Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011-2016
Zhang Z, Jackson SL, Martinez E, Gillespie C, Yang Q
The American journal of clinical nutrition · 57 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cross-sectional study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
- Intake measured by
- Food diaries or recalls
Who paid for it
- Funding
- Independent funding
- Government
- U.S. Department of Health and Human Services
- Government
- National Institutes of Health
- Government
- Centers for Disease Control and Prevention
- Government
- Intramural CDC HHS
- Grants
- National Institutes of Health (CC999999)
Based on 4 listed funder(s).
Publication
- Published
- 2020-09-07 · Am J Clin Nutr · vol. 113 · issue 2 · pp. 428–436
- Publisher
- Elsevier BV
- Cited
- 79 citations · more than 98% of similar papers · 7.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 52 works
- Access
- Open access (hybrid journal) · PUBLIC-DOMAIN
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Nutritional Studies and Diet
- Keywords
- Quartile, Medicine, National Health and Nutrition Examination Survey, Cross-sectional study, Demography, Logistic regression, Calorie, Cardiovascular health, Environmental health, Disease, Confidence interval, Internal medicine, Population
- MeSH
- humans, cardiovascular diseases, nutrition surveys, cross-sectional studies, feeding behavior, health status, food handling, adult, aged, middle aged, united states, female, male, young adult
5 authors
From US, BR
- Zefeng Zhang · correspondingCenters for Disease Control and Prevention
- Sandra L. JacksonCenters for Disease Control and Prevention
- Euridice MartinezUniversidade de São Paulo
- Cathleen GillespieCenters for Disease Control and Prevention
- Quanhe YangCenters for Disease Control and Prevention
Abstract
Background
Higher intake of ultraprocessed foods (UPFs) might be associated with increased risk of cardiovascular disease.
Objectives
Our objective was to examine the association between usual percentage of calories (%kcal) from UPFs and the American Heart Association's "Life's Simple 7" cardiovascular health (CVH) metrics in US adults.
Methods
We analyzed data from 11,246 adults aged ≥20 y from the NHANES 2011-2016 (a cross-sectional, nationally representative survey). UPF designation was assigned on the basis of the NOVA classification system, according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 representing poor, intermediate, or ideal health, respectively. Scores of the 6 metrics (excluding diet) were summed, and CVH was categorized as inadequate (0-4), average (5-8), or optimum (9-12). We used the National Cancer Institute's methods to estimate the usual %kcal from UPFs, and multivariable linear and multinomial logistic regression to assess the association between UPFs and CVH, adjusted for age, sex, race and Hispanic origin, education, and poverty.
Results
The weighted prevalence of inadequate, average, and optimum CVH was 8.0%, 51.7%, and 40.3%, respectively. The mean usual %kcal from UPFs was 55.4%, and midpoint of quartiles of intake ranged from 40.4% (quartile 1) to 70.5% (quartile 4). Every 5% increase in calories from UPFs was associated with 0.14 points lower CVH score (P < 0.001). The adjusted ORs for inadequate CVH were 1.40 (95% CI: 1.23, 1.60), 1.82 (1.45, 2.29), and 2.57 (1.79, 3.70), respectively, comparing quartiles 2, 3, and 4 with quartile 1 of UPF intake. The pattern of association was largely consistent across subgroups.
Conclusions
Usual %kcal from UPFs represented more than half of total calorie intake in US adults. A graded inverse association between %kcal from UPFs and CVH was observed.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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