Consumption of ultra-processed foods associated with weight gain and obesity in adults: A multi-national cohort study
Cordova, Reynalda; Kliemann, Nathalie; Huybrechts, Inge; Rauber, Fernanda; Vamos, Eszter P.; Levy, Renata Bertazzi; Wagner, Karl Heinz; Viallon, Vivian; Casagrande, Corinne; Nicolas, Geneviève; Dahm, Christina C.; Zhang, Jie; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Mancini, Francesca Romana; Laouali, Nasser; Katzke, Verena; Srour, Bernard; Jannasch, Franziska; Schulze, Matthias B.; Masala, Giovanna; Grioni, Sara; Panico, Salvatore; van der Schouw, Yvonne T.; Derksen, Jeroen W.G.; Rylander, Charlotta; Skeie, Guri; Jakszyn, Paula; Rodriguez-Barranco, Miguel; Huerta, José María; Barricarte, Aurelio; Brunkwall, Lousie; Ramne, Stina; Bodén, Stina; Perez-Cornago, Aurora; Heath, Alicia K.; Vineis, Paolo; Weiderpass, Elisabete; Monteiro, Carlos Augusto; Gunter, Marc J.; Millett, Christopher; Freisling, Heinz
(2021) Clinical Nutrition, volume 40, issue 9, pp. 5079 - 5088
(Article)
Abstract
Background: There is a worldwide shift towards increased consumption of ultra-processed foods (UPF) with concurrent rising prevalence of obesity. We examined the relationship between the consumption of UPF and weight gain and risk of obesity. Methods: This prospective cohort included 348 748 men and women aged 25–70 years. Participants were
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recruited between 1992 and 2000 from 9 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Two body weight measures were available, at baseline and after a median follow-up time of 5 years. Foods and drinks were assessed at baseline by dietary questionnaires and classified according to their degree of processing using NOVA classification. Multilevel mixed linear regression was used to estimate the association between UPF consumption and body weight change (kg/5 years). To estimate the relative risk of becoming overweight or obese after 5 years we used Poisson regression stratified according to baseline body mass index (BMI). Results: After multivariable adjustment, higher UPF consumption (per 1 SD increment) was positively associated with weight gain (0·12 kg/5 years, 95% CI 0·09 to 0·15). Comparing highest vs. lowest quintile of UPF consumption was associated with a 15% greater risk (95% CI 1·11, 1·19) of becoming overweight or obese in normal weight participants, and with a 16% greater risk (95% CI 1·09, 1·23) of becoming obese in participants who were overweight at baseline. Conclusions: These results are supportive of public health campaigns to substitute UPF for less processed alternatives for obesity prevention and weight management.
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Keywords: Adults, Europe, NOVA, Obesity, Ultra-processed foods, Weight gain, Nutrition and Dietetics, Critical Care and Intensive Care Medicine, Journal Article
ISSN: 0261-5614
Publisher: Churchill Livingstone
Note: Funding Information: The Public Health Policy Evaluation Unit is grateful for support from the NIHR School for Public Health Research . Swedish Cancer Society , Swedish Research Council and County Council of Västerbotten , Sweden. Funding Information: This work was partially financially supported by the Fondation de France (FDF, grant no. 00081166 , HF, RC). Funding Information: Fernanda Rauber is a beneficiary of a postdoctoral fellowship from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) , grant numbers 2016/14302-7 . Funding Information: The national cohorts are supported by the following funders: Ligue Contre le Cancer , Institut Gustave-Roussy , Mutuelle Générale de l'Education Nationale , Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid , German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health,Welfare and Sports (VWS) , Netherlands Cancer Registry (NKR) , LK Research Funds , Dutch Prevention Funds , Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS-ISCIII) , the Regional Governments of Andalucía , Asturias , Basque Country, Murcia , Navarra , and the Catalan Institute of Oncology (Barceloan), Spain); Cancer Research UK ( 14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council ( 1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK). Funding Information: Reynalda Cordova is a recipient of a DOC Fellowship of the Austrian Academy of Sciences at the Institute of Nutritional Sciences, University of Vienna.This work was partially financially supported by the Fondation de France (FDF, grant no. 00081166, HF, RC).Fernanda Rauber is a beneficiary of a postdoctoral fellowship from the Funda??o de Amparo ? Pesquisa do Estado de S?o Paulo (FAPESP), grant numbers 2016/14302-7.The national cohorts are supported by the following funders: Ligue Contre le Cancer, Institut Gustave-Roussy, Mutuelle G?n?rale de l'Education Nationale, Institut National de la Sant? et de la Recherche M?dicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health,Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland),World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS-ISCIII), the Regional Governments of Andaluc?a, Asturias, Basque Country, Murcia, Navarra, and the Catalan Institute of Oncology (Barceloan), Spain); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK).The Public Health Policy Evaluation Unit is grateful for support from the NIHR School for Public Health Research. Swedish Cancer Society, Swedish Research Council and County Council of V?sterbotten, Sweden. Publisher Copyright: © 2021
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