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. 2018 Aug;21(12):2271-2279.
doi: 10.1017/S1368980018000861. Epub 2018 Apr 12.

Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008-2010)

Fernanda Marcelina Silva  1 , Luana Giatti  2 , Roberta Carvalho de Figueiredo  3 , Maria Del Carmen Bisi Molina  4 , Letícia de Oliveira Cardoso  5 , Bruce Bartholow Duncan  5 , Sandhi Maria Barreto  1
Affiliations

Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008-2010)

Fernanda Marcelina Silva et al. Public Health Nutr. 2018 Aug.

Abstract

Objective: To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.

Design: Cross-sectional analysis of the ELSA-Brasil baseline (2008-2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals' total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake.

Setting: Six Brazilian capital cities, 2008-2010.

Subjects: Active and retired civil servants, aged 35-64 years, from universities and research organizations (n 8977).

Results: Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (β; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose-response gradient.

Conclusions: Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.

Keywords: ELSA-Brasil; Food consumption; Obesity; Ultra-processed foods; Waist circumference.

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Figures

Fig. 1
Fig. 1
Distribution of (a) mean BMI and (b) mean waist circumference (WC) according to quartile of the relative contribution of ultra-processed foods to total energy intake in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010 (n 8977). Values are means, with their 95 % CI represented by vertical bars, adjusted for sex and age (both P trend<0·01)
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