Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review.

Ramona De Amicis, Sara Paola Mambrini, Marta Pellizzari, Andrea Foppiani, Simona Bertoli, Alberto Battezzati, Alessandro Leone

Journal: European journal of nutrition 2022;61(5):2297-2311

PMID: 35322333

Plain Language Summary

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Ultra-processed foods (UPFs) are mostly or entirely lacking whole foods and fibre and are often high in fat sugar and salt. The consumption of UPFs may be linked to obesity in adolescents and this systematic review and meta-analysis aimed to synthesis the current research investigating this link. The results showed that over the long-term, the consumption of UPFs was associated with obesity, abdominal obesity, and increased body mass index in children. It was concluded that the long-term consumption of UPFs negatively impacts body composition in children and adolescents. This study could be used by healthcare professionals to understand the importance of dietary advice recommending whole foods with limited or no processed foods for the healthy body development of children.

Abstract

PURPOSE

According to the NOVA classification, ultra-processed foods are products made through physical, biological and chemical processes and typically with multiple ingredients and additives, in which whole foods are mostly or entirely absent. From a nutritional point of view, they are typically energy-dense foods high in fat, sugar, and salt and low in fiber. The association between the consumption of ultra-processed food and obesity and adiposity measurements has been established in adults. However, the situation remains unclear in children and adolescents.

METHODS

We carried out a systematic review, in which we summarize observational studies investigating the association between the consumption of ultra-processed food, as defined by NOVA classification, and obesity and adiposity parameters among children and adolescents. A literature search was performed using PUBMED and Web of Science databases for relevant articles published prior to May 2021.

RESULTS

Ten studies, five longitudinal and five cross-sectional, mainly conducted in Brazil, were included in this review. Four longitudinal studies in children with a follow-up longer than 4 years found a positive association between the consumption of ultra-processed food and obesity and adiposity parameters, whereas cross-sectional studies failed to find an association.

CONCLUSION

These data suggest that a consistent intake of ultra-processed foods over time is needed to impact nutritional status and body composition of children and adolescents. Further well-designed prospective studies worldwide are needed to confirm these findings considering country-related differences in dietary habits and food production technologies.

© 2022. The Author(s).

Address: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.; International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.; Division of Nutritional Rehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy.; International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.; Lab of Nutrition and Obesity Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy.; International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy. [email protected].

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