The estimated burden of ultra-processed foods on cardiovascular disease outcomes in Brazil: A modeling study

Abstract

IntroductionUltra-processed foods (UPF) have been associated with an increased risk of cardiovascular diseases (CVD). This study aimed to estimate CVD premature deaths, incident cases, and disability adjusted life-years (DALYs) attributable to the consumption of UPF in Brazilian adults in 2019.MethodsA validated a comparative risk assessment model was adapted to estimate the burden of major CVD outcomes (coronary heart disease and stroke) attributable to the consumption of UPF in Brazilian adults aged 30 to 69 years. The model inputs included nationally representative data of the UPF contribution to the total energy of the diet, national official demographic records, CVD outcomes (incidence, deaths and DALYs) from the Global Burden of Disease study for 2019, and relative risks from meta-analysis studies.ResultsWe estimated that approximately 19,200 premature deaths (95% uncertainty intervals – UI, 7,097 to 32,353), 74,900 new cases (95% UI, 25,983 to 128,725), and 883,000 DALYs/year (95% UI, 324,279 to 1,492,593) from CVD were attributable to the consumption of UPF in Brazil, corresponding to about 22% of the premature deaths from CVD and to 33% of the total premature all-cause deaths attributable to UPF intake among Brazilian adults. Reducing UPF consumption by 10% in the adult population would avert approximately 11% of the premature CVD deaths, equivalent to 2,100 deaths/year (95% UI, 697 to 4,511). A 20% reduction in UPF intake would avert approximately 21% of the premature CVD deaths or 4,100 deaths (95% UI, 1,413 to 8,047), and a 50% reduction in UPF intake would avert about 52% of the premature CVD deaths, corresponding to 9,900 deaths/year (95% UI, 3,682 to 17,820). If UPF consumption among adults was reduced to that of the first quintile of UPF intake in the baseline scenario, approximately 81% of the premature CVD deaths would be averted, corresponding to some 15,600 deaths/year (95% UI, 5,229 to 27,519).ConclusionOur study estimated a high burden of premature CVD outcomes attributable to the consumption of UPF in Brazil. Our findings support food policies aimed at reducing the consumption of UPF, such as fiscal and regulatory policies, which are imperative to prevent CVD in Brazil.

Perspective on the consumption of ultra-processed foods among university students

“…There are food policies in many countries, such as fiscal and regulatory policies in Brazil, that were created with the sole purpose of reducing the intake of these ultra -processed foods because they cause diseases related to cardiovascular diseases [26]. In the same way, Chinese adults who consume these foods have elevated hypertension [27].…”

“…Similarly childhood obesity is attributed to the consumption of ultra -processed foods, but there is no clear evidence of this [23], nor has it been possible to prove its relationship with hypertension [24]. Other studies affirm that the intake of ultra -processed foods influences the acquisition of type 2 diabetes; however, due to the great variety of these products and their different nutritional content, it is not possible to affirm that all consumers of ultra-processed foods will present the same results [25] and much less with anemia [26] Among the main consequences attributed to the intake of ultra -processed foods is the risk of contracting cardiovascular diseases [27]. The relationship between the consumption of ultra -processed foods a nd the risk of suffering cardio metabolic diseases is directly proportional [28].…”

Applying the Nova food classification to food product databases using discriminative ingredients: a methodological proposal

“…The Nova food classification has been applied to observational studies (8,9), cohort studies (10)(11)(12), and randomized trials (13) to assess the link between UPF consumption and health outcomes. At the moment, evidence is available on the associations of UPF with health outcomes such as weight gain (14), type 2 diabetes (15), cardiometabolic diseases (16), cerebrovascular disease (16), cancer (17), premature deaths (18), all-cause mortality (16), among others (9,19,20).…”