Study: Ultraprocessed food increases cardiovascular risk in children

Ultraprocessed food consumption in children could influence their risk of cardiovascular disease later in life, according to a recent study.

An analysis of data from more than 1400 preschool aged children followed for up to 10 years, results of the study suggest elevated levels of ultraprocessed food consumption was linked to negative changes in BMI, waist circumference, fat mass index, and lipid profile during the follow-up period relative to those with lower levels of ultraprocessed food consumption.

“Our findings give cause for concern,” said principal investigator Nancy Babio, PhD, of the Unit of Human Nutrition at Universitat Rovira I Virgili. “Although the magnitude of the associations we found could be thought to be of limited clinical importance, the boys and girls taking part in our study were very young but, even so, there was a significant relationship between their consumption and these parameters.”

As highlighted by Babio and colleagues, the prevalence and consumption of processed and ultraprocessed foods has exploded since the turn of the century. To explore the downstream impact of this increase in uptake on health, investigators designed a cross-sectional analysis of data recorded within the Childhood Obesity Risk Assessment Longitudinal Study (CORALS), with the specific intent of evaluating associations between ultraprocessed food consumption and cardiometabolic risk factors during follow-up.^1,2

A prospective ongoing multicenter study in preschool age children, CORALS was launched with the intent of identifying potential risk factors for childhood obesity. Eligible patients were aged 3-6 years and attended the selected schools across 7 cities in Spain. As part of study protocol, participants were required to attend the inclusion visit and complete several questionnaires.²

From the study, Babio and colleagues identified 1426 individuals from the 1509 enrollees for inclusion in the current study. This cohort had a mean age of 5.8 (SD, 1.1) years and 49.0% were boys. Investigators pointed out 54 participants were excluded due to missing food and beverage frequency questionnaire data and 29 were excluded due to missing or implausible reported energy intake.¹

For the purpose of analysis, energy-adjusted ultraprocessed food consumption was assessed in grams per day based on food frequency questionnaires and the NOVA food classification system. Associations between intake levels and adiposity and cardiometabolic parameters were estimated using linear regression models.¹

Upon initial analyses, investigators found mothers of children with high ultraprocessed food consumption were younger, had a higher BMI, were more likely to have overweight or obesity, and had lower education levels and employment rates. Analysis of primary outcomes revealed those in the highest tertile showed higher z scores of BMI (β coefficient, 0.20; 95% CI, 0.05-0.35), waist circumference (β coefficient, 0.20; 95% CI, 0.05-0.35), fat mass index (β coefficient, 0.17; 95% CI, 0.00-0.32), and fasting plasma glucose (β coefficient, 0.22; 95% CI, 0.06-0.37) and lower z scores for HDL cholesterol (β coefficient, −0.19; 95% CI, −0.36 to −0.02) relative to the lowest tertile of energy-adjusted ultraprocessed foods consumption.¹

Additional analysis suggested each 1-SD increase in energy-adjusted ultraprocessed food consumption were associated with higher z scores for BMI (β coefficient, 0.11; 95% CI, 0.05-0.17), waist circumference (β coefficient, 0.09; 95% CI, 0.02 to 0.15), fat mass index (β coefficient, 0.11; 95% CI, 0.04 to 1.18), and fasting plasma glucose (β coefficient, 0.10; 95% CI, 0.03 to 0.17) and lower HDL cholesterol (β coefficient, −0.07; 95% CI, −0.15 to −0.00). Investigators highlighted 100 grams of ultraprocessed with 100 grams of unprocessed or minimally processed foods was associated with lower z scores of BMI (β coefficient, −0.03; 95% CI, −0.06 to −0.01), fat mass index (β coefficient, −0.03; 95% CI, −0.06 to 0.00), and fasting plasma glucose (β coefficient, −0.04; 95% CI, −0.07 to −0.01).¹

Investigators called attention to several limitations within their study. These included the observational nature of the study, limited generalizability, potential misclassification because consumption was estimated from questionnaires, and potential for residual confounding.¹

“[Ultraprocessed foods] consumption was positively associated with fasting plasma glucose levels, BMI, waist circumference, and fat mass index and inversely associated with HDL cholesterol concentration,” investigators wrote.¹ “These findings highlight the importance of promoting unprocessed or minimally processed foods and reducing [ultraprocessed food] consumption, particularly starting from early ages. However, further prospective studies are warranted to validate our findings.”

This article was initially published by our sister publication, HCPLive.

References:

1. Khoury N, Martínez MÁ, Garcidueñas-Fimbres TE, et al. Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children. JAMA Netw Open. 2024;7(5):e2411852. doi:10.1001/jamanetworkopen.2024.11852
2. Garcidueñas-Fimbres TE, Paz-Graniel I, Gómez-Martínez C, et al. Associations Between Eating Speed, Diet Quality, Adiposity, and Cardiometabolic Risk Factors. J Pediatr. 2023;252:31-39.e1. doi:10.1016/j.jpeds.2022.08.024