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Annex
Summary of the strength of evidence for obesity, type 2 diabetes, cardiovascular disease (CVD), cancer, dental disease and osteoporosisa
| Obesity | Type 2 diabetes | CVD | Cancer Dental disease | Osteoporosis | | Energy and fats |
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| | High intake of energy-dense foods | C↑ |
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| | Saturated fatty acids |
| P↑ | C↑b |
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| | Trans fatty acids |
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| C↑ |
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| | Dietary cholesterol |
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| P↑ |
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| | Myristic and palmitic acid |
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| C↑ |
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| | Linoleic acid |
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| C↓ |
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| | Fish and fish oils (EPA and DHA) |
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| C↓ |
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| | Plant sterols and stanols |
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| P↓ |
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| | α-Linolenic acid |
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| P↓ |
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| | Oleic acid |
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| P↓ |
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| | Stearic acid |
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| P-NR |
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| | Nuts (unsalted) |
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| P↓ |
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| | Carbohydrate |
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| | High intake of NSP(dietary fibre) | C↓ | P↓ | P↓ |
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| | Free sugars (frequency and amount) |
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| C↑c |
| | Sugar-free chewing gum |
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| P↓c |
| | Starchd |
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| C-NR |
| | Wholegrain cereals |
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| P↓ |
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| | Vitamins |
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| | Vitamin C deficiency |
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| C↑e |
| | Vitamin D |
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| C↓f | C↓g | | Vitamin E supplements |
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| C-NR |
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| | Folate |
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| P↓ |
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| | Minerals |
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| | High sodium intake |
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| C↑ |
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| | Salt-preserved foods and salt |
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| P↑h |
| | Potassium |
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| C↓ |
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| | Calcium |
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| C↓g | | Fluoride, local |
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| C↓c |
| | Fluoride, systemic |
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| C↓c | P-NRg | | Fluoride, excess |
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| C↑f |
| | Hypocalcaemia |
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| P↑f |
| | Meat and fish |
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| | Preserved meat |
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| P↑i |
| | Chinese-style salted fish |
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| C↑j |
| | Fruits (including berries) and vegetables |
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| | Fruits (including berries) and vegetables | C↓k | P↓k | C↓ | P↓l |
| | Whole fresh fruits |
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| P-NRc |
| | Beverages, non-alcoholic |
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| | Sugars-sweetened soft drinks and fruit juices | P↑ |
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| P↑m |
| | Very hot (thermally) drinks (and food) |
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| P↑n |
| | Unfiltered boiled coffee |
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| P↑ |
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| | Beverages, alcoholic |
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| | High alcohol intake |
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| C↑o | C↑p | C↑g | | Low to moderate alcohol intake |
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| C↓q |
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| | Other food-borne |
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| | Aflatoxins |
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| C↑r |
| | Weight and physical activity |
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| | Abdominal obesity |
| C↑ |
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| | Overweight and obesity |
| C↑ | C↑ | C↑s |
| | Voluntary weight loss in overweight and obese people |
| C↓ |
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| | Low body weight |
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| C↑g | | Physical activity, regular | C↓ | C↓ | C↓ | C↓i P↓t | C↓g | | Physical inactivity/sedentary lifestyle | C↑ | C↑ |
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| | Other factors |
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| | Exclusive breastfeeding | P↓ |
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| | Maternal diabetes |
| C↑ |
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| | Intrauterine growth retardation |
| P↑ |
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| | Good oral hygiene/absence of plaque |
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| C↓e |
| | Hard cheese |
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| P↓c |
| | Environmental variables |
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| | Home and school environments that support healthy food choices for children | P↓ |
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| | Heavy marketing of energy-dense foods, and fast-food outlets | P↑ |
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| | Adverse socioeconomic conditions | P↑ |
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C↑: Convincing increasing risk; C↓: Convincing decreasing risk; C-NR: Convincing, no relationship; P↑: Probable increasing risk; P↓: Probable decreasing risk; P-NR: Probable, no relationship; EPA: eicosapentaenoic acid; DHA: docosahexaenoic acid; NSP: non-starch polysaccharides. a Only convincing (C) and probable (P) evidence are included in this summary table.
b Evidence also summarized for selected specific fatty acids, see myristic and palmitic acid.
c For dental caries.
d Includes cooked and raw starch foods, such as rice, potatoes and bread. Excludes cakes, biscuits and snacks with added sugar.
e For periodontal disease.
f For enamel developmental defects.
g In populations with high fracture incidence only; applies to men and women more than 50-60 years old.
h For stomach cancer.
i For colorectal cancer.
j For nasopharyngeal cancer.
k Based on the contributions of fruits and vegetables to non-starch polysaccharides.
l For cancer of the oral cavity, oesophagus, stomach and colorectum. m For dental erosion. n For cancer of the oral cavity, pharynx and oesophagus.
o For stroke.
p For cancer of the oral cavity, pharynx, larynx, oesophagus, liver and breast.
q For coronary heart disease.
r For liver cancer.
s For cancer of the oesophagus, colorectum, breast (in postmenopausal women), endometrium and kidney.
t For breast cancer.
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