Ultra-processed food consumption and obesity in adolescents

ABSTRACT Objective To evaluate the relationship between ultra-processed food consumption and obesity indicators in adolescents. Methods Cross-sectional study with a convenience sample of 200 10- to 18-year-old adolescents from Campinas, São Paulo (SP). Usual dietary intake was determined through a semiquantitative food frequency questionnaire. Daily intake of each food was obtained from the intake frequency. Subsequently, foods were classified as raw and minimally processed, cooking ingredients or ultra-processed foods, and their caloric contribution to the total energy value was calculated. Sociodemographic and anthropometric variables were also investigated. Overweight was defined as Z-score>+1 and obesity was defined as Z-score>+2 according to the Body Mass Index per age group. The associations were tested by chi-square test and linear trend. Results The frequency of obesity was 47.0%, and 21.5% presented increased waist circumference. The average energy intake was 4,176kcal/day, of which 50.6% was derived from ultra-processed foods. The categories with the highest caloric contributions among ultra-processed foods were industrial loaves/cakes (16.2%), sweets and candy (6.2%), pastas (6.0%) and sweetened drinks (5.1%). No association was found between ultra-processed food consumption and anthropometric indicators. Conclusion The significant contribution of ultra-processed foods to daily calories is evidence of a poor diet of this population of young people, although this has not been shown as a factor associated with excess weight. Therefore, there is an urgent need for public policies that discourage the consumption of these products and encourage the return to a traditional diet.

摘要
研究目的：评估青少年超加工食品（ultra-processed food）摄入量与肥胖相关指标之间的关联。

研究方法：本研究为横断面研究，招募来自巴西圣保罗州坎皮纳斯市的200名10~18岁青少年作为便利样本。通过半定量食物频率问卷评估研究对象的常规膳食摄入量，基于摄入频率计算每种食物的每日摄入量，随后将食物分为生鲜及极简加工食品、烹饪用食材或超加工食品，并计算各类食物对总能量摄入的热量贡献占比。同时收集研究对象的社会人口学及人体测量学变量。依据不同年龄组的体重指数（Body Mass Index, BMI），将超重定义为Z评分>+1，肥胖定义为Z评分>+2。采用卡方检验与线性趋势检验分析变量间的关联。

研究结果：本研究人群的肥胖检出率为47.0%，21.5%的研究对象存在腰围升高情况。研究对象的日均能量摄入为4176千卡，其中50.6%的能量来自超加工食品。超加工食品中热量贡献占比最高的类别为工业制面包/糕点（16.2%）、甜点与糖果（6.2%）、意面（6.0%）及含糖饮料（5.1%）。未发现超加工食品摄入量与人体测量学指标之间存在显著关联。

研究结论：超加工食品在青少年日均能量摄入中占比颇高，提示该人群的膳食质量不佳，尽管未发现其与体重超标存在关联。因此，亟需出台公共政策以限制此类食品的消费，并倡导回归传统膳食模式。