In the last three decades, there has been a significant increase in the prevalence of cardiovascular disease, which is the leading cause of death and morbidity. At the same time, an increase in the number of people with cardiometabolic risk factors (CMR), such as high fasting plasma glucose, hypertension, obesity, and high low-density lipoprotein (LDL) cholesterol, has been documented.
Although many studies have confirmed the association between highly processed food (UPF) consumption and the incidence of cardiovascular disease, not many studies have documented how improving UPF consumption affects CMR factors. Addressing this gap in research, a recent Atherosclerosis A journal study examines how changes in UPF consumption affect CMR conditions.
Research: Increased consumption of highly processed foods is associated with increased cardiometabolic risk factors in adults with metabolic syndrome: a longitudinal analysis of a randomized trial. Image credit: aquariagirl1970 / Shutterstock.com
Diet plays an important role in preventing the risk of cardiovascular diseases. Typically, foods high in energy but low in nutritional content increase CMR factors. Under the NOVA classification, food and beverages are classified as ultra-processed food (UPF) by undergoing a highly industrialized process to make them more palatable, ready-to-eat and accessible.
In the last decade, the amount of UPF consumption has increased significantly. UPF intake was associated with lower dietary quality due to higher levels of total and saturated fat, free sugars, and lower levels of fiber, proteins, vitamins, and minerals in these products.
Several longitudinal, cross-sectional studies have confirmed the relationship between UPF consumption and several factors of CMR. A French study found that high consumption of UPF increases the risk of diabetes and cardiovascular disease. Another prospective study conducted by the University of Navarra (SUN) found that higher UPF consumption increased blood pressure by 21%.
About the study
The prospective study will examine how improvements in UPF consumption affect CMR factors such as body mass index (BMI), weight, blood pressure, waist circumference, glycated hemoglobin (HbA1c), triglycerides, blood glucose, and cholesterol (total, HDL, and LDL). analyzed. , and triglycerides and glucose index (TyG index).
Relevant data were collected during the first 12 months of follow-up in the PREDIMED-Plus study. PREDIMED-Plus is an ongoing multicenter, randomized clinical trial designed to investigate the extent to which a Mediterranean diet, physical activity, and behavior-related weight loss intervention protects against cardiovascular disease.
All participants were recruited between September 2013 and December 2016 from 23 centers in the Spanish territory and randomly assigned to two groups. Male and female obese participants were recruited.
All participants had at least three of the risk factors for metabolic syndrome, including hypertension, plasma HDL cholesterol, fasting blood glucose, plasma triglycerides, and obesity. Participants’ dietary information was obtained by interview, and responses were verified using a semi-quantitative food frequency questionnaire (FFQ) at baseline, six and 12 months follow-up.
A total of 5,373 participants, 52% male and 48% female, met all eligibility criteria and were included in this study. All participants were around 65 years old. Participants with higher UPF intake were significantly younger, less physically active, and better able to follow an energy-restricted Mediterranean diet.
Higher UPF levels were positively associated with waist circumference, weight, diastolic blood pressure, TG index, HbA1c, triglycerides, and fasting blood glucose. In this context, several sociodemographic and lifestyle characteristics were adjusted.
UPF consumption decreased during the 12-month follow-up, which may be because participants were instructed to follow a Mediterranean diet. In this study, UPF provided 7.7% of total food intake by weight.
The reduction in UPF consumption may be because all participants were overweight and had metabolic syndrome at baseline. Therefore, changes in their dietary intake can be part of the health care system.
Based on multivariate-adjusted analyses, higher UPF consumption was associated with obesity and waist circumference. However, such associations were not found in the low UPF consumption group, as these associations showed a significant reciprocal relationship. After 9.1 years of follow-up, individuals with high UPF consumption showed a higher risk of hypertension compared to those with low UPF consumption.
Higher UPF consumption was strongly associated with increased diastolic blood pressure. But when this effect was studied, when UPF consumption increased by 100 grams per day, no statistical relationship was found with systolic blood pressure.
UPF consumption was also associated with adverse plasma triglyceride and TG index but not with total HDL and LDL cholesterol. A positive association between total cholesterol and a 5% increase in UPF consumption was estimated.
The current study has several limitations, including the inability to generalize across groups, as it included participants aged 55 to 75 years. In addition, all participants were overweight and had metabolic syndrome at baseline. Additionally, this study followed the NOVA classification, which is not a perfect system for classifying UPF.
Despite these limitations, this study re-emphasizes the negative impact of UPF consumption on cardiometabolic risks.
- Gonzalez-Palacios, S., Oncina-Canovas, A., García-de-la-Hera, M., inter alia. (2023) Increased consumption of highly processed foods is associated with worsening cardiometabolic risk factors in adults with metabolic syndrome: a longitudinal analysis of a randomized trial. Atherosclerosis. doi:10.1016/j.atherosclerosis.2023.05.022