Patterns of ultra-processed foods consumption throughout childhood and trajectories of growth and adiposity

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold>: Ultra-processed foods (UPF) consumption has been associated with unhealthy outcomes. However, the literature lacks robust longitudinal studies considering its cumulative effect, particularly in young populations. This study aimed to evaluate the relationship between UPF consumption patterns throughout childhood with growth and adiposity trajectories. <jats:bold>Methods:</jats:bold>Participants from the Generation XXI population-based birth cohort (Porto, Portugal) were included. Food frequency questionnaire items at 4, 7 and 10 years were classified according to the processing degree using the NOVA classification. UPF consumption patterns were identified using a probabilistic Gaussian mixture model using participants with complete data and predicting for the total sample (n=8647). To assess whether the outcome trajectories from 4 to 13 years of age [body weight, height, body mass index (BMI) z-score, waist circumference (WC) and fat mass percentage (FM%)] depend on the UPF patterns, a mixed-effects model with linear and quadratic terms for age and adjusted for confounders was used. Participants with at least one measurement at 4, 7, 10 or 13 years were included in this study (n range: 5885-6272). <jats:bold>Results</jats:bold>: Four UPF consumption patterns were identified: <jats:italic>constantly lower consumption</jats:italic>(15.4%), <jats:italic>constantly intermediate consumption</jats:italic> (56.4%), <jats:italic>transition from low to high consumption</jats:italic> (17.2%), and <jats:italic>constantly higher consumption</jats:italic>(17.1%). Compared to the <jats:italic>constantly lower UPF consumption</jats:italic>, the<jats:italic> constantly higher consumption </jats:italic>pattern was associated with greater acceleration in body weight (ß: 0.119; 95%CI: 0.027;0.212), BMI z-score (ß: 0.014; 95%CI: 0.004;0.023), WC (ß: 0.232; 95%CI: 0.144;0.319) and FM% (ß: 0.200; 95%CI: 0.092;0.308) and with lower acceleration in height (ß: -0.063; 95%CI: -0.111;-0.015). The <jats:italic>constantly intermediate UPF consumption</jats:italic> pattern was associated with greater acceleration in body weight (ß: 0.123; 95%CI: 0.043;0.203), WC (ß: 0.120; 95%CI: 0.045;0.195) and FM% (ß: 0.146; 95%CI: 0.054;0.238). <jats:bold>Conclusions</jats:bold>: C<jats:italic>onstantly higher</jats:italic> and <jats:italic>constantly intermediate UPF consumption</jats:italic> throughout childhood were associated with worse growth and adiposity trajectories until adolescence.</jats:p>