Ultraprocessed Food Consumption Can Increase Children’s Cardiometabolic Risk, Study Says

For children, eating more ultraprocessed foods was linked to increased body mass index (BMI), waist size, body fat, and blood sugar levels, as well as lower levels of good cholesterol.

These new findings were published in JAMA Network Open, and suggest that public health efforts should focus on encouraging children—and people in general—to eat more unprocessed or minimally processed foods instead.¹

This baseline cross-sectional analysis used the data of 1426 children aged 3 to 6 years who were enrolled in the Childhood Obesity Risk Assessment Longitudinal Study across 7 cities in Spain. The mean (SD) age among the children was 5.8 (1.1) years, and about half were boys. To be included, parents or caregivers had to give informed consent and complete questionnaires about the child's prenatal history, and children were excluded from the study if their families were unable to effectively communicate in Spanish or if their residence was unstable. Energy-adjusted ultraprocessed foods consumption was measured in grams per day, and data was gathered from food frequency questionnaires, with consumption based on the NOVA food classification system.

Unprocessed or minimally processed foods are whole foods that retain their natural vitamins and nutrients, and they may undergo minimal changes such as drying, boiling, or freezing to make them safe to eat and store, according to Harvard Health Publishing.² Processed foods are altered from their natural state by adding ingredients like salt, oil, or sugar, and include foods like canned vegetables or freshly baked bread.

Child eating fast food cheeseburger | Image credit: escapejaja – stock.adobe.com

Meanwhile, highly processed or ultraprocessed foods contain many added ingredients and are often made from food extracts and additives such as fats, starches, and added sugars, as well as artificial colors and flavors. Some examples of ultraprocessed foods include frozen meals, soft drinks, fast food, and packaged sweets. Harvard Health Publishing also cited a BMJ study that said ultraprocessed foods account for nearly 58% of the calories consumed in the US and contribute almost 90% of the country’s added sugar intake.³

The current study found that mothers of children who consumed high amounts of ultraprocessed foods were generally younger, had higher body mass index (BMI) scores, were more likely to have overweight or obesity, and had lower education and employment rates.¹

“Children in the top tertile were more likely to consume higher amounts of total energy, carbohydrates, yogurt, other dairy products, sugar and candy, and sugary beverages and lower amounts of protein, fat, monounsaturated and polyunsaturated fatty acids, fiber, milk, cheese, white meat, unprocessed red meat, eggs, fish, seafood, vegetables, fruits, nuts, legumes, whole and refined cereals, and oils and fat,” the study authors added.

Compared with children with the lowest ultraprocessed food consumption, those with the highest intake had z scores reflecting:

• Higher BMI (β = 0.20; 95% CI, 0.05-0.35)
• Higher waist circumference (β = 0.20; 95% CI, 0.05-0.35)
• Higher fat mass index (β = 0.17; 95% CI, 0.00-0.32)
• Higher fasting plasma glucose (β = 0.22; 95% CI, 0.06-0.37)
• Lower high-density lipoprotein (HDL) cholesterol (β = –0.19; 95% CI, –0.36 to –0.02)

Further, each SD increase in ultraprocessed food consumption was positively associated with BMI, waist circumference, fat mass index, and fasting plasma glucose, and negatively associated with HDL cholesterol. The study also revealed that replacing 100 grams of ultraprocessed foods with 100 grams of unprocessed or minimally processed foods was associated with lower z scores for BMI (β = –0.03; 95% CI, –0.06 to –0.01), fat mass index (β = –0.03; 95% CI, –0.06 to 0.00), and fasting plasma glucose (β = –0.04; 95% CI, –0.07 to –0.01).

Most of the associations in this study remained significant even after adjusting for adherence to the Mediterranean diet, indicating that other factors inherent to ultraprocessed foods—such as additives—may play a crucial role. Animal and cellular studies have highlighted potential cardiovascular risks from approved additives like sulfites, monosodium glutamate, and emulsifiers. Additionally, food processing can produce contaminants like acrylamide and acrolein, which have been linked to increased cardiovascular disease risk. Ultraprocessed foods may also contain chemicals like bisphenols and perfluoroalkyl substances, which have been associated with a higher risk of cardiometabolic issues in children.

“Our results provide new insight into the association between UPF [ultraprocessed food] consumption and health and the importance of recognizing that early dietary habits in childhood might have future implications on cardiometabolic health,” the study authors said, noting these findings are in line with past research. “While the magnitude of the associations reported in our study may be considered of limited clinical relevance, it is important to note that our study consisted of young children. Therefore, if such minimal differences can reveal a significant association, they may serve as an early warning of future cardiometabolic conditions.”

References

1. Khoury N, Martínez MÁ, Garcidueñas-Fimbres TE, et al. Ultraprocessed food consumption and cardiometabolic risk factors in children. JAMA Netw Open. 2024;7(5):e2411852. doi:10.1001/jamanetworkopen.2024.11852
2. McManus KD. What are ultra-processed foods and are they bad for our health? Harvard Health Publishing. January 9, 2020. Accessed May 17, 2024. https://www.health.harvard.edu/blog/what-are-ultra-processed-foods-and-are-they-bad-for-our-health-2020010918605
3. Martínez Steele E, Baraldi LG, Louzada ML, Moubarac JC, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016;6(3):e009892. doi:10.1136/bmjopen-2015-009892