Introduction: The consumption of ultra-processed foods (UPF), associated with overweight among adolescents, has increased in the last decades. However, few studies have investigated the association between UPF consumption and cardiovascular risk factors in adolescents from developing countries. Objective: To evaluate the association between UPF consumption and cardiometabolic risk factors in Brazilian adolescents. Methods: The sample consisted of Brazilian students aged 12–17 years from the Study of Cardiovascular Risk in Adolescents. Food consumption was assessed using a 24-hour food recall and the foods were classified according to their processing degree, based on the NOVA classification. Blood samples were collected after overnight fasting, and laboratorial analyses (triglycerides, total cholesterol, HDL-c, LDL-c, fasting glucose, insulin, and HbA1c) were performed. Overweight/obesity and blood pressure were included in cardiometabolic outcomes. Poisson regression analyses were used to evaluate associations. Results: The analysis was composed of 36,952 adolescents. The average energy consumption from UPF was 30.7% (95%CI: 29.7–31.6) per day. Adolescents with high UPF consumption (top tertile, ≥38.7% per day) ingest more sodium, saturated and trans-fat, as well as few proteins, fibers, polyunsaturated fats, vitamins, and minerals. After adjusting for possible confounders, higher UPF consumption was directly associated with high LDL-c (PR=1.012; 95%CI: 1.005–1.029), and inversely associated with low HDL-c (PR=0.972; 95%CI: 0.952–0.993). We did not find associations between UPF consumption and other cardiometabolic risk factors evaluated in this study. Conclusion: UPF consumption among Brazilian adolescents is high and can be associated with poor diet quality and changes in LDL-c.

Background:The American Academy of Pediatrics (AAP) adolescent blood pressure (BP) percentiles were updated in 2017, and have been used as reference in Brazil since then. However, specific BP percentiles for Brazilian adolescents were recently proposed based on data from the Study of Cardiovascular Risk in Adolescents (ERICA).Objectives:To compare the prevalence of arterial hypertension according to each reference, as well as to assess the cardiometabolic risk associated with the reclassification by Brazilian BP percentiles.Methods:Data from 73 399 adolescents aged 12–17 years who participated in the ERICA study were analyzed. To assess cardiometabolic risk, 6185 adolescents who were reclassified upwards by the Brazilian reference were 1 : 1 matched with adolescents that were normotensive by both references and were of the same age, sex and height percentile. The parameters evaluated were: overweight/obesity, waist circumference, total cholesterol, triglycerides, LDL-c, HDL-c, fasting glucose, HbA1c and HOMA-ir.Results:The classification according to Brazilian BP percentiles resulted in a higher prevalence of arterial hypertension (14%, 95% CI 13.2–14.8), when compared with the AAP percentiles (10.6%, 95% CI 10.0–11.2). The use of the Brazilian reference also resulted in higher prevalence of arterial hypertension in girls, teenagers ranging from 12 to 14 years, and those classified with adequate weight, overweight or obesity. In the case–control analysis, cardiometabolic risk factors were present more often in adolescents reclassified with arterial hypertension by the ERICA reference.Discussion:The use of the BP percentiles proposed by ERICA is a sensitive method for tracking Brazilian adolescents with hypertension and higher cardiometabolic risk.

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