Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Nutrients. 2020 Aug 7;12(8):2368. doi: 10.3390/nu12082368.
Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults.
The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables.
Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99-2.44) for the second tertile of UPF consumption and 1.62 (1.04-2.54) for the third tertile; for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet.
A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health.
超加工食品（UPF）的消费与心血管疾病及其危险因素的发生率增加有关。本研究的目的是首次评估老年人中 UPF 消费与腹型肥胖（AO）发生率之间的前瞻性关联。
研究样本包括西班牙营养与心血管风险老年人研究（Seniors-ENRICA-1 研究）中的 652 名参与者（平均年龄 67 岁，44%为女性）。在基线时，收集了标准化的人体测量数据（包括腰围）。经过中位数为 6 年的随访后，再次测量了腰围，并计算了腹型肥胖（AO）的发生率，定义为男性腰围≥102cm，女性腰围≥88cm。在基线时，使用计算机化和验证过的饮食史收集了饮食信息。获取了前一年的常规饮食信息。根据 NOVA 分类法，对 880 种食品进行了加工程度分类。主要或完全由源自食品的物质制成的食品或饮料，很少或没有未改变的原始食品存在的食品被归类为 UPF。为每位参与者计算了 UPF 提供的能量百分比，并计算了性别特异性三分位数。建立了逻辑回归模型，并调整了社会人口统计学、生活方式、发病和药物治疗变量。
在基线时没有 AO 的参与者中，有 177 人在随访期间发生了 AO。UPF 的平均消耗量占总能量的 17%（第一三分位数为 7%；第三三分位数为 29%）。与最低三分位数相比，新发 AO 风险的比值比（95%置信区间）为：第二三分位数 UPF 消费为 1.55（0.99-2.44），第三三分位数为 1.62（1.04-2.54）；对于线性趋势：0.037。在调整了纤维摄入、超长链 omega-3 脂肪酸的摄入量和对地中海饮食的依从性等潜在饮食混杂因素后，结果仍然具有统计学意义。
在西班牙老年人中，较高的 UPF 消费与新发 AO 呈正相关。这些发现扩展了 UPF 消费对心血管代谢健康有害影响的现有证据。
