Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults
Introduction
Ultra-processed foods are formulations made by the food industry mostly from substances extracted from foods or obtained from the further processing of constituents of foods or through chemical synthesis, with little if any whole foods (Monteiro et al., 2012, Moodie et al., 2013). Compared to the rest of the diet, these formulations have less fiber and protein, more added sugar, and, when solid, higher energy density (Monteiro et al., 2011, Moubarac et al., 2013). They are also extremely palatable and habit-forming, convenient, sold in large portion sizes, and aggressively advertised and marketed (Monteiro et al., 2012, Moodie et al., 2013, Ludwig, 2011). Sales of ultra-processed foods have increased in parallel with the rates of obesity worldwide, particularly in middle-income countries (Monteiro et al., 2013).
One analysis in Brazil showed that household purchase of ultra-processed foods was associated with greater prevalence of obesity (Canella et al., 2014). However, this study had only used purchase data rather than individual-level consumption data. To our knowledge, no evidence in a developing country is available for how much people consume ultra-processed foods across different demographic groups and how it is related to obesity.
The objective of the present study was to evaluate the association of the intake of ultra-processed foods with obesity indicators in a nationally representative sample of Brazilian adolescents and adults.
Section snippets
Design and population
We performed a cross-sectional analysis based on individual-level dietary data from 34,003 individuals aged ≥ 10 years in Brazil, collected as part of the 2008–2009 National Household Budget Survey (Instituto Brasileiro de Geografia e Estatística, Ibge, 2011a). These individuals represented a randomly selected subsample of 25% of the 55,970 total households randomly selected for the budget survey. The survey employed a complex clustered sampling procedure, first selecting census tracts and then
Results
A total of 30,243 Brazilian adults were evaluated (Table 1). Consistent with the national population, the great majority resided in urban areas, 51% were women and 52% African-descent. Forty-one percent of the participants were excess weight and 12% obese.
Mean reported energy intake was 1908 kcal. Nationally, more than two thirds (68.6%) of these calories came from unprocessed, minimally, or moderately processed foods, while 29.6% came from ultra-processed foods.
On average, rice and beans
Discussion
We found a cross-sectional association between the intake of ultra-processed foods and excess weight and obesity among Brazilian adolescents and adults. Although there was heterogeneity by sex and age, our finding supports that, on average, there are potential detrimental effects of consuming ultra-processed foods.
We suggest that this association is, at least partially, explained by intrinsic characteristics of ultra-processed foods that promote overconsumption. This is particularly important
Conclusion
In conclusion, our findings support the role of ultra-processed foods consumption in the obesity epidemic in Brazil. While cross-sectional, the size and generalizability of our study provide evidence that may support the role of ultra-processed foods in the obesity epidemic. These results demonstrate a need for interventional studies, including policy interventions, to test the effects of reducing ultra-processed foods on obesity.
Supplementary information is available at Preventive Medicine's
Conflict of interest
No conflicts of interest.
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- 1
M.L.C. Louzada was funded by the São Paulo Research Foundation (2013/08260-1).
- 2
J-C. Moubarac was funded by the São Paulo Research Foundation (2011/08425-5).
- 3
F. Imamura was supported by Medical Research Council Epidemiology Unit Core Support (MC_UU_12015/5).
- 4
D. Mozaffarian declare: Ad hoc honoraria for one-time scientific presentations/reviews on diet from Quaker Oats, Pollock Institute, and Bunge (each < 10 k/12 months); ad hoc consulting for Foodminds, Nutrition Impact, Amarin, Astra Zeneca, Winston and Strawn LLP, and Life Sciences Research Organization (each < 10 k/12 months); Unilever North America Scientific Advisory Board (< 10 k/12 months), royalties from UpToDate, for an online chapter on fish oil (< 10 k/12 months).