Effect of the food processing degree on cardiometabolic health outcomes: A prospective approach in childhood

Vilela, Sofia; Magalhães, Vânia; Severo, Mílton; Oliveira, Andréia; Torres, Duarte; Lopes, Carla

doi:10.1016/j.clnu.2022.07.034

Cited by 10 publications

(8 citation statements)

References 42 publications

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“…Similarly, in a Brazilian cohort, UPF consumption during preschool years was associated with increases in waist circumference from preschool to school age . Other studies found no significant association between UPF consumption and HDL cholesterol and fasting plasma glucose concentrations . Therefore, to our knowledge, our study is the first in children to find significant associations with the aforementioned risk factors and is in line with other studies assessing adult populations …”

Section: Discussionsupporting

confidence: 92%

“…39 Other studies found no significant association between UPF consumption and HDL cholesterol and fasting plasma glucose concentrations. 37,40 Therefore, to our knowledge, our study is the first in children to find significant associations with the aforementioned risk factors and is in line with other studies assessing adult populations. 41 Our results provide new insight into the association between UPF consumption and health and the importance of recognizing that early dietary habits in childhood might have future implications on cardiometabolic health.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

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Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children

Khoury,

Martínez,

Garcidueñas-Fimbres

et al. 2024

JAMA Netw Open

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ImportanceHigh intake of ultraprocessed foods (UPFs) has been associated with higher cardiometabolic risk in adults; however, the evidence in children is limited.ObjectiveTo investigate the association between UPF consumption and cardiometabolic risk factors in the Childhood Obesity Risk Assessment Longitudinal Study (CORALS).Design, Setting, and ParticipantsThis baseline cross-sectional analysis was conducted using the data of CORALS participants recruited between March 22, 2019, and June 30, 2022. Preschool children (aged 3-6 years) were recruited from schools and centers in 7 cities in Spain. Inclusion criteria included informed consent signed by parents or caregivers and having a completed a set of questionnaires about the child’s prenatal history at home. Exclusion criteria included low command of Spanish or unstable residence.ExposureEnergy-adjusted UPF consumption (in grams per day) from food frequency questionnaires and based on the NOVA food classification system.Main Outcomes and MeasuresAge- and sex-specific z scores of adiposity parameters (body mass index [BMI], fat mass index, waist-to-height ratio, and waist circumference) and cardiometabolic parameters (diastolic and systolic blood pressure, fasting plasma glucose, homeostasis model assessment for insulin resistance, high-density and low-density lipoprotein cholesterol, and triglycerides) were estimated using linear regression models.ResultsOf 1509 enrolled CORALS participants, 1426 (mean [SD] age, 5.8 [1.1] years; 698 boys [49.0%]) were included in this study. Mothers of children with high UPF consumption were younger, had a higher BMI, were more likely to have overweight or obesity, and had lower education levels and employment rates. Compared with participants in the lowest tertile of energy-adjusted UPF consumption, those in the highest tertile showed higher z scores of BMI (β coefficient, 0.20; 95% CI, 0.05-0.35), waist circumference (β coefficient, 0.20; 95% CI, 0.05-0.35), fat mass index (β coefficient, 0.17; 95% CI, 0.00-0.32), and fasting plasma glucose (β coefficient, 0.22; 95% CI, 0.06-0.37) and lower z scores for HDL cholesterol (β coefficient, −0.19; 95% CI, −0.36 to −0.02). One-SD increments in energy-adjusted UPF consumption were associated with higher z scores for BMI (β coefficient, 0.11; 95% CI, 0.05-0.17), waist circumference (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 cholesterol (β coefficient, −0.07; 95% CI, −0.15 to −0.00). 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).Conclusions and RelevanceThese findings suggest that high UPF consumption in young children is associated with adiposity and other cardiometabolic risk factors, highlighting the need for public health initiatives to promote the replacement of UPFs with unprocessed or minimally processed foods.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children

Khoury,

Martínez,

Garcidueñas-Fimbres

et al. 2024

JAMA Netw Open

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“…As mudanças resultantes nos padrões alimentares globais levaram a uma transição para dietas altamente processadas (BIANCA et al,2021;VILELA et al,2022). As crianças são influenciadas pela alimentação e estilo de vida da família e estão sujeitas a mudanças nos padrões ambientais e comportamentais devido à transição para o ambiente escolar (FILGUEIRAS et al,2019).…”

Section: Consumo Alimentar Na Infânciaunclassified

“…O alto consumo de alimentos in natura ou minimamente processados tem um efeito favorável na saúde cardiometabólica das crianças posteriormente, nomeadamente menor peso corporal e gordura corporal, menor circunferência da cintura, níveis séricos de insulina e na pressão arterial (VILELA et.,2022). Uma dieta infantil abundante em nutrientes com propriedades anti-inflamatórias pode reduzir a chance do risco cardiometabólico e do acometimento de excesso de peso corporal (BUCKLAND et al,2022;VILELA et al,2022).…”

Section: Relação Da Dieta Com O Risco Cardiometabólicounclassified

Capacidade antioxidante total da dieta (CATd) e Índice inflamatório da dieta (IID-c) de crianças de 4 a 7 anos: associação com o consumo alimentar, características sociodemográficas, hábitos de vida e risco cardiometabólico

Carmo¹

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Introdução: A dieta é considerada um fator de risco modificável na infância, e pode atuar na prevenção do excesso de peso e no acometimento de doenças cardiovasculares. A exposição a alimentos ultraprocessados (UPP) e de baixa qualidade nutricional prejudica a formação dos hábitos alimentares das crianças e, além disso, é considerado pró-inflamatório. Vários instrumentos avaliam a qualidade da dieta, dentre eles o Índice Inflamatório da Dieta para crianças (IID-c), que caracteriza de forma geral as propriedades inflamatórias da dieta e a capacidade antioxidante total da dieta (CATd), que avalia os nutrientes antioxidantes consumidos. Objetivo: Avaliar a associação entre o IID-c, CATd e sua associação com o consumo alimentar, características sociodemográficas, hábitos de vida e risco cardiometabólico. Metodologia: Trata-se de um estudo transversal, realizado com 403 crianças de idades entre 4 e 7 anos, que foram acompanhadas pelo Programa de Apoio à Lactação (PROLAC) do município de Viçosa-MG nos primeiros meses de vida. Foi realizada uma parceria com os autores que calcularam o escore de IID-c. Os marcadores de risco cardiometabólico (RC) analisados foram excesso de peso (IMC), percentual de gordura corporal e massa magra, relação cintura-estatura (RCE), pressão arterial média (PAM), síndrome metabólica (SM) e perfil lipídico. A análise descritiva dos dados foi feita por meio de medidas de distribuição de frequências, de tendência central e de dispersão. A normalidade das variáveis contínuas foi avaliada pelo teste de Shapiro-Wilk. Para a comparação das médias de CATd e IID-c de acordo com as categorias das variáveis sociodemográficas, estilo de vida e consumo alimentar, aplicou-se os testes t de Student ou ANOVA, com post hoc de Bonferroni. Para investigar os fatores associados à CATd e ao IID-c foi aplicada a análise de regressão linear. O nível de significância estatística considerado foi α = 5%. Resultados: A média de CATd das crianças foi de 2,45 mmol/1000 kcal (DP = 0,94) e os valores variaram de +0,93 a +7,89. A média do IID-c foi de 1,22 (DP 1,10) e os valores variaram de -2,53 a + 3,79. Dentre as crianças avaliadas, 25,7% apresentavam excesso de peso e 34,0% SM. Na análise do perfil lipídico, observou-se que as crianças que apresentaram alteração nas concentrações séricas de colesterol total foram 37,7%, LDL 28,2%, HDL 38,2% e triglicerídeos com 28,3%. As crianças com maior renda per capita (β: -0,449; IC95%: -0,71- -0,18) e maior consumo de alimentos UPP (β: -0,651; IC95%: -1,00- -0,29), apresentaram menores valores de CATd. Maiores consumos de frutas e hortaliças apresentaram maior CATd (β: 0,301; IC95%: 0,08 – 0,52). Em relação ao escore do IID-c, crianças com maior consumo de UPP (β: 0,499; IC95%: 0,13- 0,86) e menor consumo de alimentos in natura/minimamente processados (β: -0,783; IC95%: -1,14- -0,42), frutas e hortaliças (β: -0,578; IC95%: -0,80- -0,34), apresentam maiores valores de IID- c. Não foram encontradas associações entre IID-c e CATd com fatores de RC. Conclusão: Aspectos sociodemográficos, como a renda familiar, e o consumo de alimentos segundo o grau de processamento, foram associados ao perfil inflamatório da dieta das crianças. Palavras-chave: Capacidade antioxidante total da dieta. Índice inflamatório da dieta. Alimentos ultraprocessados. Crianças. Risco cardiometabólico.

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Mediterranean Diet and Cardiometabolic Biomarkers in Children and Adolescents

López-Gil,

García-Hermoso,

Martínez-González

et al. 2024

JAMA Netw Open

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ImportanceNo prior systematic review and meta-analysis has specifically verified the association of Mediterranean diet (MedDiet)–based interventions with biomarkers of cardiometabolic health in children and adolescents.ObjectiveTo review and analyze the randomized clinical trials (RCTs) that assessed the effects of MedDiet-based interventions on biomarkers of cardiometabolic health among children and adolescents.Data SourcesFour electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) from database inception to April 25, 2024.Study SelectionOnly RCTs investigating the effect of interventions promoting the MedDiet on cardiometabolic biomarkers (ie, systolic blood pressure [SBP], diastolic blood pressure [DBP], triglycerides [TGs], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], glucose, insulin, and homeostatic model assessment for insulin resistance [HOMA-IR]) among children and adolescents (aged ≤18 years) were included.Data Extraction and SynthesisA systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were extracted from the studies by 2 independent reviewers. Results across studies were summarized using random-effects meta-analysis.Main Outcome and MeasuresThe effect size of each trial was computed by unstandardized mean differences (MDs) of changes in biomarker levels (ie, SBP, DBP, TGs, TC, HDL-C, LDL-C, glucose, insulin, HOMA-IR) between the intervention and the control groups. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach.ResultsNine RCTs were included (mean study duration, 17 weeks; range, 8-40 weeks). These studies involved 577 participants (mean age, 11 years [range, 3-18 years]; 344 girls [59.6%]). Compared with the control group, the MedDiet-based interventions showed a significant association with reductions in SBP (mean difference, −4.75 mm Hg; 95% CI, −8.97 to −0.52 mm Hg), TGs (mean difference, −16.42 mg/dL; 95% CI, −27.57 to −5.27 mg/dL), TC (mean difference, −9.06 mg/dL; 95% CI, −15.65 to −2.48 mg/dL), and LDL-C (mean difference, −10.48 mg/dL; 95% CI, −17.77 to −3.19 mg/dL) and increases in HDL-C (mean difference, 2.24 mg/dL; 95% CI, 0.34-4.14 mg/dL). No significant associations were observed with the other biomarkers studied (ie, DBP, glucose, insulin, and HOMA-IR).Conclusions and RelevanceThese findings suggest that MedDiet-based interventions may be useful tools to optimize cardiometabolic health among children and adolescents.

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Effect of the food processing degree on cardiometabolic health outcomes: A prospective approach in childhood

Cited by 10 publications

References 42 publications

Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children

Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children

Capacidade antioxidante total da dieta (CATd) e Índice inflamatório da dieta (IID-c) de crianças de 4 a 7 anos: associação com o consumo alimentar, características sociodemográficas, hábitos de vida e risco cardiometabólico

Mediterranean Diet and Cardiometabolic Biomarkers in Children and Adolescents

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