Ultra-processed foods consumption and the risk of metabolically unhealthy phenotype in normal-weight and overweight/obese adults: a prospective investigation

Abstract This study investigated the association between ultra-processed foods (UPF) and the risk of metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obese (MUO). We included 512 normal-weight and 787 overweight/obese adults with a metabolically healthy phenotype from the Tehran and Lipid Glucose Study, who were followed from the third (baseline) to the sixth study examinations. Each 10% increase in energy intake from UPF was related to a 54% (95% CI = 21–96%) and 2% (95% CI = 1–3%) higher risk of MUNW and MUO, respectively. The risk of MUNW was significantly higher in quartile 4 compared to quartile 1. The restricted cubic splines suggested that the risk of MUNW increases monotonically when UPF accounts for at least 20% of energy intake. No non-linear association was observed between UPF and the risk of MUO. Energy intake from UPF was positively related to the risk of MUNW and MUO.

[1]  Wei Huang,et al.  Ultra-processed Foods Consumption Increases the Risk of Hypertension in Adults: A Systematic Review and Meta-Analysis. , 2022, American journal of hypertension.

[2]  F. Sofi,et al.  Consumption of Ultra-Processed Foods Is Inversely Associated with Adherence to the Mediterranean Diet: A Cross-Sectional Study , 2022, Nutrients.

[3]  Lingling Liu,et al.  Risk of Stroke Among Different Metabolic Obesity Phenotypes: A Systematic Review and Meta-Analysis , 2022, Frontiers in Cardiovascular Medicine.

[4]  H. Mozaffari,et al.  Metabolic phenotypes and risk of colorectal cancer: a systematic review and meta-analysis of cohort studies , 2022, BMC cancer.

[5]  B. Abiri,et al.  Dietary determinants of healthy/unhealthy metabolic phenotype in individuals with normal weight or overweight/obesity: a systematic review , 2022, Critical reviews in food science and nutrition.

[6]  Wanich Suksatan,et al.  Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose–Response Meta-Analysis of 207,291 Participants , 2021, Nutrients.

[7]  A. Jayedi,et al.  Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis , 2021, Nutrients.

[8]  G. Grosso,et al.  Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples , 2021, Nutrients.

[9]  P. Austin,et al.  Choice of Time-Scale in Time-to-Event Analysis: Evaluating Age-Dependent Associations. , 2021, Annals of epidemiology.

[10]  Qiu Zhao,et al.  Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies , 2020, Nutrition Journal.

[11]  F. Sofi,et al.  Consumption of ultra-processed foods and health status: a systematic review and meta-analysis , 2020, British Journal of Nutrition.

[12]  F. Azizi,et al.  Dietary determinants of unhealthy metabolic phenotype in normal weight and overweight/obese adults: results of a prospective study , 2020, International journal of food sciences and nutrition.

[13]  M. Touvier,et al.  Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé) , 2019, BMJ.

[14]  M. Schulze.  Metabolic health in normal-weight and obese individuals , 2018, Diabetologia.

[15]  F. Rauber,et al.  Ultra-processed foods: what they are and how to identify them , 2019, Public Health Nutrition.

[16]  International Association for the Study of Obesity , 2018, The Grants Register 2019.

[17]  F. Azizi,et al.  Review of Rationale, Design, and Initial Findings: Tehran Lipid and Glucose Study , 2018, International journal of endocrinology and metabolism.

[18]  F. Hu,et al.  Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90 257 women (the Nurses' Health Study): 30 year follow-up from a prospective cohort study. , 2018, The lancet. Diabetes & endocrinology.

[19]  M. Schulze,et al.  Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis , 2016, European journal of preventive cardiology.

[20]  A. Fardet.  Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. , 2016, Food & function.

[21]  Alaa M Althubaiti,et al.  Information bias in health research: definition, pitfalls, and adjustment methods , 2016, Journal of multidisciplinary healthcare.

[22]  R. Kimokoti,et al.  Metabolically Healthy Obesity Is Not Associated with Food Intake in White or Black Men. , 2015, The Journal of nutrition.

[23]  D. Hu,et al.  Prevalence of Metabolically Healthy Obese and Metabolically Obese but Normal Weight in Adults Worldwide: A Meta-Analysis , 2015, Hormone and Metabolic Research.

[24]  R. Kimokoti,et al.  Food intake does not differ between obese women who are metabolically healthy or abnormal. , 2014, The Journal of nutrition.

[25]  B. Popkin,et al.  Ultra‐processed products are becoming dominant in the global food system , 2013, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[26]  P. Kearney,et al.  Defining Metabolically Healthy Obesity: Role of Dietary and Lifestyle Factors , 2013, PloS one.

[27]  Ian J. Brown,et al.  Diet composition and activity level of at risk and metabolically healthy obese American adults , 2012, Obesity.

[28]  D. van der A,et al.  Dietary Determinants of Changes in Waist Circumference Adjusted for Body Mass Index – a Proxy Measure of Visceral Adiposity , 2010, PloS one.

[29]  Fereidoun Azizi,et al.  Reproducibility and Relative Validity of Food Group Intake in a Food Frequency Questionnaire Developed for the Tehran Lipid and Glucose Study , 2010, Journal of epidemiology.

[30]  S. Grundy,et al.  Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International As , 2009, Circulation.

[31]  P. Mirmiran,et al.  Reliability and relative validity of an FFQ for nutrients in the Tehran Lipid and Glucose Study , 2009, Public Health Nutrition.

[32]  David B Allison,et al.  Metabolic and behavioral characteristics of metabolically obese but normal-weight women. , 2004, The Journal of clinical endocrinology and metabolism.

[33]  Randy Hodson,et al.  Reliability and Validity , 2019, Fast Facts to Loving your Research Project.

[34]  F. Azizi,et al.  Reliability and validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian urban adult population. , 2012, Archives of Iranian medicine.