Ultra-processed food consumption, appetitive traits and BMI in children: a prospective study

Abstract

This study aimed to investigate the association of ultra-processed food consumption at 4 and 7 years of age with appetitive traits at 7 years, and body mass index (BMI) at 10 years of age. Participants were 1175 children of the population-based birth cohort Generation XXI, who provided food diaries and complete data on socio-demographic variables, anthropometric measures, and the Portuguese Children’s Eating Behaviour Questionnaire (P-CEBQ). Foods were grouped according to NOVA classification into: “unprocessed, minimally or moderately processed, and culinary preparations”; “processed”; “ultra-processed”. To assess tracking of groups’ consumption, Pearson’s Correlation Coefficient (r) and the Intraclass Correlation Coefficient (ICC) were calculated. Generalized linear models were fitted to test main associations, mediators, and interactions among the variables. Ultra-processed consumption exhibited a fair level of stability between ages 4 and 7 (r=0.34; ICC=0.32; 95%CI: 0.25; 0.39), corresponding respectively to 27.3% (449.8 kcal per day; SD=217.2) and 29.3% (526.9 kcal per day; SD=229.7) of total energy intake. After adjusting for maternal and child characteristics, higher ultra-processed consumption at 4 years was associated directly with ‘Food Responsiveness’ (β̂ = 0.019; 95%CI: 0.007; 0.037), and indirectly through energy intake with avoidant traits: ‘Food Fussiness’ (β̂ = -0.007; 95% CI: 0.002; 0.012) and ‘Satiety Responsiveness’ (β̂ = -0.007; 95% CI: 0.003; 0.012). Ultra-processed consumption at 4 years old was associated with BMI at 10 years old, but appetitive behaviours were not powerful mediators of this association. The results suggest a path by which ultra-processed products may impact on later appetitive traits and higher BMI in children.

Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort

“…Two studies 16 , 17 found no significant associations between UPF consumption at 4 years of age and BMI measures 3 to 4 years later, whereas 1 study 20 reported no differences in BMI growth from 16 to 18 years of age. However, a Portuguese study 19 reported a 0.028 increase in BMI z score at 10 years of age per 100-kcal/d higher UPF consumption at 4 years of age, and a Brazilian study 18 reported a 0.20 increase in BMI and 0.14 increase in FMI, from 6 to 11 years of age per 100-g/d increase in UPF consumption. Our findings were based on multiple adiposity measurements from 7 to 24 years of age and detailed 3-day food diaries, whereas previous studies were largely based on food frequency questionnaires that may have limited ability to accurately capture UPFs.…”

“…Previous cohort studies of children/adolescents (sample size, 307-3454 participants) 16 , 17 , 18 , 19 , 20 had shorter follow-up and yielded inconsistent findings. Two studies 16 , 17 found no significant associations between UPF consumption at 4 years of age and BMI measures 3 to 4 years later, whereas 1 study 20 reported no differences in BMI growth from 16 to 18 years of age.…”

“… 8 Associations of UPF consumption with adiposity in children and adolescents remain scarce, with only few previous small-scale studies available. 16 , 17 , 18 , 19 , 20 This study investigates prospective associations between UPF consumption and objectively assessed adiposity measurements from childhood to early adulthood in a large cohort of British children.…”

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

“…On average, the age of participants was 38.9 years, although half of the studies did not report this information. Fifteen studies focused only on children [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], seven on adolescents [31][32][33][34][35][36][37], five on pregnant women [38][39][40][41][42], and three on older subjects [43][44][45], whereas others focused on an adult population or on 2 target groups. Overall, 58.8% of participants were women.…”

Ultra-Processed Food Consumption Among Chilean Preschoolers Is Associated With Diets Promoting Non-communicable Diseases

“…Conversely, evidence of the link between UPF consumption and the nutrient composition of the diet or health impact among children is scarce (14)(15)(16)(17)(18). Studies on UPF consumption in children indicate that the intake of these products is higher than that in the general population (19,20).…”