000186551 001__ 186551 000186551 005__ 20240229145749.0 000186551 0247_ $$2doi$$a10.3389/fnut.2022.1035580 000186551 0247_ $$2pmid$$apmid:36590209 000186551 0247_ $$2pmc$$apmc:PMC9800919 000186551 0247_ $$2altmetric$$aaltmetric:140273742 000186551 037__ $$aDKFZ-2023-00004 000186551 041__ $$aEnglish 000186551 082__ $$a630 000186551 1001_ $$aHuybrechts, Inge$$b0 000186551 245__ $$aCharacterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: Application of the Nova classification and validation using selected biomarkers of food processing. 000186551 260__ $$aLausanne$$bFrontiers Media$$c2022 000186551 3367_ $$2DRIVER$$aarticle 000186551 3367_ $$2DataCite$$aOutput Types/Journal article 000186551 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1672673074_4387 000186551 3367_ $$2BibTeX$$aARTICLE 000186551 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000186551 3367_ $$00$$2EndNote$$aJournal Article 000186551 520__ $$aEpidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) 'Ultra-processed' foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements.After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25-p75: 58-66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF).Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were -0.07 and -0.37 for elaidic acid and 4-methyl syringol sulfate, respectively).These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods. 000186551 536__ $$0G:(DE-HGF)POF4-313$$a313 - Krebsrisikofaktoren und Prävention (POF4-313)$$cPOF4-313$$fPOF IV$$x0 000186551 588__ $$aDataset connected to CrossRef, PubMed, , Journals: inrepo02.dkfz.de 000186551 650_7 $$2Other$$aEPIC 000186551 650_7 $$2Other$$aNova 000186551 650_7 $$2Other$$abiomarkers 000186551 650_7 $$2Other$$aelaidic acid 000186551 650_7 $$2Other$$afood processing 000186551 650_7 $$2Other$$asyringol 000186551 7001_ $$aRauber, Fernanda$$b1 000186551 7001_ $$aNicolas, Geneviève$$b2 000186551 7001_ $$aCasagrande, Corinne$$b3 000186551 7001_ $$aKliemann, Nathalie$$b4 000186551 7001_ $$aWedekind, Roland$$b5 000186551 7001_ $$aBiessy, Carine$$b6 000186551 7001_ $$aScalbert, Augustin$$b7 000186551 7001_ $$aTouvier, Mathilde$$b8 000186551 7001_ $$aAleksandrova, Krasimira$$b9 000186551 7001_ $$aJakszyn, Paula$$b10 000186551 7001_ $$aSkeie, Guri$$b11 000186551 7001_ $$0P:(DE-He78)0b48ce513fe49013263657450a12f870$$aBajracharya, Rashmita$$b12$$udkfz 000186551 7001_ $$aBoer, Jolanda M A$$b13 000186551 7001_ $$aBorné, Yan$$b14 000186551 7001_ $$aChajes, Veronique$$b15 000186551 7001_ $$aDahm, Christina C$$b16 000186551 7001_ $$aDansero, Lucia$$b17 000186551 7001_ $$aGuevara, Marcela$$b18 000186551 7001_ $$aHeath, Alicia K$$b19 000186551 7001_ $$aIbsen, Daniel B$$b20 000186551 7001_ $$aPapier, Keren$$b21 000186551 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena$$b22$$udkfz 000186551 7001_ $$aKyrø, Cecilie$$b23 000186551 7001_ $$aMasala, Giovanna$$b24 000186551 7001_ $$aMolina-Montes, Esther$$b25 000186551 7001_ $$aRobinson, Oliver J K$$b26 000186551 7001_ $$aSantiuste de Pablos, Carmen$$b27 000186551 7001_ $$aSchulze, Matthias B$$b28 000186551 7001_ $$aSimeon, Vittorio$$b29 000186551 7001_ $$aSonestedt, Emily$$b30 000186551 7001_ $$aTjønneland, Anne$$b31 000186551 7001_ $$aTumino, Rosario$$b32 000186551 7001_ $$avan der Schouw, Yvonne T$$b33 000186551 7001_ $$aVerschuren, W M Monique$$b34 000186551 7001_ $$aVozar, Beatrice$$b35 000186551 7001_ $$aWinkvist, Anna$$b36 000186551 7001_ $$aGunter, Marc J$$b37 000186551 7001_ $$aMonteiro, Carlos A$$b38 000186551 7001_ $$aMillett, Christopher$$b39 000186551 7001_ $$aLevy, Renata Bertazzi$$b40 000186551 773__ $$0PERI:(DE-600)2776676-7$$a10.3389/fnut.2022.1035580$$gVol. 9, p. 1035580$$p1035580$$tFrontiers in nutrition$$v9$$x2296-861X$$y2022 000186551 909CO $$ooai:inrepo02.dkfz.de:186551$$pVDB 000186551 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bFRONT NUTR : 2021$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0501$$2StatID$$aDBCoverage$$bDOAJ Seal$$d2021-05-11T13:21:47Z 000186551 915__ $$0StatID:(DE-HGF)0500$$2StatID$$aDBCoverage$$bDOAJ$$d2021-05-11T13:21:47Z 000186551 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bDOAJ : Blind peer review$$d2021-05-11T13:21:47Z 000186551 915__ $$0LIC:(DE-HGF)CCBYNV$$2V:(DE-HGF)$$aCreative Commons Attribution CC BY (No Version)$$bDOAJ$$d2021-05-11T13:21:47Z 000186551 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)9905$$2StatID$$aIF >= 5$$bFRONT NUTR : 2021$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0561$$2StatID$$aArticle Processing Charges$$d2022-11-22 000186551 915__ $$0StatID:(DE-HGF)0700$$2StatID$$aFees$$d2022-11-22 000186551 9141_ $$y2022 000186551 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)0b48ce513fe49013263657450a12f870$$aDeutsches Krebsforschungszentrum$$b12$$kDKFZ 000186551 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aDeutsches Krebsforschungszentrum$$b22$$kDKFZ 000186551 9131_ $$0G:(DE-HGF)POF4-313$$1G:(DE-HGF)POF4-310$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lKrebsforschung$$vKrebsrisikofaktoren und Prävention$$x0 000186551 9201_ $$0I:(DE-He78)C020-20160331$$kC020$$lC020 Epidemiologie von Krebs$$x0 000186551 980__ $$ajournal 000186551 980__ $$aVDB 000186551 980__ $$aI:(DE-He78)C020-20160331 000186551 980__ $$aUNRESTRICTED