Santos Iná S, Bierhals Isabel O, Costa Caroline S, Matijasevich Alicia, Tovo-Rodrigues Luciana
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil.
Pediatr Obes. 2024 Apr;19(4):e13104. doi: 10.1111/ijpo.13104. Epub 2024 Jan 31.
The association of ultra-processed food (UPF) consumption with obesity and adipose tissue in children/adolescents remains poorly understood.
To assess the association of UPF consumption with excessive weight (EW-defined as BMI-for-age ≥+1 z-score) and body composition at 15 years.
In a birth cohort, daily UPF consumption was estimated by Food Frequency Questionnaires at 6 and 15 years. Those in the higher tercile of UPF consumption at both follow-ups were the 'always-high consumers'. Air-displacement plethysmography provided fat mass (FM-kg), fat-free mass (FFM-kg), %FM, %FFM, FM index (FMI-kg/m ) and FFM index (FFMI-kg/m ). Logistic regression and linear regression were used to estimate, respectively, odds ratios and beta coefficients.
Amongst 1584 participants, almost one in every seven were always-high consumers. In crude analyses, there was no association between variation in UPF consumption and EW, and body fat parameters were lower in the always-high consumer group than amongst the always-low consumers, in both sexes. With adjustment for confounders, the odds ratio for EW was higher in the always-high consumer than amongst the always-low consumer group, and the direction of the associations with FM parameters was reversed: males from the always-high consumer group presented almost twice as high FM (10.5 vs. 18.6 kg; p < 0.001) and twice as high FMI (3.4 vs. 6.3 kg/m ; p < 0.001) than the always-low consumer group, and females from the always-high consumer group presented on average 32% more FM and FMI than the always-low consumer group.
In crude and adjusted analyses there was a strong association between high UPF consumption from childhood to adolescence, EW and higher body fat parameters at 15 years, but its deleterious association with body adiposity was only uncovered after adjusting for confounders.
超加工食品(UPF)消费与儿童/青少年肥胖及脂肪组织之间的关联仍知之甚少。
评估15岁时UPF消费与超重(EW,定义为年龄别BMI≥+1 z评分)及身体成分之间的关联。
在一个出生队列中,通过食物频率问卷在6岁和15岁时估算每日UPF消费量。在两次随访中UPF消费处于较高三分位数的人群为“始终高消费人群”。空气置换体积描记法测量体脂质量(FM-kg)、去脂体重(FFM-kg)、体脂百分比(%FM)、去脂体重百分比(%FFM)、体脂指数(FMI-kg/m²)和去脂体重指数(FFMI-kg/m²)。分别采用逻辑回归和线性回归来估计比值比和β系数。
在1584名参与者中,每七人中有近一人是始终高消费人群。在粗分析中,UPF消费变化与EW之间无关联,且始终高消费人群组的体脂参数低于始终低消费人群组,男女皆是如此。在对混杂因素进行调整后,始终高消费人群中EW的比值比高于始终低消费人群组,且与FM参数的关联方向发生了逆转:始终高消费人群组的男性FM几乎是始终低消费人群组的两倍(10.5 vs. 18.6 kg;p<0.001),FMI也是两倍(3.4 vs. 6.3 kg/m²;p<0.001),始终高消费人群组的女性FM和FMI平均比始终低消费人群组高32%。
在粗分析和调整分析中,从童年到青少年期间高UPF消费与15岁时的EW及更高的体脂参数之间存在强关联,但只有在对混杂因素进行调整后,才发现其与身体肥胖的有害关联。