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Nutrition in acute and chronic diseases

Consumption of ultra-processed foods and cardiometabolic risk factors in Brazilian adolescents: results from ERICA

European Journal of Clinical Nutrition volume 77, pages 1084–1092 (2023)Cite this article

Subjects

Abstract

Introduction

The consumption of ultra-processed foods (UPF) has increased over the past few decades. However, few studies have investigated the association between UPF consumption and cardiometabolic risk factors in adolescents from developing countries.

Objective

To evaluate the association between UPF consumption and cardiometabolic risk factors in Brazilian adolescents.

Methods

This study included students aged 12–17 years who participated in the ERICA. Food consumption was assessed using a 24-h food recall, and the foods were classified based on their degree of processing, utilizing the NOVA classification. Participants’ blood samples were collected after an overnight fast and exams were performed (triglycerides, total cholesterol, HDL-c, LDL-c, fasting glucose, insulin, and HbA1c). Overweight/obesity and blood pressure were also investigated. Associations were evaluated using Poisson regression models.

Results

The analysis included a total of 36,952 adolescents. The energy consumption from UPF was 30.7% (95%CI: 29.7–31.6) per day. Adolescents with high UPF consumption, defined as the top tertile (≥38.7% per day), were observed to have higher intake of sodium, saturated and trans-fat, while having lower intake of proteins, fibers, polyunsaturated fats, vitamins and minerals. After adjusting for potential confounders, it was observed that higher UPF consumption was directly associated with high LDL-c (PR = 1.012; 95%CI: 1.005–1.029) and inversely with low HDL-c (PR = 0.972; 95%CI: 0.952–0.993). No associations were found between UPF consumption and other cardiometabolic risk factors.

Conclusion

Brazilian adolescents have presented a high consumption of UPF, which is associated to poor diet quality and can contribute to elevated LDL-c levels.

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Fig. 1
Fig. 2: Overall and change frequency in cardiovascular risk variables according to tertiles of consumption of ultra-processed foods in adolescents from ERICA (n = 36,952), Brazil, 2013–2014.

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Data availability

The databank of this study contains information that could serve as a potential source of identification of the participants, especially at the schools where the data collection was performed and in cities where only one school participated. Thus, to fulfill the criteria imposed by the institutional review board of the Institute of Collective Health Studies, Federal University of Rio de Janeiro and the institution review boards of each unit of the Federation of Brazil, the storage, management, and availability of the databank has been kept restricted by the central team of the Study of Cardiovascular Risk in Adolescents (ERICA) (contact via the publication committee at ericapublica@gmail.com or www.erica.ufrj.br).

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Funding

The ERICA project was financed by the Department of Science and Technology of the Department of Science and Technology and Strategic Inputs of the Ministry of Health (Decit /SCTIE/MS) and the Health Sector Fund (CT–Saúde) of the Ministry of Science, Technology and Innovation (MCTI) by the Innovation and Research Financing Agency (FINEP: protocol 01090421), and the National Council for Scientific and Technological Development (CNPq: protocols 565037/2010-2, 405009/2012-7 and 457050/2013-6). We thank the Research Incentive Fund at the Hospital de Clínicas de Porto Alegre (FIPE-HCPA–20090098, 20150400 and 20200522). This work was supported by the Coordination for the Improvement of Higher Education Personnel–Brazil (CAPES)–Financing Code 001.

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Authors and Affiliations

  1. Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Mariana Migliavacca Madalosso, Nina Nayara Ferreira Martins, Beatriz D. Schaan & Felipe Vogt Cureau

  2. Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Brenda Massochin Medeiros & Beatriz D. Schaan

  3. Graduate Program in Public Health, Universidade Federal de Minas Gerais, School of Medicine, Belo Horizonte, MG, Brazil

    Luana Lara Rocha

  4. Department of Nutrition, Universidade Federal de Minas Gerais, School of Nursing, Belo Horizonte, MG, Brazil

    Larissa Loures Mendes

  5. Graduate Program in Physical Education, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

    Felipe Vogt Cureau

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Contributions

MMM: Conceptualization, analyzed the data and wrote the paper; NNFM: Analyzed the data and wrote the paper; BMM: Wrote the paper, review & editing; LLR: Analyzed the data and review & editing; LLM: Analyzed the data and review & editing; BDS: Supervision, review & editing; FVC: Conceptualization, supervision, analyzed the data and wrote the paper, review & editing.

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Correspondence to Mariana Migliavacca Madalosso.

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The Study of Cardiovascular Risks in Adolescents (ERICA) was conducted in accordance with the Declaration of Helsinki and approved by the Research Ethics Committees of all participating centers.

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Madalosso, M.M., Martins, N.N.F., Medeiros, B.M. et al. Consumption of ultra-processed foods and cardiometabolic risk factors in Brazilian adolescents: results from ERICA. Eur J Clin Nutr 77, 1084–1092 (2023). https://doi.org/10.1038/s41430-023-01329-0

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