The risk of obesity is 45% higher in adolescents whose diet is based on ultra-processed foods

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This discovery was made by USP researchers based on data from 3,587 young people aged 12 to 19 who participated in the US National Health and Nutrition Survey. Another worrying fact is the 63% increase in the risk of visceral obesity, which is strongly associated with metabolic and cardiovascular diseases.

By Karina Toledo in FAPESP Agency – Based on data from 3,587 adolescents aged 12 to 19 who participated in the US National Health and Nutrition Survey, researchers at the University of São Paulo (USP) calculated the impact of consumption of ultra-processed foods on the risk of obesity. .

In the study, young people were divided into three groups according to the amount ingested of these products. Comparing those who ate the most ultra-processed foods (on average 64% of total grams of diet) with those who ate less (18.5% on average), it was observed that those in the first group were 45% more likely to be obese, 52% more likely to have abdominal obesity (fat located in the belly) and – the most disturbing data – 63% higher risk of visceral obesity (accumulation of fat between organs), which is strongly linked to the development of hypertension, coronary artery disease, type 2 diabetes, dyslipidemia and increased risk of mortality.

The full results of the research, supported by FAPESP, have been disclosed to Journal of the Academy of Nutrition and Dietetics.

“The scientific evidence has become quite strong regarding the negative role of ultra-processed foods in the obesity pandemic. This is very well demonstrated for adults. Among young people, we had already seen that the consumption of these products is high – accounting for about two-thirds of the diets of North American adolescents – but results regarding the association between ultra-processed dietary habits and health effects, including obesity, were sparse and inconsistent “, Explain Daniela Nerifirst author of the article and a member of the Nupens of Epidemiological Research in Nutrition and Health (Nupens) of the USP School of Public Health.

The context

Coordinated by the teacher Carlos Augusto Monteiro, the Nupens team was a pioneer in linking changes in industrial food processing to the obesity pandemic, which began in the United States in the 1980s and by the 21st century has affected most countries in the world. . Based on this assumption, the group developed a classification of foods, called NEW, depending on the level of industrial processing. The work supported the recommendations of the Food guide for the Brazilian population launched in 2014, which recommends favoring culinary preparations with in nature or minimally processed and steer clear of ultra-processed — a category that can include anything from soft drinks, stuffed cookies, and packaged snacks to even seemingly innocent whole-grain bread (Read more on:

“In general, ultra-processed foods and beverages contain chemical additives – such as colorings, flavorings, emulsifiers and thickeners – which aim to improve the sensory characteristics of the product. Many of them have high energy density and high levels of sugar and fat, which directly contribute to weight gain. But even low-calorie foods like diet sodas can promote the development of obesity in ways that go beyond nutritional composition. For example, interfering with the body’s satiety signaling or altering the gut microbiota,” explains Neri.


In the recently published research, adolescent diets were assessed using a methodology known as the 24-Hour Food Log, which involves obtaining information on the types and amounts of all foods and drinks ingested the day before the interview. , as well as the times and places of consumption of meals. Most of the participants included in the analysis (86%) underwent two such interviews, with an interval of two weeks between them.

Based on this reminder, the young people were divided into three groups. In the first were those who consumed up to 29% of the total grams in the diet from ultra-processed foods. In the second, those for whom this percentage varied between 29% and 47% and, in the last tertile, those whose values ​​were greater than 48%.

The participants’ anthropometric data were also assessed, including weight, height and waist circumference. These indices were evaluated for age and sex, according to the growth model of the Centers for Disease Control (CDC) of the United States.

“The risk of total obesity was estimated based on BMI, which is calculated by dividing weight [em quilos] by height squared [em metros]. To assess abdominal obesity, we used the measurement of abdominal circumference. And a lesser known parameter, which is the sagittal abdominal diameter, has been used as Proxy [valor representativo] visceral obesity,” says Neri.

As the researcher explains, the sagittal abdominal diameter is an indirect and non-invasive way to measure the amount of fat between organs. “The individual lies down on the stretcher and, with a kind of ruler [paquímetro], the distance between the lower back and the navel area is measured, so that the softer subcutaneous fat falls to the sides and the stiffer visceral fat remains in place. In this way, possible measurement errors that could be caused by creases in the waist area are avoided.

All data assessed in the USP survey were drawn from the National Health and Nutrition Examination Survey (Nhanes) – the nationwide survey of health and nutrition conducted continuously in the United States. This is a public database covering a nationally representative sample of the US population. In the study, information collected between 2011 and 2016 was used. According to Neri, the findings can be extrapolated to young Brazilians, who are also exposed from an early age to ultra-processed foods, albeit to a lesser extent.

“In Brazil, there is no survey that provides both information on adolescent food consumption and anthropometric data collected during face-to-face assessments. This type of nutrition survey is expensive and requires ongoing funding. In the country, there are similar, but simpler initiatives,” comments Neri.

At vigil, which is the national survey conducted annually by the Ministry of Health to monitor risk and protective factors for chronic diseases, for example, data collection is by telephone and only from people over the age of 18 . The most recent data from this survey, disclosed in January of this year by the Institute for Health Policy Studies (IEPS), point out that the rate of obesity in the adult population of Brazil has increased from 11.8% in 2006 to 21.5% in 2020 , that is, it practically doubled.

The household budget survey (POF) from the Brazilian Institute of Geography and Statistics (IBGE) provides data on the food consumption of adolescents and adults in the country, but does not contain information on the health status of the respondents.

According to the latest edition of the POF, carried out between 2017 and 2018, more than half (53.4%) of the calories consumed by Brazilians come from food. in nature (vegetables, fruits, meats, milk, etc.) or slightly processed (cereals and flour for example), 15.6% of processed culinary ingredients (such as salt, sugar and olive oil), 11, 3% processed foods (cheeses, artisanal bread products, canned fruits and vegetables) and 19.7% ultra-processed foods. Among adolescents analyzed in the POF, the proportion of ultra-processed foods represents 27% of total daily calories, while among adults aged 60 and over this percentage is 15.1%.


In another study conducted in Nupens and disclosed in the magazine Opinion on Obesitythe researchers compared adolescent diet data from the 2017-2018 POF with similar information from seven other countries: Argentina, Australia, Chile, Colombia, Mexico, the United States and the United Kingdom.

The share of ultra-processed foods in young people’s diets varied greatly across countries, being lowest in Colombia (19% of food calories) and Brazil (27%) and highest among Britons (68%) and North Americans (66%). Despite the consumption gap, the impact on diet quality was very similar across all populations assessed, Neri tells FAPESP Agency.

“In this study, young people were also divided into groups based on their consumption of ultra-processed foods. And we observed that as the participation of these products increases, there is a deterioration in the quality of the diet, that is, the energy density and the sugar level increase. On the other hand, fiber reduction occurs. The negative effect is very similar in all countries, regardless of the proportion of ultra-processed products, region or culture.

Although rice and beans are still the basis of the Brazilian diet, points out the researcher, a lifting published last year by the Ministry of Health revealed that the consumption of ultra-processed foods is frequent in the country even among children under 5 years old: more than 80% of individuals in this age group consume them regularly.

“The ingestion of these products takes away space from the food in nature or minimally processed at a stage where eating habits are forming,” warns Neri. “This exposure of children and adolescents to these obesogenic foods represents a real programming of future health problems. It’s really worrying.

For the researcher, controlling this exposure exceeds the capacities of families, since it would be necessary to remodel the entire current food system.

“In addition to raising consumer awareness, action must be taken on several fronts through public policies. Different strategies are possible, such as restricting advertising, especially for children, and increasing the taxation of these products, while increasing access to food. in nature. Another fundamental measure concerns labels, which should provide clearer information to guide consumers’ food choices,” says Neri.

The studies published by the Nupens team were funded by FAPESP through five projects (15/14900-9, 16/25853-4, 18/17972-9, 19/22278-7 and 16/14302-7).

The article Associations between consumption of ultra-processed foods and indicators of adiposity among American adolescents: cross-sectional analysis of the 2011-2016 National Health and Nutrition Survey can be read at:

and the item Consumption of ultra-processed foods and dietary nutrient profiles associated with obesity: a multi-country study of children and adolescents is available on:

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