Ultra-processed food consumption and obesity in adolescents

Abstract

Objective To evaluate the relationship between ultra-processed food consumption and obesity indicators in adolescents. Methods Cross-sectional study with a convenience sample of 200 10- to 18-year-old adolescents from Campinas, São Paulo (SP). Usual dietary intake was determined through a semiquantitative food frequency questionnaire. Daily intake of each food was obtained from the intake frequency. Subsequently, foods were classified as raw and minimally processed, cooking ingredients or ultra-processed foods, and their caloric contribution to the total energy value was calculated. Sociodemographic and anthropometric variables were also investigated. Overweight was defined as Z-score>+1 and obesity was defined as Z-score>+2 according to the Body Mass Index per age group. The associations were tested by chi-square test and linear trend. Results The frequency of obesity was 47.0%, and 21.5% presented increased waist circumference. The average energy intake was 4,176kcal/day, of which 50.6% was derived from ultra-processed foods. The categories with the highest caloric contributions among ultra-processed foods were industrial loaves/cakes (16.2%), sweets and candy (6.2%), pastas (6.0%) and sweetened drinks (5.1%). No association was found between ultra-processed food consumption and anthropometric indicators. Conclusion The significant contribution of ultra-processed foods to daily calories is evidence of a poor diet of this population of young people, although this has not been shown as a factor associated with excess weight. Therefore, there is an urgent need for public policies that discourage the consumption of these products and encourage the return to a traditional diet.

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 children and adolescents (Brazil only) the proportion of total energy intake from UPF was reported as 41.8–43.4% at ages 3–4 years, 47.7–49.2% at ages 6–8 years [ 77 , 78 , 79 ] and 50.6% in adolescents [ 73 ]. One study reported 46.2% of adolescents consumed UPF weekly (median ≥ 3 times per week) [ 76 ], and another study reported frequency intakes varied from 9.9 (private schools) to 14.5 (public schools) times per day [ 74 ].…”

“…In a nationally representative cross-sectional sample on children and adolescents aged 10–19, Louzada et al [ 56 ] found no significant association with UPF and mean BMI, overweight/obesity or obesity. In a small cross-sectional study on adolescents aged 10–18 years ( n = 200), Enes et al [ 73 ] found no association between UPF consumption and anthropometric indicators. In a prospective cohort study, Cunha et al [ 74 ] followed 1035 adolescents (mean age 16 years) for three consecutive years and found no significant difference in BMI and percentage body fat trajectories.…”

“…In cross-sectional studies, one study on adolescents showed an association of higher UPF intake and metabolic syndrome [ 75 ], and a second on adolescents showed no association with overweight, higher waist circumference and high blood pressure [ 76 ]. Three studies investigating overweight and obesity on older children and adolescents aged 10–19 years showed no association of UPF with anthropometrics measured [ 56 , 73 , 74 ]. Direct comparisons of the studies were difficult due to differing study designs, exposure measurements and outcomes and methodological weaknesses.…”

“…Direct comparisons of the studies were difficult due to differing study designs, exposure measurements and outcomes and methodological weaknesses. Two of the studies reported quite high mean energy intakes of >4000 Kcal/day (>17,000 KJ) [ 73 , 74 ], and one study had a very small sample ( n = 200) with a low power of the statistical test [ 73 ]. In the prospective study there was a large drop-out rate of 43% [ 74 ].…”