Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Health Research Institute of Navarra, Pamplona, Spain; CIBER of Physiopathology of Obesity and Nutrition, Carlos III Institute of Health, Madrid, Spain.
Am J Clin Nutr. 2024 Oct;120(4):836-845. doi: 10.1016/j.ajcnut.2024.07.024. Epub 2024 Aug 22.
Suboptimal diets may promote undesired weight gain in youths, with high ultraprocessed food (UPF) intake becoming a significant concern in the United States.
We evaluated the association between UPF intake and body mass index [BMI (in kg/m)] change in large United States youth cohorts.
Participants included children and adolescents (7-17 y) from the Growing Up Today Study (GUTS1 and GUTS2) who completed baseline and ≥1 follow-up diet and anthropometrics assessment (GUTS1 1996-2001: N = 15,797; GUTS2 2004-2011: N = 9720). Follow-up years were based on diet assessment availability. UPFs were categorized using the Nova system, with intakes evaluated as the cumulative mean percent energy from UPFs and subgroups. BMI was assessed using self-reported body weight/height. Changes in BMI annually and over 2, 4-5, and 7 y in association with UPF intake were examined using multivariable repeated-measure linear mixed models.
At baseline, the mean percentage of energy from UPFs was 49.9% in GUTS1 and 49.5% in GUTS2 participants; mean BMI was 18.7 and 19.8, respectively. After multivariable adjustments for sociodemographic and lifestyle factors, each 10% increment in UPF intake was associated with a 0.01 (95% confidence interval: 0.003, 0.03) increase annually and a 0.07 (0.01, 0.13) increase over 5 y in GUTS1 participants. In GUTS2, increases were 0.02 (0.003, 0.04) annually and 0.09 (0.01, 0.18) over 4 y. Among GUTS1, statistically significant annual BMI increases of 0.02-0.07 were associated with elevated intake of ultraprocessed breakfast cereals, savory snacks, and ready-to-eat/heat foods, especially pizza, burgers, and sandwiches. No association was found between UPF intake and overweight/obesity risk.
A higher UPF intake was associated with a modest yet significant increase in BMI in large prospective cohorts of United States youths, calling for public health efforts to promote healthful food intake among youths to prevent excessive weight gain.
饮食不均衡可能会导致青少年体重增加，而超高加工食品（UPF）的摄入在美国是一个严重的问题。
我们评估了美国大型青少年队列中超加工食品（UPF）的摄入与体重指数（BMI）变化之间的关系。
参与者包括参加“今日成长研究”（GUTS1 和 GUTS2）的儿童和青少年（7-17 岁），他们完成了基线和至少一次随访饮食和人体测量评估（GUTS1：1996-2001 年，N=15797；GUTS2：2004-2011 年，N=9720）。随访年限根据饮食评估的可用性而定。UPF 采用 Nova 系统进行分类，摄入量评估为 UPF 累计平均能量百分比和亚组。体重指数通过自我报告的体重/身高进行评估。使用多变量重复测量线性混合模型，研究 UPF 摄入与 BMI 每年以及 2、4-5 和 7 年的变化之间的关系。
在 GUTS1 中，基线时 UPF 能量占比的平均值为 49.9%，GUTS2 中为 49.5%；参与者的平均 BMI 分别为 18.7 和 19.8。在调整了社会人口统计学和生活方式因素后，UPF 摄入量每增加 10%，与 GUTS1 参与者每年 BMI 增加 0.01（95%置信区间：0.003，0.03）和 5 年内 BMI 增加 0.07（0.01，0.13）有关。在 GUTS2 中，每年增加 0.02（0.003，0.04），4 年内增加 0.09（0.01，0.18）。在 GUTS1 中，与超加工早餐谷物、咸味零食和即食/加热食品（尤其是披萨、汉堡和三明治）摄入增加相关的 BMI 每年增加 0.02-0.07 与统计学显著相关。没有发现 UPF 摄入与超重/肥胖风险之间的关联。
在大型美国青少年前瞻性队列中，较高的 UPF 摄入量与 BMI 的适度但显著增加有关，这需要开展公共卫生工作，促进青少年健康饮食，以防止体重过度增加。
