Consumption of ultra-processed foods and cardiometabolic risk factors in Brazilian adolescents: results from ERICA

Abstract

Introduction: The consumption of ultra-processed foods (UPF), associated with overweight among adolescents, has increased in the last decades. However, few studies have investigated the association between UPF consumption and cardiovascular risk factors in adolescents from developing countries. Objective: To evaluate the association between UPF consumption and cardiometabolic risk factors in Brazilian adolescents. Methods: The sample consisted of Brazilian students aged 12–17 years from the Study of Cardiovascular Risk in Adolescents. Food consumption was assessed using a 24-hour food recall and the foods were classified according to their processing degree, based on the NOVA classification. Blood samples were collected after overnight fasting, and laboratorial analyses (triglycerides, total cholesterol, HDL-c, LDL-c, fasting glucose, insulin, and HbA1c) were performed. Overweight/obesity and blood pressure were included in cardiometabolic outcomes. Poisson regression analyses were used to evaluate associations. Results: The analysis was composed of 36,952 adolescents. The average energy consumption from UPF was 30.7% (95%CI: 29.7–31.6) per day. Adolescents with high UPF consumption (top tertile, ≥38.7% per day) ingest more sodium, saturated and trans-fat, as well as few proteins, fibers, polyunsaturated fats, vitamins, and minerals. After adjusting for possible confounders, higher UPF consumption was directly associated with high LDL-c (PR=1.012; 95%CI: 1.005–1.029), and inversely associated with low HDL-c (PR=0.972; 95%CI: 0.952–0.993). We did not find associations between UPF consumption and other cardiometabolic risk factors evaluated in this study. Conclusion: UPF consumption among Brazilian adolescents is high and can be associated with poor diet quality and changes in LDL-c.