Performing Department
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Non Technical Summary
Current issue/program and So what?Ultra-processed foods (UPF) make up about 56-67% of the dietary consumption of the American public. They contain little to no whole foods and include frozen and prepared meals, most packaged snacks, desserts, and carbonated soft drinks. Ultra-processed foods are thought to promote excess energy intake because they are less satiating yet highly palatable, have higher energy density, and are low in fiber. However, the evidence to support this claim is limited and the nutritional quality of foods has not been considered within and between processing levels. Therefore, dietary guidance regarding UPF is lacking for the American public, specifically regarding whether some UPF may align with the US Dietary Guidelines and do not pose the same risk as those UPF that do not align with the US Dietary Guidelines. This is especially timely as pressure mounts to include guidance about UPF in upcoming US Dietary Guidelines.Methods/Approaches The primary goal of this project is to add to the evidence base about UPF and nutritional content, and their impact on eating behaviors. It aims to answer the question of whether over-consumption of UPF is related to processing level or if UPF that align with the US Dietary Guidelines for Americans are lower risk than those that do not. During this study, test meals will be developed and assessed, and then consumed under controlled laboratory conditions by participants using the Universal Eating Monitor, the gold-standard measure in eating behaviors research. The study is a randomized crossover trial that will test three different meals varying in terms of UPF content and nutritional quality. Energy intake, satiating efficiency, eating rate, and glycemic responses will all be examined.Impact and societal benefitsThese preliminary findings will be the basis for longer-term UPF-related interventions, including randomized control trials assessing relationships between UPF intake and relevant health markers. This study can be the foundation for designing diets high in UPF, which may be more convenient and accessible and less costly, and high in nutritional quality and fiber. These longer-term UPF studies will also integrate consumer education that takes into account nutritional quality based on the US Dietary Guidelines. This is of particular importance when trying to address how diet and nutrition can impact chronic diseases such as obesity, diabetes, and coronary heart disease. Additionally, it is critical to know how UPF can be incorporated in a healthy manner aligns with USDA's goals and priority areas of satisfying healthy food and fiber needs in a way that is accessible to all Americans.
Animal Health Component
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Research Effort Categories
Basic
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Applied
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Developmental
100%
Goals / Objectives
The overarching purpose of this research is to address our most critical health challenges, such as obesity, associated health risks, and fiber intakes that fall far below recommendations. This Seed project's major achievement will be creation of an evidence base for future integrated projects that educate consumers about processed foods while considering adherence to the US Dietary Guidelines and nutrient content. This study's short-term goals are to examine energy intake, satiating efficiency, eating rate, and glycemic responses to three test meals that differ by levels of food processing and alignment with the US Dietary Guidelines for Americans. The project's long-term goals are to prepare for funding further randomized controlled trials related to ultra-processed foods. This topic is important when examining how diet and nutrition can impact chronic diseases and aligns with USDA's goals of satisfying healthy food and fiber needs. The milestones will be to develop and evaluate experimental and control test meals and methodology, to inform designs for dietary interventions and educational materials that will be tested in future projects applicable to AFRI Priority Areas.This project's objectives are to:Develop a randomized crossover study testing three standardized meals varying in UPF and NQ, during three laboratory visits separated by 4-7 days each in young adults of any gender, race, or ethnicity.Conduct this study to address the following hypotheses:Adults will consume similar energy from the low-UPF/high-NQ meal and the high-UPF/high-NQ meal, both of which will be lower than the high-UPF/low-NQ meal.Adults will have similar postprandial satiating efficiency after the low-UPF/high-NQ and high- UPF/high-NQ meals, both of which will be higher than the high-UPF/low-NQ meal.Adults will consume similar amounts of energy over the rest of the day after low-UPF/high-NQ and high-UPF/high-NQ meals, both of which will be lower than after the high-UPF/low-NQ meal.Adults will consume the low-UPF/high-NQ and high-UPF/high-NQ at similar rates and have similar glycemic responses after the low-UPF/high-NQ and high-UPF/high-NQ meals, both of which will be lower than the high-UPF/low-NQ meal.Analyze data resulting from this study and assess findings to inform future research.Disseminate findings at scientific conferences and in peer-reviewed journals.Write an AFRI grant proposal based on the findings of this Seed Grant. The proposed project would involve interventions to reduce intakes of foods that are both highly processed and have poor alignment with the US Dietary Guidelines, while considering affordability and convenience for populations with limited financial resources and time.
Project Methods
Efforts: The proposed work will be the first to compare two meals with high nutritional quality (NQ, based on US Dietary Guidelines) but differing by processing level, with a low-NQ control meal that includes ultra-processed foods (UPF). This unique 3-testmeal design will measure energy intake, satiety, and eating behaviors under carefully controlled laboratory conditions. Importantly, it will track food and beverage consumption for the remainder of each day too, to assess possible energy intake compensation, and levels of processing of self-selected foods. It will also be the first UPF study to directly measure eating behaviors on the gold standard Universal Eating Monitor (UEM), and consider possible factors such as eating rate, palatability ratings, and blood glucose. Using a within-subjects randomized crossover design, 40 adults will consume the three test meals during individualized lab visits. In addition to measures of energy intake and appetite, this will include testing of eating rate, palatability, and blood glucose. The protocol will be approved by the university's Institutional Review Board, and all participants will complete the informed consent process and sign informed consent forms.Participants will be recruited from the university and surrounding areas through flyers, list servs, class announcements, and social media. Prospective participants will complete a brief online screening survey. Inclusion criteria include non-smokers/vapers of all genders, races and ethnicities, age 18-39 years, with body mass index (BMI) of 20-40 kg/m2 who are not pregnant or lactating. They should not have allergies or intolerances to the test foods. Additionally, they should be free from major diseases, conditions, or medications that may impact study outcomes. Based on these criteria, selected individuals will be contacted via email to set up a phone/Zoom conversation to verify eligibility, address questions, provide information, schedule the three one-on-one lab visits, and assure that preparation for the first test day is understood.The protocol will commence after successful telephone screening for all inclusion and exclusion criteria, the consent process is completed, and consent forms are signed. Testing during the three lab visits will be identical and will occur after a 12-hour overnight fast. Participants should not consume alcohol or engage in vigorous exercise for ≥36 hours and have no caffeine for ≥18 hours before their visit. The day prior to each test day is the preparation day. Participants will match diet patterns and activity on their three preparation days as closely as possible. Prior to each preparation day, a reminder will be sent with specific instructions.Evaluation: The first milestone is completion of all three test days by 40 participants, the second is full analyses of results, followed by interpretation and dissemination of findings and then submission of the AFRI grant proposal based on this work. For the first milestone, participants will report to the lab on three separate mornings, in a fasting state, and preparation day compliance will be verbally confirmed (the visit will be re-scheduled in the case of non-compliance as defined above). They will then void their bladders. For descriptive and potential confounding variable purposes, participant BMI will be measured, using a wall-mounted stadiometer (Seca; Hamburg, Germany) for height and digital scale (InBody; Seoul, South Korea) for weight, both in duplicate. Participants will then complete a 24-hour dietary recall using ASA2451 to check compliance and UPF/NQ intake. The prior day's physical activity will be assessed by 24-hour recall,52 along with meal palatability ratings during each visit.Before the meal, participants will complete validated visual analogue scales (VAS) with appetite ratings.53 Fasting blood glucose will be measured by capillary fingerstick using a safety lancet, and tested with rapid-readout Hemocue (Angleholm, Sweden). Capillary samples will be used because they are more sensitive than venous samples postprandially54 and tend to promote recruitment and retention due to their lower invasiveness than venipuncture. Participants will then consume an ad libitum test breakfast, either low-UPF/high-NQ, high-UPF/high-NQ meals, or high-UPF/low-NQ (control; Cx), matched for presented energy, flavor profiles, macronutrients, energy density, and palatability, as shown in the table below. The two experimental (Ex 1 and Ex2) meals will be matched for fiber content.Low-UPF/High-NQ (Ex1)High-UPF/High-NQ (Ex2)High-UPF/Low-NQ (Control; Cx)Steel-cut rolled oats, honey, cinnamonCinnamon flavored oatmeal packetCinnamon sugar donut (fat in it helps balance butter)Dairy milk (skim or 1% in the oatmeal)Whey protein powder (in oatmeal)Vanilla dairy drink (will balance fat & protein)Whole wheat bakery toastWhole wheat commercial toastFruit flavor toaster pastry100% fruit puree (on toast)Commercial fruit jelly (on toast)Pure dairy butter (on toast)Butter-like spread (on toast)Fresh squeezed orange juiceOrange juice from concentrateOrange flavored drinkTest meals will be served on a UEM, which is a table with an embedded scale that reads food disappearance during the meal at 2-second intervals, to measure eating rate and grams consumed.55 Total energy consumption is calculated by weighed differences of all food and beverage items. Participants will be told to eat until they are comfortably satiated with no other eating instructions. When the participants volitionally terminate the meal, they will complete another VAS appetite rating. Additionally, they will complete a VAS palatability rating of the meal, which may serve as a potential confounder (although palatability will be matched). Postprandial VAS and blood glucose will be collected at minutes 30, 60, 90, and 120 after breakfast (total: 1 pre- and 4 postprandial measures). During these two hours, participants will remain in the lab where they can perform quiet activities such as reading. They will also be instructed on the use of My Fitness Pal, which they will use to track all their food and beverage intake, along with satiety ratings for the remainder of the day and submit electronically. My Fitness Pal has been validated for tracking energy intake in this population.56 To improve recruitment and retention, participants will receive a $30, $40, and $80 stipend upon completion of visits 1 ,2 and 3, respectively.Analysis: Statistical analyses will be run in SAS and SPSS. Sample sizes are based on previous work49,50 and calculated using GPower version 3.1.9.6.,57 accounting for 10% attrition. For power at p<0.05 and =0.80 with an effect size of 0.20, 36 participants are required, so 40 will be recruited. Analyses will include descriptive tests such as means and standard error of means for all variables, along with normality by examining skewness and kurtosis. Non-parametric tests will be used if any non-normal data are detected. Repeated measures analysis of variance (ANOVA) will be employed to compare changes in outcomes over time, with consideration of confounders and testing order through analysis of covariance (ANCOVA), as appropriate. Secondary and tertiary outcomes will be examined in a similar fashion. Correlations and multiple regression will examine relationships among outcomes, for example energy intake, satiety, blood glucose and palatability. Indicators of success include informative evaluations of findings that will advance the scientific literature related to UPF and NQ, provide foundational data for the AFRI grant proposal, and build an evidence base to improve consumer education about UPF and NQ.