Based on data from 3,587 adolescents aged 12 to 19 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016 in the United States, researchers from the University of São Paulo (USP) in Brazil calculated the Impact of consuming ultra-processed foods on the risk of obesity.
They divided study participants into three groups based on the amount of ultra-processed foods consumed. When they compared those with the highest level (64% of the total diet by weight on average) to those with the lowest level (18.5%), they found that the former were 45% more likely to be obese, 52% more likely to have abdominal obesity (excess fat around the waist) and, more alarmingly, 63% more likely to have visceral obesity (excess fat in and around the abdominal organs , including the liver and intestines), which is closely correlated with the development of high blood pressure, coronary artery disease, type 2 diabetes, dyslipidemia (high cholesterol), and an increased risk of death.
The full results of the study, which was supported by FAPESP, are reported in an article published in the Journal of the Academy of Nutrition and Dietetics.
FAPESP financed the study through four projects (15/14900-9, 16/25853-4, 18/17972-9 and 19/22278-7).
"There is substantial scientific evidence for the negative role of ultra-processed foods in the obesity pandemic. This is very well established for adults. With regard to youth, we had already found that the consumption of these products is high, accounting for about two-thirds of the diet of adolescents in the US, but research on the association between the consumption of ultra-processed foods and health outcomes, including obesity, was low and inconsistent.”
Daniela Neri, first author of the article
Neri is affiliated with the Center for Epidemiological Studies in Nutrition and Health (NUPENS) of the School of Public Health (FSP-USP).
Bottom
Led by Professor Carlos Augusto Monteiro, the NUPENS team was one of the first to associate changes in industrial food processing with the obesity pandemic, which began in the US in the 1980s and has spread ever since. has spread to most other countries. Based on this hypothesis, the group developed a food classification system called NOVA, based on the degree of industrial processing of the products. The system reported the recommendations in the 2014 edition of the Dietary Guidelines for the Brazilian Population which emphasized the benefits of a diet based on fresh or minimally processed foods, and emphatically ruled out ultra-processed foods ranging from soft drinks, filled cookies and instant noodles to packaged snacks and even a seemingly innocent type of whole wheat bread (more at: agency.FAPESP.br/20905/).
“In general terms, ultra-processed foods and beverages contain chemical additives designed to make the products more appealing to the senses, such as colorants, flavourings, emulsifiers and thickeners. Many ultra-processed foods are high in energy density and contain a large amount of sugar. and fat, all of which contribute directly to weight gain,” Neri said. “But even low-calorie products, such as diet drinks, can promote obesity in ways that go beyond nutritional composition, for example, by interfering with satiety signaling or modifying the gut microbiota.
Methodology
The recently published study used data collected using a methodology known as a 24-hour food recall, in which subjects are asked to report all foods and beverages consumed in the previous 24 hours, detailing amounts, times and places. . Most of the participants included in the analysis (86%) were interviewed twice on this topic, with an interval of two weeks between interviews.
The adolescents were divided into three groups based on this information: those in whose diet ultra-processed foods represented up to 29% by weight, between 29% and 47% and 48% or more.
The researchers also used anthropometric data, such as weight, height, and waist circumference. These measurements were evaluated against age- and sex-specific growth charts approved by the US Centers for Disease Control (CDC).
“The total risk of obesity was estimated on the basis of the body mass index or BMI, which is the weight [ in kilos ] divided by the height squared [ in meters ]Neri said. “We use waist circumference to assess abdominal obesity and sagittal abdominal diameter, a lesser-known parameter, as an indicator of visceral obesity.”
Sagittal abdominal diameter measurement, he explained, is an indirect, noninvasive method of estimating the amount of visceral fat: “The subject lies down and we use a caliper or sagitometer to measure the distance between the top of the table and the region of the navel. The softer subcutaneous fat falls to the sides, and the harder visceral fat stays in place. This approach avoids possible measurement errors that could be caused by skin folds in the region Of the waist”.
All the data analyzed in the study comes from NHANES surveys conducted between 2011 and 2016. According to Neri, the findings can be extrapolated to Brazilian adolescents, who are also exposed to ultra-processed foods from an early age, although to a lesser extent than their peers. American people.
“Brazil does not conduct adolescent nutrition surveys that also collect anthropometric data in person. Surveys of this type at the national level are very expensive and require ongoing funding. We have some similar surveys, but they are simpler,” Neri said.
An example is Vigitel, an annual national survey conducted by the Ministry of Health to monitor risk and protection against chronic diseases, which includes telephone interviews with people over eighteen years of age. The latest data from this survey, published in January 2022 by the Institute for Health Policy Studies (IEPS), shows that the adult obesity rate in Brazil almost doubled from 11.8% in 2006 to 21.5% in 2020.
The Consumer Expenditure Survey (POF) conducted by IBGE, the national statistics office, collects data on the eating habits of adolescents and adults, but not on their health.
According to the latest POF, carried out in 2017-18, more than half (53.4%) of the average daily caloric intake of the Brazilian comes from fresh foods such as vegetables, fruits, meat and milk or minimally processed foods such as cereals and flours. , 15.6% from processed ingredients such as sugar, salt, and olive oil, 11.3% from processed foods such as cheese, artisan bread, and canned fruits and vegetables, and 19.7% from processed foods. ultraprocessed. In the case of adolescents, the survey data shows that ultra-processed foods account for 27% of caloric intake, and for those over 60 years of age the proportion is 15.1%.
comparisons
In another study conducted by NUPENS, researchers compared data on the diet of Brazilian adolescents from the 2017-18 POF with similar data from Argentina, Australia, Chile, Colombia, Mexico, the United Kingdom, and the United States.
Ultra-processed foods ranged from 19% of energy intake in Colombia and 27% in Brazil to 68% in the UK and 66% in the US. Despite the variability in proportional terms, the impact of ultra-processed foods in the quality of the diet was similar in all the groups analyzed, according to Neri.
“In this study, too, subjects were divided into groups according to their consumption of ultra-processed foods. We observed a deterioration in the quality of their diet as the proportion of ultra-processed foods increased, increasing energy density and sugar content, and reduce fiber content. The negative effect is very similar in all countries, regardless of the proportion of ultra-processed foods, the region or the culture,” he said.
Although rice and beans still constitute the staple diet for most Brazilians, he added, a survey commissioned by the Ministry of Health in 2019 showed that the consumption of ultra-processed foods is prevalent even among those under five. More than 80% of all children in this group regularly consume these products.
“Children who consume these products have proportionally less room to consume fresh produce or minimally processed foods at a time when dietary habits are being formed,” Neri said. “By being exposed to these obesogenic foods, children and adolescents are being programmed for future health problems. It is extremely concerning.”
Families alone cannot be responsible for controlling this exposure, which requires reform of the prevailing food system as a whole. “We must go beyond consumer education by taking public policy action on several fronts,” Neri said. “Different strategies are possible, such as imposing restrictions on advertising, especially when targeting children, and increasing taxes on ultra-processed food products while at the same time improving access to fresh produce. Another vital measure importance would be to require manufacturers of these products to include clearer information on labels to help consumers make better choices.”
Source:
São Paulo Research Foundation (FAPESP)
Magazine Reference:
Neri, D. et al. (2022). Associations between consumption of ultra-processed foods and indicators of adiposity in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2011-2016. Journal of the Academy of Nutrition and Dietetics. doi.org/10.1016/j.jand.2022.01.005.