Maria Laura da Costa Louzada1, Larissa Galastri Baraldi2, Euridice Martinez Steele3, Ana Paula Bortoletto Martins4, Daniela Silva Canella5, Jean-Claude Moubarac6, Renata Bertazzi Levy7, Geoffrey Cannon8, Ashkan Afshin9, Fumiaki Imamura10, Dariush Mozaffarian11, Carlos Augusto Monteiro12. 1. Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: maria.laura.louzada@gmail.com. 2. Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: laribaraldi@gmail.com. 3. Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: emar_steele@hotmail.com. 4. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: anapbmartins@gmail.com. 5. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: danicanella@gmail.com. 6. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: jcmoubarac@gmail.com. 7. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo, 455, S27, São Paulo 01246-903, Brazil. Electronic address: rlevy@usp.br. 8. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: geoffreycannon@aol.com. 9. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, United States. Electronic address: ashkan.Afshin@tufts.edu. 10. Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0SP, UK. Electronic address: fumiaki.imamura@mrc-epid.cam.ac.uk. 11. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, United States. Electronic address: dariush.mozaffarian@tufts.edu. 12. Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil. Electronic address: carlosam@usp.br.
Abstract
OBJECTIVES: The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents. METHODS: We used cross-sectional data on 30,243 individuals aged ≥10 years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. RESULTS: Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94 kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. CONCLUSION: Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.
OBJECTIVES: The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents. METHODS: We used cross-sectional data on 30,243 individuals aged ≥10 years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. RESULTS: Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94 kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. CONCLUSION: Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.