Plain language summary
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.
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.