Abstract
We examined the association between the consumption of ultra-processed foods and adiposity in a nationally representative sample of the UK adult population. We studied 6,143 participants (19 to 96 years, 51.6% female) sampled by the UK National Diet and Nutrition Survey (2008–16). Food items reported in four-day food diary were classified according to the NOVA system. Multiple linear and logistic regressions were used to evaluate associations between the dietary contribution of ultra-processed foods (sex-specific quartile and continuous) and Body Mass Index (BMI), Waist Circumference (WC) and obesity (BMI>30kg/m2) and abdominal obesity (men: WC≥102cm, women: WC≥88cm) status. Models were adjusted for sociodemographic and lifestyle characteristics. In multivariable analyses, the highest consumption of ultra-processed food was associated with 1.66 kg/m2 higher BMI (95%CI 0.96–2.36), 3.56 cm greater WC (95%CI 1.79–5.33) and 90% higher odds for being obese (OR = 1.90, 95%CI 1.39–2.61), compared with the lowest consumption. A 10% increase in the consumption of ultra-processed foods was associated with an increase of 0.38 kg/m2 in BMI (95%CI 0.20–0.55), 0.87 cm in WC (95%CI 0.40–1.33) and 18% higher odds of being obese (OR = 1.18, 95%CI 1.08–1.28). The consumption of ultra-processed food was associated with an increase in BMI, WC and prevalence of obesity in both sexes. A dose response relationship was observed in both sexes, with a 10% increase in the consumption of ultra-processed foods being associated with a 18% increase in the prevalence of obesity in men and a 17% increase in women. Higher consumption of ultra-processed food is associated with greater adiposity in the UK adult population. Policy makers should consider actions that promote consumption of unprocessed or minimally processed foods and reduce consumption of ultra-processed foods.
Highlights
Increasing prevalence of obesity is driving greater chronic disease and mortality burdens globally [1]
We studied 6,143 participants (19 to 96 years, 51.6% female) sampled by the United Kingdom (UK) National Diet and Nutrition Survey (2008–16)
Analyses of 2008–2014 national dietary survey reveal that ultra-processed foods already make up more than half of the total dietary energy consumed in the UK [8]
Summary
Increasing prevalence of obesity is driving greater chronic disease and mortality burdens globally [1]. Ultra-processed foods are industrial formulations of food-derived substances (e.g. oils, fats, sugars, starch, protein isolates) that contain little if any whole food and often include ingredients not used in culinary preparations, such as flavourings, colourings, emulsifiers and other cosmetic additives [9]. These formulations are hyper-palatable, attractive, convenient, sold in large packages, and highly marketed [6,10]. Analyses of nationally representative studies conducted in the UK [8], the United States [11], Canada [12] and Brazil [13] have shown strong associations between consumption of ultra-processed foods and dietary nutrient profiles that predict increased risk of obesity and several other diet-related chronic diseases. Given the very high levels of ultra-processed food consumption and obesity in the UK, this study used more recent data from the UK NDNS (2008–2016) to evaluate the association between ultra-processed food consumption and a wider set of obesity indicators than previously studied—overall and abdominal obesity, greater body mass index and waist circumference
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