Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study

Diana Barbosa Cunha,Teresa Helena Macedo da Costa,Rosely Sichieri,Gloria Valeria da Veiga,Rosangela Alves Pereira

doi:10.1038/s41387-018-0043-z

Diana Barbosa Cunha, Teresa Helena Macedo da Costa + Show 3 more

Open Access

https://doi.org/10.1038/s41387-018-0043-z

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Abstract

Background/objectivesIn Brazil, the increase in obesity rates has been accompanied by increased consumption of ultra-processed food (UPF). The objective of this paper was to evaluate body mass index (BMI) and body fat percentage (%BF) trajectories in adolescents over a 3-year follow-up according to the frequency of UPF consumption.Subjects/methodsData of three consecutive years (2010, 2011, and 2012) were obtained from the Adolescent Nutritional Assessment Longitudinal Study (ELANA) that aimed to assess changes in anthropometric indicators of nutritional status, and 1035 adolescents enrolled in the 1st year of high school from six schools (four private and two public) in the metropolitan area of Rio de Janeiro, Brazil were included. At three follow-ups, they had their weights and heights measured. Body composition was measured at the first and second follow-ups. Mixed linear regression models were used to estimate BMI and %BF trajectories based on quartiles of UPF intake, adjusting for type of school, sex, physical activity, and underreporting.ResultsCompared to their counterparts in the 1st quartile, adolescents in the 4th quartile of UPF consumption had a lower daily intake of fruits, cooked vegetables, and raw vegetables and a higher intake of total sugar and physical activity levels (p < 0.001). There was an inverse association between UPF consumption and BMI both at baseline and at follow-up. Values for %BF followed the same trend. Adolescents in the 4th quartile had the greatest level of physical activity and lowest total energy intake.ConclusionThis study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in BMI associated with greater UPF consumption, even after adjusting for physical activity.

Highlights

Introduction The recommendations of the BrazilianDietary Guidelines, published in 2014, are based on the degree of processing of food items[1], and is grounded in the work developed by Monteiro and colleagues[2], which shows a greater quality of diets with a reduced proportion of ultraprocessed foods (UPFs)[2, 3].ultra-processed food (UPF) are defined as formulations modified by industrial procedures using parts or substances extracted from food sources maintaining little or no characteristics of the whole food[2]
This study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in body mass index (BMI) associated with greater UPF consumption, even after adjusting for physical activity
UPFs are defined as formulations modified by industrial procedures using parts or substances extracted from food sources maintaining little or no characteristics of the whole food[2]

Summary

Introduction

UPFs are defined as formulations modified by industrial procedures using parts or substances extracted from food sources maintaining little or no characteristics of the whole food[2]. During the process, they receive artificial or chemical additives and most of them are energy-dense, composed of low nutrient diversity, but are highly palatable and convenient The classification of foods as processed and ultraprocessed is recent, and no longitudinal study has previously analyzed the association between the consumption of UPF with weight gain in adolescents. Cross-sectional studies have described a detrimental association between UPF and dietary quality[2, 5,6,7], and with excessive weight[2, 5, 6, 8,9,10,11].

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