Cortes Caroline, Brandão Joana Maia, Cunha Diana Barbosa, Paravidino Vitor Barreto, Sichieri Rosely
Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Rio de Janeiro, Brazil.
Eur J Pediatr. 2023 Sep;182(9):4077-4085. doi: 10.1007/s00431-023-05076-z. Epub 2023 Jul 4.
To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg. Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension. What is Known: • Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children. • Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide. What is New: • Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight. • The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).
利用饮食和尿液标志物，研究超加工食品（UPF）消费对肥胖儿童收缩压（SBP）和舒张压（DBP）的影响。我们对一项涉及7至12岁肥胖儿童的随机临床试验进行了二次分析。在六个月的时间里，儿童及其监护人每月参加一次旨在促进减少UPF消费的个人咨询和教育活动。每次就诊时，记录血压、体重、身高和24小时饮食回忆情况。此外，在基线、第二个月和第五个月随访时收集即时尿样。共有96名儿童纳入分析。能量摄入、UPF摄入和血压呈二次变化模式，前两个月下降，此后上升。UPF消费与DBP之间存在关联。UPF的摄入量与尿钠钾比（r = 0.29；p = 0.008）和饮食钠钾比（r = 0.40；p < 0.001）相关。UPF每增加100克，DBP升高0.28 mmHg（p值 = 0.01）。在进一步调整体重指数（BMI）和身体活动的变化后，DBP升高0.22 mmHg。结论：我们的研究结果表明，减少UPF消费可能对肥胖儿童的血压有影响。对BMI和身体活动的进一步调整不影响结果。因此，减少UPF消费可被视为预防高血压的一种策略。已知信息：• 超加工食品消费与心血管疾病风险增加有关；然而，这一证据在儿童中仍然有限。• 全球范围内，超加工食品摄入热量占总热量的比例正在增加。新发现：• 超加工食品消费对舒张压有影响，与体重变化无关。• 超加工食品的摄入量与饮食钠钾比相关（r = 0.40；p < 0.001）。
