. 53% of the specific foods referred to in \'eat less\' advice were UPFs.
Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.