The risk of obesity is 45% higher among young people whose diet is based on ultra-processed foods

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Based on data from 3,587 young people aged 12-19 who participated in the 2011-16 National Health and Nutrition Examination Survey (NHANES) in the United States, researchers at the University of São Paulo (USP) in Brazil have calculated the effect of consuming ultra-processed foods at risk of obesity.

They divided the study participants into three groups according to the amount of ultra-processed foods ingested. When they compared those with the highest level (64% of the total diet on average in weight) with those with the lowest level (18.5%), they found that the former were 45% more likely to be overweight, 52% more likely to have abdominal obesity (excess fat around the waist) and, most alarmingly, 63% more likely to have visceral obesity (excess fat on and around the abdominal organs, including the liver and intestines), which are closely related to 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 were supported by FAPESP, are reported in an article published in the Journal of the Academy of Nutrition and Dietetics.

“There is considerable scientific evidence for the negative role of ultra-processed foods in the obesity pandemic. This is very well established for adults. As for young people, we had already found that the consumption of these products is high, which accounts for about two-thirds of young people’s diets in the United States, but research into the relationship between consuming ultra-processed foods and health outcomes, including obesity, was sparse and inconsistent, “Daniela Neri, first author of the article, told Agência FAPESP. Neri is affiliated with the Center for Epidemiological Studies in Nutrition and Health (NUPENS) at the School of Public Health (FSP-USP).


Led by Professor Carlos Augusto Monteiro, the NUPENS team was one of the first to associate changes in the industrial processing of foods with the obesity pandemic, which began in the United States in the 1980s and has since spread to most other countries. Based on this hypothesis, the group developed a food classification system called NOVA, based on the extent to which products are industrially processed. The system informed the recommendations of 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 excluded ultra-processed foods ranging from soft drinks, filled cookies and instant. noodles for packed snacks and even a seemingly innocent type of wholemeal bread.

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“In general, ultra-processed foods and beverages contain chemical additives designed to make the products more appealing to the senses, such as dyes, flavorings, emulsifiers and thickeners. Many ultra-processed foods have a high energy density and contain a lot of sugar. weight gain, “said Neri. “But even low-calorie products such as diet drinks can promote the development of obesity in ways that go beyond the nutritional composition, such as by interfering with satiety signaling or modifying the intestinal microbiota.”


The recently published study used data collected by a method known as 24-hour food recall, in which subjects are asked to report all foods and beverages consumed in the previous 24 hours, with details of quantities, times and places. Most of the participants in the analysis (86%) were interviewed twice on this topic, with an interval of two weeks between the interviews.

The young people were divided into three groups on the basis of this information: Those in whose diet ultra-processed foods accounted for 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 measures were evaluated against age- and gender-specific growth charts approved by the US Centers for Disease Control (CDC).

“Total obesity risk was estimated on the basis of body mass index or BMI, which is weight [in kilos] divided by the height of the second [in meters]”We used waist circumference to assess abdominal obesity and sagittal abdominal diameter, a lesser known parameter, as a proxy for visceral obesity.”

Measuring sagittal abdominal diameter, she explained, is an indirect and non-invasive method of estimating the amount of visceral fat: “The subject lies down and we use a caliper or a sagittometer to measure the distance between the top of the stretcher and the umbilical region. The softer subcutaneous fat falls to the sides and the inner fat, which is harder, stays in place. This procedure avoids possible measurement errors that may be caused by skin folds in the area of ​​the waist. “

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All the data analyzed in the study came from NHANES studies conducted between 2011 and 2016. According to Neri, the results can be extrapolated to Brazilian youth, who are also exposed to ultra-processed foods from an early age, though to a lesser extent than their American peers.

“Brazil does not conduct juvenile nutrition surveys that also collect anthropometric data in person. Nationwide surveys of this kind are very expensive and require ongoing funding. We have a few similar surveys, but they are simpler,” Neri said.

One example is Vigitel, an annual national survey conducted by the Ministry of Health to monitor the risk of chronic disease and protection involving telephone interviews with over eighteen. The latest data from this study, published in January 2022 by the Institute for Health Policy Studies (IEPS), shows that the number of obesity in adults 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 bureau, collects data on the dietary habits of adolescents and adults, but not on their health.

According to the latest POF, which was conducted in 2017-18, more than half (53.4%) of the average Brazilian’s daily caloric intake comes from fresh foods such as vegetables, fruits, meat and milk or minimally processed foods such as grains and flour, 15 , 6% from processed ingredients such as sugar, salt and olive oil, 11.3% from processed foods such as cheese, artisanal bread and canned fruits and vegetables and 19.7% from ultra-processed foods. For young people, the survey data show that ultra-processed foods account for 27% of calorie intake, and for over sixty the proportion is 15.1%.


In another study conducted by NUPENS, the researchers compared data on the diet of Brazilian youth from POF 2017-18 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 effect of ultra-processed foods on dietary quality was similar in all the groups analyzed, according to Neri.

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“Also in this study, the 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 increases, which increases the energy density and sugar content. And. “The negative effect is very similar across all countries regardless of the proportion of ultra-processed foods, region or culture,” she said.

Although rice and beans still make up the main diet for most Brazilians, she added that a study commissioned by the Ministry of Health in 2019 showed that consuming ultra-processed foods is frequent, even among under fives. More than 80% of all children in this group regularly consume these products.

“Children who consume these products have relatively less room to consume fresh ingredients or minimally processed foods at a time when dietary habits are being formed,” Neri said. “By being exposed to these obese foods, children and adolescents are being programmed for future health problems. It is extremely worrying.”

Families alone cannot be held responsible for controlling this exposure, which requires a reform of the prevailing diet system as a whole. “We need to go beyond consumer information by taking public policy on multiple fronts,” Neri said. “Different strategies are possible, such as placing restrictions on advertising, especially when targeted at children, and raising taxes on ultra-processed foods while improving access to fresh ingredients. Another very important measure would be to require producers of these products to to include clearer information on labels to help consumers make better choices. ”

Americans Eat More Ultra-Processed Foods More Information: Daniela Neri et al., Associations Between Ultra-Processed Foods Consumption and Indicators of Adiposity in U.S. Adolescents: Cross-Sectional Analysis of the 2011-2016 National Health and Nutrition Examination Survey, Journal of the Academy of Nutrition and Dietetics (2022). DOI: 10.1016 / j.jand.2022.01.005

Quote: The risk of obesity is 45% higher among young people whose diet is based on ultra-processed foods (2022, April 12) Retrieved April 14, 2022 from higher- teens-diet-based.html

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