title: Current food classifications in epidemiological studies do not enable solid nutritional recommendations for preventing diet-related chronic diseases: the impact of food processing.
abstract: To date, observational studies in nutrition have categorized foods into groups such as dairy, cereals, fruits, and vegetables. However, the strength of the association between food groups and chronic diseases is far from convincing. In most international expert surveys, risks are most commonly scored as probable, limited, or insufficient rather than convincing. In this position paper, we hypothesize that current food classifications based on botanical or animal origins can be improved to yield solid recommendations. We propose using a food classification that employs food processes to rank foods in epidemiological studies. Indeed, food health potential results from both nutrient density and food structure (i.e., the matrix effect), both of which can potentially be positively or negatively modified by processing. For example, cereal-based foods may be more or less refined, fractionated, and recombined with added salt, sugars, and fats, yielding a panoply of products with very different nutritional values. The same is true for other food groups. Finally, we propose that from a nutritional perspective, food processing will be an important issue to consider in the coming years, particularly in terms of strengthening the links between food and health and for proposing improved nutritional recommendations or actions.
authors.affiliation: National Institute for Agricultural Research (INRA), Joint Research Unit 1019, Human Nutrition Research Center of Auvergne, Clermont-Ferrand, France; University of Auvergne, Unit of Human Nutrition, Clermont-Ferrand, France; anthony.fardet@clermont.inra.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fardet
authors.affiliation: National Institute for Agricultural Research (INRA), Joint Research Unit 1019, Human Nutrition Research Center of Auvergne, Clermont-Ferrand, France; University of Auvergne, Unit of Human Nutrition, Clermont-Ferrand, France;
authors.forename: Edmond
authors.initials: E
authors.lastname: Rock
authors.affiliation: Gaston Berger University, Saint-Louis, Senegal;
authors.forename: Joseph
authors.initials: J
authors.lastname: Bassama
authors.affiliation: Montpellier SupAgro, CIRAD, Joint Research Unit QualiSud 95, Montpellier, France;
authors.forename: Philippe
authors.initials: P
authors.lastname: Bohuon
authors.affiliation: Central Food Technological Research Institute, Mysore, India; and.
authors.forename: Pichan
authors.initials: P
authors.lastname: Prabhasankar
authors.affiliation: Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
authors.forename: Carlos
authors.initials: C
authors.lastname: Monteiro
authors.affiliation: Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Moubarac
authors.affiliation: Montpellier SupAgro, CIRAD, Joint Research Unit QualiSud 95, Montpellier, France;
authors.forename: Nawel
authors.initials: N
authors.lastname: Achir
mesh_terms: D000818:Animals; D001315:Australia; D001938:Brazil; D002908:Chronic Disease / Q000517:prevention & control*; D004032:Diet / Q000009:adverse effects*; D016021:Epidemiologic Studies; D005285:Fermentation; D005502:Food / Q000145:classification*; D005511:Food Handling / Q000379:methods*; D057141:Food, Preserved; D006801:Humans; D009369:Neoplasms; D018673:Nutrition Policy; D009753:Nutritive Value
keywords: dietary guidelines; epidemiological studies; food groups; food processing ranking; health potential