儿童时期超加工食品消费模式与生长和肥胖轨迹。

Patterns of ultra-processed foods consumption throughout childhood and trajectories of growth and adiposity.

机构信息

EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, CIM-FMUP, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal.

EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.

出版信息

Clin Nutr. 2024 Oct;43(10):2364-2371. doi: 10.1016/j.clnu.2024.08.032. Epub 2024 Aug 30.

DOI:10.1016/j.clnu.2024.08.032

PMID:39265297

Abstract

BACKGROUND & AIMS: Ultra-processed foods (UPF) consumption has been associated with unhealthy outcomes. However, the literature lacks robust longitudinal studies considering its cumulative effect, particularly in young populations. This study aimed to evaluate the relationship between UPF consumption patterns throughout childhood with growth and adiposity trajectories.

METHODS

Generation XXI population-based birth cohort (Porto, Portugal) participants were included. Food frequency questionnaire items at 4, 7 and 10 years were classified according to the processing degree using NOVA. UPF consumption patterns based on total quantity were identified using a probabilistic Gaussian mixture model using participants with complete data and predicting for the total sample (n = 8647). To assess whether the outcome trajectories from 4 to 13 years [body weight (kg), height (cm), body mass index (BMI) z-score, waist circumference (WC) (cm) and fat mass (FM) (%)] depend on UPF patterns, a mixed-effects model with linear and quadratic terms for age adjusted for confounders was used. Participants with at least 2 measurements at 4, 7, 10 or 13 years were included in this study (n range: 5885-6272).

RESULTS

Four UPF consumption patterns were identified: constantly lower consumption (15.4%), constantly intermediate consumption (56.4%), transition from low to high consumption (11.2%), and constantly higher consumption (17.1%). Compared to the constantly lower UPF consumption, the constantly higher consumption pattern was associated with greater acceleration in body weight (β: 0.119; 95%CI: 0.027; 0.212), BMI z-score (β: 0.014; 95%CI: 0.004; 0.023), WC (β: 0.232; 95%CI: 0.144; 0.319) and FM% (β: 0.200; 95%CI: 0.092; 0.308) and with lower acceleration in height (β: -0.063; 95%CI: -0.111;-0.015). The constantly intermediate UPF consumption pattern was associated with greater acceleration in body weight (β: 0.123; 95%CI: 0.043; 0.203), WC (β: 0.120; 95%CI: 0.045; 0.195) and FM% (β: 0.146; 95%CI: 0.054; 0.238).

CONCLUSION

Constantly higher and constantly intermediate UPF consumption throughout childhood were associated with worse growth and adiposity trajectories until adolescence.

摘要

背景与目的

超加工食品（UPF）的消费与不健康的结果有关。然而，文献中缺乏关于其累积效应的强有力的纵向研究，特别是在年轻人群中。本研究旨在评估儿童期整个 UPF 消费模式与生长和肥胖轨迹之间的关系。

方法

本研究纳入了基于世代 XXI 的人群队列（葡萄牙波尔图）参与者。在 4、7 和 10 岁时使用食品频率问卷项目，根据 NOVA 对加工程度进行分类。使用概率高斯混合模型，基于参与者的完整数据识别基于总数量的 UPF 消费模式，并预测总样本（n=8647）。为了评估从 4 岁到 13 岁的结果轨迹[体重（kg）、身高（cm）、体重指数（BMI）z 评分、腰围（WC）（cm）和脂肪量（FM）（%）]是否取决于 UPF 模式，使用混合效应模型，对年龄进行线性和二次调整，以调整混杂因素。在本研究中，至少有 2 次在 4、7、10 或 13 岁时测量的参与者被纳入（n 范围：5885-6272）。

结果

确定了四种 UPF 消费模式：持续较低的消费（15.4%）、持续中等的消费（56.4%）、从低到高的消费过渡（11.2%）和持续较高的消费（17.1%）。与持续较低的 UPF 消费相比，持续较高的消费模式与体重的更大加速有关（β：0.119；95%CI：0.027；0.212）、BMI z 评分（β：0.014；95%CI：0.004；0.023）、WC（β：0.232；95%CI：0.144；0.319）和 FM%（β：0.200；95%CI：0.092；0.308），与身高的加速较小有关（β：-0.063；95%CI：-0.111；-0.015）。持续中等的 UPF 消费模式与体重（β：0.123；95%CI：0.043；0.203）、WC（β：0.120；95%CI：0.045；0.195）和 FM%（β：0.146；95%CI：0.054；0.238）的更大加速有关。