Abstract 12187: Association Between Ultra-Processed Food Intake and Cardiovascular Health Among US Women of Reproductive Age: NHANES 2007-2018

Abstract

Introduction: Studies have showed that higher intake of ultra-processed foods (UPF) is associated with increased risk of lower cardiovascular health (CVH) among adolescents and adults. As UPF intake is a modifiable risk factor of cardiovascular disease, examining the association of UPF and CVH among women of reproductive age (WRA) may help improve CVH among this population. Hypothesis: A higher percentage of calories (%kcal) from UPF is associated with lower CVH among WRA aged 22-44 years. Methods: We analyzed data on 5,780 WRA from NHANES 2007-2018. UPF was assigned from the Nova classification, which categorizes foods according to the extent and purpose of food processing. CVH was defined by using the Life’s Essential 8 (LE8) on a scale of 0 to 100. Scores of the seven LE8 metrics (excluding diet) were averaged, and the levels of CVH (low, moderate, and high) were defined using tertiles. We estimated the usual %kcal from UPF intake by using up to two 24-hour dietary recalls and the National Cancer Institute’s usual intake method to account for measurement error. We used multivariable linear and multinomial logistic regression to assess the association between UPF and CVH, adjusting for covariates. Results: The mean usual %kcal from UPF was 57.2%, and midpoint of quartiles of intake were 43.8%, 53.5%, 60.9%, and 70.6% for Q1, Q2, Q3, and Q4, respectively. Every 10% increase in calories from UPF was associated with 3.6 points lower CVH score ( P < .001). The adjusted odds ratios and 95% confidence intervals for low CVH were 1.76 (1.52-2.03), 2.70 (2.10-3.47), and 4.72 (3.19-7.04), respectively, comparing Q2, Q3, and Q4 to Q1 of UPF intake. The corresponding adjusted odds ratio and 95% confidence intervals for moderate CVH were 1.17 (1.02-1.34), 1.32 (1.04-1.68), and 1.55 (1.06-2.26). The pattern of association was largely consistent across subgroups, except for non-Hispanic Black women, and was consistent across sensitivity analyses. Conclusions: Among US WRA, UPF represented more than half of total calorie intake and showed a graded inverse association with CVH. Our analyses highlight the importance of limiting the consumption of UPF among WRA to maintain CVH.