Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis

Ultra-processed foods’ (UPFs’) consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1–4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of cases, processing degree was not linked to allergens’ presence. Recipe/matrix complexity was more strongly linked to allergens’ presence with NOVA4 foods declaring 1.3 allergenic ingredients vs. 0.4 allergenic ingredients in NOVA1 foods (p < 0.01). Exposure to trace allergens was more common for NOVA4 than NOVA1 foods (45.4% vs. 28.7%), but the extent of contamination was similar (2.3 vs. 2.8 trace allergens). Overall, UPFs are more complex mixtures with higher numbers of allergens per food and are more prone to cross-contamination. However, indicating a food’s degree of processing is not sufficient to help identify allergen-free choices within the same subcategory.

[1]  M. Kapsokefalou,et al.  Ultra-Processed Foods in the Mediterranean Diet according to the NOVA Classification System; A Food Level Analysis of Branded Foods in Greece , 2023, Foods.

[2]  M. Kapsokefalou,et al.  Nutritional Quality of Plant-Based Meat and Dairy Imitation Products and Comparison with Animal-Based Counterparts , 2023, Nutrients.

[3]  M. Kapsokefalou,et al.  Alignment of Nutri-Score with Mediterranean Diet Pyramid: A Food Level Analysis , 2022, Nutrients.

[4]  C. Cao,et al.  Ultra-processed foods and allergic symptoms among children and adults in the United States: A population-based analysis of NHANES 2005–2006 , 2022, Frontiers in Public Health.

[5]  M. Kapsokefalou,et al.  The Expansion of the Hellenic Food Thesaurus; Allergens Labelling and Allergens-Free Claims on Greek Branded Food Products , 2022, Nutrients.

[6]  M. Touvier,et al.  Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. , 2022, The lancet. Gastroenterology & hepatology.

[7]  M. Maillot,et al.  Ultra-processed foods: how functional is the NOVA system? , 2022, European Journal of Clinical Nutrition.

[8]  G. Grosso,et al.  Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples , 2021, Nutrients.

[9]  M. Kapsokefalou,et al.  Development of the Hellenic Food Thesaurus (HelTH), a branded food composition database: Aims, design and preliminary findings. , 2021, Food chemistry.

[10]  S. Sicherer,et al.  Clinical Relevance of Cross-Reactivity in Food Allergy. , 2021, The journal of allergy and clinical immunology. In practice.

[11]  A. Fernández-Montero,et al.  [Consumption of ultra-processed products and wheezing respiratory diseases in children: The SENDO project]. , 2020, Anales de pediatria.

[12]  M. Lawrence,et al.  Ultra-Processed Foods and Health Outcomes: A Narrative Review , 2020, Nutrients.

[13]  J. P. Lopes,et al.  Food allergy: epidemiology, pathogenesis, diagnosis, prevention, and treatment. , 2020, Current opinion in immunology.

[14]  F. Barros,et al.  Ultra‐processed food consumption during childhood and asthma in adolescence: Data from the 2004 Pelotas birth cohort study , 2020, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[15]  M. Touvier,et al.  Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. , 2019, JAMA internal medicine.

[16]  A. Hâncu,et al.  Asthma and Ultra-Processed Food. , 2019, Maedica.

[17]  M. Touvier,et al.  Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé) , 2019, BMJ.

[18]  F. Rauber,et al.  Dietary share of ultra-processed foods and metabolic syndrome in the US adult population. , 2019, Preventive medicine.

[19]  M. Touvier,et al.  Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Santé cohort , 2019, BMC Medicine.

[20]  Laurence H. Schnabel,et al.  Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France , 2019, JAMA internal medicine.

[21]  F. Rauber,et al.  Ultra-processed foods: what they are and how to identify them , 2019, Public Health Nutrition.

[22]  J. Soon.  Food allergen labelling: "May contain" evidence from Malaysia. , 2018, Food research international.

[23]  N. Gouveia,et al.  Associations of ultra‐processed food and drink products with asthma and wheezing among Brazilian adolescents , 2018, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[24]  H. Sampson,et al.  Phenotypes and endotypes of food allergy: A path to better understanding the pathogenesis and prognosis of food allergy. , 2018, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[25]  M. Touvier,et al.  Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort , 2018, British Medical Journal.

[26]  J. Volatier,et al.  Allergens labeling on French processed foods – an Oqali study , 2017, Food science & nutrition.

[27]  R. Levy,et al.  The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing , 2017, Public Health Nutrition.

[28]  C. Camargo,et al.  Cured meat intake is associated with worsening asthma symptoms , 2016, Thorax.

[29]  M. Martínez-González,et al.  Ultra‐Processed Food Consumption and the Incidence of Hypertension in a Mediterranean Cohort: The Seguimiento Universidad de Navarra Project , 2016, American journal of hypertension.

[30]  D. Mozaffarian,et al.  Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. , 2015, Preventive medicine.

[31]  K. Verhoeckx,et al.  Food processing and allergenicity. , 2015, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[32]  P. Turner,et al.  Advice provided by Health Professionals regarding precautionary allergen labelling , 2014, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[33]  Kirsten Beyer,et al.  A global survey of changing patterns of food allergy burden in children , 2013, The World Allergy Organization journal.

[34]  T. Halldorsson,et al.  Consumption of Artificially-Sweetened Soft Drinks in Pregnancy and Risk of Child Asthma and Allergic Rhinitis , 2013, PloS one.

[35]  C. Monteiro,et al.  Nutrition and health. The issue is not food, nor nutrients, so much as processing , 2009, Public Health Nutrition.

[36]  E. Mills,et al.  The impact of processing on allergenicity of food , 2008, Current opinion in allergy and clinical immunology.

[37]  M. Messina,et al.  Recent Surveys on Food Allergy Prevalence , 2020 .

[38]  Scott H Sicherer,et al.  Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. , 2018, The Journal of allergy and clinical immunology.

[39]  J. Motta,et al.  Design of a digital and self-reported food frequency questionnaire to estimate food consumption in adolescents and young adults: birth cohorts at Pelotas, Rio Grande do Sul, Brazil. , 2016, Revista brasileira de epidemiologia = Brazilian journal of epidemiology.