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High consumption of ultraprocessed foods (UPFs) in young children was associated with worse cardiometabolic health later in life, according to a new study published in JAMA Network Open.¹

Results of an analysis of data from more than 1400 preschool children (aged 3-6 years) in Spain followed for up to a decade showed that high intake of UPFs was positively associated with body mass index (BMI), waist circumference (WC), fat mass index, and fasting plasma glucose and negatively associated with high-density lipoprotein cholesterol (HDL-C) levels.¹

"Our findings give cause for concern,” principal investigator Nancy Babio, PhD, of Universitat Rovira i Virgili in Spain, said in a press release. "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.”²

The prevalence and consumption of UPFs has increased among children and adolescents because they are highly available and cost-effective and widely marketed to this population. Previous research has found a link between high consumption of UPFs and increased cardiometabolic risk in adults, but the evidence in children is limited, according to Babio and colleagues. To explore further, they analyzed data from the Childhood Obesity Risk Assessment Longitudinal Study, an ongoing prospective study of children aged 3-6 years in 7 cities in Spain.¹

Investigators assessed the energy-adjusted UPF consumption in grams per day from food frequency questionnaires, which were based on the NOVA Food Classification system, the most widely used UPF classification. Using linear regression models, they then estimated age-and sex-specific z scores of adiposity and cardiometabolic parameters, such as BMI, fat mass index, blood pressure, triglycerides, fasting plasma glucose, and cholesterol levels.¹

A total of 1426 children (mean age, 5.8 years; 49.0% boys) were included in the current study and categorized into 3 tertiles of energy-adjusted UPF consumption, with the first and lowest group having a baseline mean daily measurement of 192.8 g, increasing to 354.8 g for the second group, and 593.4 g for the third and highest group. The percentage of participants with obesity was 17.5% in the first group, 20.9% in the second group, and 25.0% in the third group. The third group had the highest average fat mass index (3.97 kg/m²), systolic blood pressure (104 mm Hg), and triglyceride (56 mg/dL) level.¹

Findings¹

Researchers observed that mothers of children with the highest UPF intake (third tertile) were younger, had a higher BMI, were more likely to have obesity or overweight, and had lower education levels and employment rates.

Compared with participants in the lowest tertile of energy-adjusted UPF consumption, those in the highest had higher z scores of BMI (β coefficient 0.20, 95% CI 0.05-0.35), WC (β coefficient 0.20, 95% CI 0.05-0.35), and fasting plasma glucose (β coefficient 0.22, 95% CI 0.06-0.37). Children in the third tertile also had lower z scores for HDL-C than those in the lowest tertile (β coefficient –0.19, 95% CI –0.36 to –0.02), investigators added.

Additionally, one-standard deviation increase in energy-adjusted UPF consumption was associated with higher z scores for BMI (β coefficient 0.11, 95% CI 0.05-0.17), WC (β coefficient 0.09, 95% CI 0.02-0.15), fat mass index (β coefficient 0.11, 95% CI 0.04-1.18), and fasting plasma glucose (β coefficient 0.10, 95% CI 0.03-0.17), and lower HDL-C (β coefficient –0.07, 95% CI –0.15 to –0.00).

Researchers observed substituting 100 g of UPFs with 100 g 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).

Investigators also noted that children of mothers with lower education or lower socioeconomic status were more likely to consume UPFs, suggesting that educational and socioeconomic status contribute to the purchase of cheaper, unhealthy foods (eg, UPFs), which makes children more susceptible to health issues later in life.

“These findings highlight the importance of promoting unprocessed or minimally processed foods and reducing UPF consumption, particularly starting from early ages,” Babio et al concluded. “However, further prospective studies are warranted to validate our findings.”

References:

1. Babio N, Khoury N, Martínez MÁ, et al. Ultraprocessed food consumption and cardiometabolic risk factors in children. JAMA Netw Open. Published online May 17, 2024. doi:10.1001/jamanetworkopen.2024
2. Ultra-processed foods increase cardiometabolic risk in children. News release. Universitat Rovira i Virgili. May 21, 2024. Accessed May 23, 2024. https://diaridigital.urv.cat/en/ultra-processed-foods-increase-cardiometabolic-risk-in-children/