Association between consumption of ultra-processed foods and serum C-reactive protein levels: cross-sectional results from the ELSA-Brasil study

Abstract

BACKGROUND: There may be a direct association between consumption of ultra-processed foods and C-reactive protein (CRP) levels, under the assumption that the high glycemic index of these food products could stimulate the entire chronic inflammation cascade, along with an indirect association mediated by obesity. The types of food consumed, including ultra-processed products, strongly influence obesity, and are also associated with higher serum CRP levels. OBJECTIVE: Our aim was to investigate whether the caloric contribution of ultra-processed foods to diet is associated with CRP levels, independent of body mass index (BMI). DESIGN AND SETTING: Cross-sectional analysis on the Longitudinal Study of Adult Health (ELSA-Brasil) baseline cohort (2008)(2009)(2010). METHODS: Dietary information, obtained through a food frequency questionnaire, was used to estimate the percentage of energy contribution from ultra-processed food to individuals' total caloric intake. CRP levels were the response variable. Sex-specific associations were estimated using generalized linear models with gamma distribution and log-link function. RESULTS: Ultra-processed food accounted for 20% of total energy intake. Among men, after adjustments for sociodemographic characteristics, there was no association between ultra-processed food intake and CRP levels. Among women, after adjustment for sociodemographic characteristics, smoking and physical activity, the highest tercile of ultra-processed food intake was associated with mean CRP levels that were 14% higher (95% confidence interval: 1.04-1.24) than those of the lowest tercile. However, after considering BMI, this association lost statistical significance. CONCLUSION: Our findings suggest that the positive association of ultra-processed food consumption with CRP levels among women seems to be mediated by the presence of adiposity.

Ultra-Processed Foods and Health Outcomes: A Narrative Review

“…Study types were ecological ( n = 3), cross-sectional ( n = 19), prospective cohort ( n = 19), case–control ( n = 1); and one randomised controlled trial (RCT). Studies were conducted in Brazil ( n = 16) [ 53 , 56 , 62 , 63 , 66 , 70 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ], France ( n = 8) [ 61 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ], Spain ( n = 6) [ 65 , 72 , 90 , 91 , 92 , 93 ], USA ( n = 4) [ 59 , 67 , 71 , 94 ], Canada ( n = 2) [ 57 , 68 ], UK ( n = 2) [ 55 , 60 ], and one each in Sweden [ 36 ], Lebanon [ 69 ] and Malaysia [ 64 ]. There was one study on 19 European countries [ 52 ], and one global study [ 37 ].…”

“…In studies on adults reporting the proportion of total energy intake from UPF, Malaysia was lowest (23%) [ 64 ]. Higher levels of consumption were reported in Spain (24.4%) [ 92 ], Lebanon (27.1%) [ 69 ], Brazil (20–29.6%) [ 56 , 62 , 66 , 70 ], France (29.9–35.9%) [ 61 , 86 , 87 ], Canada (45.1–51.9%) [ 57 , 68 ], and UK (53–54.3%) [ 55 , 60 ]. The highest levels were reported in the USA (55.5–56.1%) [ 59 , 71 ].…”

“…The association was strongest in younger adults [ 71 ]. In a study in Brazil of 8468 adults, Lopes et al [ 70 ] found women in the highest tercile of UPF by percent energy intake had higher levels of C-reactive protein (CRP) than those in the lowest tercile. When controlling for BMI, the association was not statistically significant.…”

“…When controlling for BMI, the association was not statistically significant. No association was found in men [ 70 ]. In Canada, Lavigne-Robichard et al’s [ 68 ] study of adults ( n = 811) found those in the highest quintile of UPF intake by percent energy had a higher prevalence of metabolic syndrome, reduced high-density lipoprotein cholesterol and elevated fasting glucose [ 68 ].…”

Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies

“…UPFs consumption increases added sugar intake, which is associated with obesity and several other health outcomes [19,21,62,63]. Moreover, higher intake of UPFs induces changes in gut microbiota, serum C-reactive protein levels and lipoprotein profiles [64][65][66][67]. Displacement of unprocessed or minimally processed foods might play a potential role in decreased diet quality [37].…”