Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

AbstractObjective:To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.Design:We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity.Setting:Brazil.Participants:Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010).Results:UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF.Conclusions:Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.

Download Full-text

Consumption of ultra-processed foods and the risk of overweight and obesity, and weight trajectories in the French cohort NutriNet-Santé

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003559 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Marie Beslay ◽

Caroline Méjean ◽

Benjamin Allès ◽

Thibault Fiolet ◽

...

Keyword(s):

Food Intake ◽

Confidence Interval ◽

Prospective Study ◽

Food Consumption ◽

Overweight And Obesity ◽

Processed Foods ◽

Processed Food ◽

Weight Trajectories ◽

Incident Cases

AbstractIntroductionPrevious epidemiological studies have found associations between the consumption of ultra-processed foods and the risk of obesity-related outcomes, such as post-menopausal breast cancer, cardiovascular diseases, hypertension and mortality. However, only one Spanish prospective study has explored the associations between the consumption of ultra-processed foods and the risk of overweight and obesity. The aim of this study is to investigate the associations between ultra-processed food consumption and the risk of overweight and obesity, as well as the associations between ultra-processed food consumption and weight trajectories, in middle-aged adults included in the French large scale NutriNet-Santé cohort.MethodsOverall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records, merged with a food composition database of 3300 different products. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risks of overweight and obesity were assessed using multivariable Cox proportional hazard models. Associations between ultra-processed food intake and weight trajectories were assessed using multivariable linear mixed models for repeated measures with random slope and intercept. Models were adjusted for known risk factors (sociodemographic, lifestyle, and nutritional factors).ResultsUltra-processed food intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (95% confidence interval 1.08 to 1.14); P < 0.0001, median follow-up: 4.1y, 260304 person-years) and obesity (n = 3066 incident cases; HR = 1.09 (95% confidence interval 1.05 to 1.13); P < 0.0001, median follow-up: 8.0y 365344 person-years). Higher consumers of ultra-processed foods (4th quartile) were more likely to present an increase in body mass index over time (change of BMI/time-unit in Q4 vs Q1 = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionIn this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

Download Full-text

Abstract P181: Processed food intake is adversely associated with multiple indicators of cardiometabolic health in US adults: Findings from the National Health and Nutrition Examination Surveys (2005-2008)

Circulation ◽

10.1161/circ.129.suppl_1.p181 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Leah Lipsky ◽

Tonja Nansel ◽

Virginia Quick

Keyword(s):

Waist Circumference ◽

Food Intake ◽

Weight Status ◽

Cardiometabolic Health ◽

Processed Foods ◽

Processed Food ◽

C Reactive Protein ◽

Reactive Protein ◽

Former Smokers ◽

Never Smokers

Introduction: Reducing intake of ingredients characteristic of processed foods is vital to improving ideal cardiovascular dietary behaviors described in the American Heart Association 2020 Strategic Impact Goals. Hypothesis: We sought to develop an indicator of processed food intake and evaluate its hypothesized adverse relationships with biomarkers of cardiometabolic health in a nationally representative sample of US adults. Methods: Data from two 24 hour recalls were examined for US adults (>=18y) in NHANES (2005-2008). An index of processed food intake (PFI) was developed using the mean of the standardized (mean=0, standard deviation=1), energy-adjusted (per 1000 kcal) intakes of refined grains, processed meat, discretionary oils, discretionary solid fat, added sugar and sodium. We evaluated bivariate associations of PFI with demographics (sex, poverty-income ratio, education) and behavioral factors (smoking, nutritional supplement use). Multivariable linear regressions were used to examine associations of PFI with BMI (kg/m2), waist circumference (cm), and biomarkers for cardiometabolic health (total cholesterol, HDL-C, LDL-C, triglycerides, apo-b and c-reactive protein), adjusting for demographic and behavioral covariates. We tested for potential interactions between PFI and weight status, sex, and smoking. Results: PFI was higher in smokers than never smokers (p<.001). PFI was lower for those with at least a college degree than those with less education (p=.004) and for NH White vs. NH Black adults (p=.04). Adjusting for covariates, higher PFI was associated with greater BMI (p<.001) and waist circumference (p<.001), lower HDL-C (p<.001), and higher c-reactive protein (p=.01). Interactions (p<.05) were observed between PFI and sex for predicting BMI, and between PFI and smoking for predicting TC and HDL-C. The magnitude of associations was larger for female vs. male and for current and former smokers vs. non-smokers. No interactions were observed between PFI and weight status. Conclusion: Intake of components characteristic of processed foods is adversely associated with a variety of cardiometabolic biomarkers. Positive associations of PFI with BMI were greater for females vs. males, while associations of PFI with TC and HDL-C were greater for current and former smokers vs. never smokers. The nutritional value of dietary components of PFI is primarily restricted to energy, protein, and sodium, none of which are considered lacking in the diets of US adults. These findings underscore the rationale for encouraging replacing such components with foods that promote cardiovascular health including fruit, vegetables, whole grains, fish, legumes, nuts and seeds. Acknowledgment: This research was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.

Download Full-text

Abstract 24: Changes in Generalized and Central Adiposity are Dynamically Associated with Left Ventricular Remodeling

Circulation ◽

10.1161/circ.133.suppl_1.24 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Bryan R Wilner ◽

Sonia Garg ◽

Colby R Ayers ◽

Satyam Sarma ◽

Anand Rohatgi ◽

...

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Waist Circumference ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Study Cohort ◽

Central Adiposity ◽

Lv Mass

Introduction: Obesity is linked to an adverse cardiac structural phenotype in cross-sectional studies. However, the effects of longitudinal changes in generalized and central adiposity on left ventricular (LV) remodeling are unknown. Methods: Participants without baseline cardiovascular disease or LV dysfunction in the Dallas Heart Study underwent assessment of body composition and cardiac structure by MRI at baseline and then 7 years later. Associations between change in weight and waist circumference with alterations in structure and function were assessed using multivariable linear regression. Results: The study cohort (n=1262) had a mean age of 44 years and was 43% (545 of 1262) male, 44% (556 of 1262) African-American, and 36% (460 of 1262) obese at baseline. At 7 years follow-up, 7% (85 of 1262) had >10% weight loss, 8% (108 of 1262) had 5-10% weight loss, 44% (551 of 1262) had <5% weight change, 20% (248 of 1262) had 5-10% weight gain, and 21% (270 of 1262) had >10% weight gain. Those who gained >10% weight were younger, had lower BMI and LV mass at baseline, and had greater increases in blood pressure, glucose, triglycerides, LDL cholesterol, and hs-CRP over follow-up. In multivariable models adjusted for age, sex, race, and baseline and interim development of comorbidities, 1-standard deviation increases in body weight and waist circumference over follow-up were significantly associated with higher LV mass, LV wall thickness, and concentricity; but minimally or not significantly associated with LV end-diastolic volume or ejection fraction (EF) (Table). Conclusion: Increases in generalized and central adiposity are characterized primarily by concentric remodeling, with a more modest impact on LV volume and EF. These results support the notion that the development of specific obesity patterns may impact cardiac remodeling with potential implications for the development of cardiac hypertrophy and heart failure.

Download Full-text

Back pain and its risk factors in Brazilian adolescents: a longitudinal study

British Journal of Pain ◽

10.1177/2049463719871751 ◽

2019 ◽

pp. 204946371987175 ◽

Cited By ~ 1

Author(s):

Matias Noll ◽

Cláudia Tarragô Candotti ◽

Bruna Nichele da Rosa ◽

Adriane Vieira ◽

Jefferson Fagundes Loss

Keyword(s):

Risk Factors ◽

Back Pain ◽

Longitudinal Study ◽

Latin American ◽

Outcome Variable ◽

Evaluation Instrument ◽

Robust Variance ◽

History Of ◽

Latin American Countries

Owing to the lack of longitudinal studies in Latin American countries, we aimed to evaluate back pain and its risk factors in a 3-year longitudinal study of Brazilian adolescents. We analysed data of 525 adolescents (aged 11–16 years) attending primary school (fifth to eighth grade) in Brazil. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument (BackPEI) questionnaire in 2011 and at a follow-up evaluation that was conducted 3 years later (2014). Back pain was the outcome variable; the exposure variables included exercise, behavioural, hereditary and postural factors. Generalized estimating equations were used to perform a Poisson regression model with robust variance to evaluate the risk factors for back pain. The prevalence of back pain at baseline was 56% ( n = 294); this increased significantly at the 3-year follow-up evaluation to 65.9% ( n = 346). The frequency of experiencing back pain also significantly increased after 3 years in both boys ( p = 0.002) and girls ( p = 0.001). The prevalence of back pain increased significantly in adolescents up to the age of 13 years, stabilized in those aged 14 years and older and was higher among girls. A family history of back pain (in the parents), watching television for lengthy periods and carrying a backpack asymmetrically were predictors for back pain.

Download Full-text

Significant Decrease in Childhood Obesity and Waist Circumference over 15 Years in Switzerland: A Repeated Cross-Sectional Study

Nutrients ◽

10.3390/nu11081922 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1922

Author(s):

Isabelle Herter-Aeberli ◽

Ester Osuna ◽

Zuzana Sarnovská ◽

Michael B. Zimmermann

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Childhood Obesity ◽

Waist Circumference ◽

Parental Education ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Central Adiposity ◽

Parental Factors ◽

The Past

Despite a global increase in childhood obesity over the past decades, several countries, including Switzerland, have recently reported stabilizing trends. Using national data from school-aged children in Switzerland over the past 16 years, our study aim was to assess changes in the prevalence of overweight and obesity, central adiposity and predictors of obesity related to lifestyle and parental factors. Nationally representative samples of children aged 6–12 years were studied in 2002 (n = 2493), 2007 (n = 2218), 2012 (n = 2963), and 2017/18 (n = 2279). Height and weight, waist circumference, and multiple skinfold thicknesses were measured. Potential risk factors for overweight and obesity were determined using a self-administered questionnaire in 2017/18, collecting data on diet, physical activity, and parental factors. Prevalence (95% CI) of overweight (incl. obesity) and obesity in 2017/18 was 15.9% (14.4–17.4) and 5.3% (4.5–6.3), respectively. Binary logistic regression revealed a small but significant decrease in the prevalence of overweight (including obesity) since 2002 (OR (95% CI) = 0.988 (0.978–0.997)), while the change in obesity alone was not significant. The most important risk factors for childhood overweight/obesity in 2017/18 were low parental education, non-Swiss origin of the parents, low physical activity of the child, and male sex. In conclusion, we have shown a small but significant declining trend in the childhood overweight/obesity prevalence over the past 15 years in Switzerland. Based on the risk factor analysis, preventive action in schoolchildren might be most effective in boys, migrant populations, and families with lower education, and should emphasize physical activity.

Download Full-text

Changes of overweight and obesity prevalence among school children in North West of Iran after 3 years follow-up (2009-2011): A longitudinal study

International Journal of Preventive Medicine ◽

10.4103/2008-7802.183651 ◽

2016 ◽

Vol 7 (1) ◽

pp. 79 ◽

Cited By ~ 1

Author(s):

Parvin Ayremlou ◽

SakinehNouri Saeidlou ◽

Fatemeh Rezaiegoyjeloo ◽

Fariba Babaie

Keyword(s):

Longitudinal Study ◽

School Children ◽

Overweight And Obesity ◽

Obesity Prevalence ◽

North West

Download Full-text

Consumption of ultra-processed food products, diet quality and nutritional status among Mexican children

Proceedings of The Nutrition Society ◽

10.1017/s0029665120006126 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Alejandra Donaji Benítez-Arciniega ◽

Ivonne Vizcarra-Bordi ◽

Roxana Valdés-Ramos ◽

Leidi Rocío Mercado-García ◽

Carmen Liliana Ceballos-Juárez ◽

...

Keyword(s):

Nutritional Status ◽

Food Consumption ◽

Diet Quality ◽

Food System ◽

Positive Association ◽

Overweight And Obesity ◽

Nutritional Deficiencies ◽

Processed Meat ◽

Processed Foods ◽

Processed Food

AbstractUltra-processed food consumption has increased in recent years. The evidence suggests a positive association between consumption of ultra-processed food consumption and low diet-quality and malnutrition, characterized by nutritional deficiencies and high prevalence of obesity and overweight. In México the combined prevalence of overweight and obesity in schoolchildren is 33.2%, and ultra-processed food consumption varies from 40.4% to 81.5% depending on the product. The objective of this study was to describe the association between ultra-processed food consumption, diet-quality and nutritional status in Mexican schoolchildren. We analyzed dietetic and anthropometric data from 364 children (6–12 years) of two communities in the center of México. Four 3d-recalls (three days records followed up for ten months including weekdays and weekends) were used for data collection. Consumed foods were classified according to the level of processing using the NOVA classification. Portions of each food, dietary energy, macro and micronutrients intakes were calculated in accordance with the Mexican equivalent food system, nutrition labelling of each product and software Nutrimind® 15.0. Nutritional status was evaluated according to BMI categories; diet-quality was assessed calculating a dietary score. All data were adjusted by energy. In our study, 32% of foods consumed by schoolchildren were ultra-processed, 49% were minimally processed or unprocessed. 30% of the energy intake derived from ultra-processed foods (95% CI 29.2–33.2%). Major ultra-processed foods in habitual diet were bakery, pastries (23%), sugar-sweetened beverages (dairy and non-dairy) (22%), processed meat (18%), pizzas and pastas (9%), and canned vegetables (4%). Children in the highest quartile of ultra-processed foods consumption, presented lower diet-quality than those in the lowest quartile. In this group of children, 38.0% presented combined overweight or obesity, although there were no statistically significant differences between nutritional status and ultra-processed food consumption. Regular ultra-processed food consumption is associated with a lower diet quality in healthy schoolchildren. It is necessary to implement strategies to reduce intake of these products to avoid possible risks to health in early ages.

Download Full-text

Waist Circumference as a Predictor of Adiponectin Levels in Peritoneal Dialysis Patients: A 12-Month Follow-up Study

Peritoneal Dialysis International ◽

10.3747/pdi.2011.00129 ◽

2013 ◽

Vol 33 (2) ◽

pp. 182-188 ◽

Cited By ~ 8

Author(s):

Ana Paula Bazanelli ◽

Maria Ayako Kamimura ◽

Maria Eugenia Fernandes Canziani ◽

Silvia Regina Manfredi ◽

Lilian Cuppari

Keyword(s):

Peritoneal Dialysis ◽

Waist Circumference ◽

Residual Renal Function ◽

Enzyme Linked Immunosorbent Assay ◽

Central Adiposity ◽

Dialysis Unit ◽

Dialysis Vintage ◽

Unit Increase ◽

Independent Determinant

ObjectivesThis prospective study, conducted at the dialysis unit of the Nephrology Division, Federal University of Sao Paulo–Oswaldo Ramos Foundation, Brazil, aimed to evaluate whether waist circumference (WC) can predict adiponectin levels in patients undergoing peritoneal dialysis (PD).MethodsAmong 115 patients on PD at a single dialysis center who were evaluated at 6 and 12 months, 57% were men, 31% had diabetes, mean age was 52.8 ± 16.1 years, body mass index was 25 ± 4.3 kg/m2, and dialysis vintage was 13 months (range: 5 – 33 months). We measured WC at the umbilicus level. Adiponectin was determined by an enzyme-linked immunosorbent assay.ResultsAt baseline, WC was inversely associated with adiponectin ( r = –0.48, p < 0.01). After adjustment for sex, age, diabetes, peritoneal clearance, and residual renal function, WC was an independent determinant of serum adiponectin (β = –0.52; 95% confidence interval: –0.73 to –0.31; p < 0.001). In the prospective analysis, after adjustment for confounders, changes in WC predicted changes in adiponectin. For each unit increase in WC, adiponectin declined by 0.39 mg/L ( p < 0.001).ConclusionsThis study demonstrates that WC is associated with adiponectin and, more importantly, that this simple marker of central adiposity was able to predict changes in adiponectin levels over time.

Download Full-text