Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors

Abstract

The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPFs were categorized using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high versus low cardiovascular risk). UPFs contributed 40.69% (SD 6.21) to total energy intake. The main UPF groups were ready-to-eat and take-away/fast foods (22.2% energy from UPFs). The multivariable logistic regression revealed that an absolute increase of 10% in UPF intake (OR=1.90; 95% CI: 1.01;3.58) was associated with central adiposity. An absolute increase of 10% in UPF intake (OR=3.77; 95% CI: 1.80;7.87) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.

A Review of Healthy Dietary Choices for Cardiovascular Disease: From Individual Nutrients and Foods to Dietary Patterns

“…A significant association between ultra-processed food intake and mortality has been observed in a prospective analysis within the Third National Health and Nutrition Examination Study (NHANES III) [194]. Moreover, ultra-processed food consumption may be a modifiable risk factor for cardiovascular consequences in children and adolescents [195].…”

Sodium overload during postnatal phases impairs diastolic function and exacerbates reperfusion arrhythmias in adult rats

“…In addition, evidence underscores the widespread consumption of processed and industrialized foods among contemporary children and adolescents, which leads to a high-sodium intake. 32,33 Given the established correlation between excessive sodium consumption and adverse cardiovascular outcomes, 18,19 it is imperative to explore the potential long-term ramifications of such dietary practices during critical periods of growth and development. Taken together, the present study design not only aligns with the physiological plasticity characterizing this developmental phase, but also mirrors the modern dietary milieu experienced by youth, thereby augmenting the relevance and translational impact of our findings.…”

Longer Breastfeeding Duration is Associated With Lower Consumption of Ultraprocessed Foods in a Sample of Spanish Preschoolers: The SENDO Project

“…57 Besides, the use of the NOVA classification system in nutritional epidemiology research is widespread, which facilitates comparison with other studies. 58,59 Other classification systems, such as the Nutriscore, 60 are also not free of limitations and are less commonly used in epidemiological studies. Moreover, FFQs are prone to bias, which could result in misclassification.…”