Consumption of Ultraprocessed Foods and Body Fat Distribution Among U.S. Adults

Abstract

The association between ultra-processed food (UPF) consumption and body composition, and potential variation by sociodemographic factors, is unclear. This study aims to examine the cross-sectional associations of UPF consumption with imaging markers of body fat distribution in a nationally representative sample of US adults, overall and by sociodemographic strata. A total of 9,640 men and non-pregnant women aged 20-59 years were included from 4 cycles (2011-2012, 2013-2014, 2015-2016, 2017-2018) of the National Health and Nutrition Examination Survey (NHANES) with valid 24-hour dietary recalls and available whole-body DXA scans. UPFs were identified using the NOVA classification, with % energy from UPF assessed in quintiles. Primary outcomes were absolute % fat (total, android, gynoid), and secondary ones were % fat (head, arm, leg, trunk), total abdominal fat (area, mass, volume), subcutaneous adipose tissue (area, mass, volume), and visceral adipose tissue (area, mass, volume). Multivariable-adjusted generalized linear regressions estimated independent relationships of UPF intake with body composition overall and by sociodemographic subgroups. Analyses were conducted in September 2022 and January 2023 RESULTS: UPF consumption accounted for more than half (55.5%) of daily energy consumption in this sample. Compared with the lowest quintile of UPF consumption (<39.4 %energy), adults in the highest quintile (>72.1 %energy) had 1.60 higher total %fat (95% CI, 0.94, 2.26), 2.08 higher android %fat (95% CI, 1.26, 2.89), and 1.32 higher gynoid %fat (95% CI, 0.71, 1.93) (all P-trend<0.001). Consistent findings were observed for secondary outcomes. Associations of UPF intake with total %fat, android %fat, and gynoid %fat varied by age, sex, race and ethnicity, education, and income. Among those in the highest quintile of UPF consumption compared to the lowest quintile counterpart, total %fat was 1.85 (95% CI, 0.86, 2.84) higher for non-Hispanic white adults and 1.57 (95% CI, 0.68, 2.46) higher for Hispanic adults (P-trends<0.001) while no difference was observed among non-Hispanic black adults (-0.22; 95% CI, -0.93, 1.36) (P-trend=0.47) and non-Hispanic Asian adults (0.93; 95% CI, -0.57, 2.42) (P-trend=0.04) (P-interaction=0.001). Associational patterns were similar for android %fat and gynoid %fat. In a national US sample, higher intake of UPF was associated with greater body fat, in particular android fat, and this relationship was most prominent in certain population subgroups. These cross-sectional findings call for prospective and interventional studies to assess the impact of UPF on body composition in different populations.