What's the Impact of Ultra-Processed Food on Children?

Priscilla Lynch 

June 14, 2021

Editor's note, 14 June 2021: This article was updated to correct the references.

UK children are consuming 'exceptionally high' proportions of ultra-processed foods (UPFs), increasing their risk of obesity and damaging their long-term health, according to the findings of a large prospective cohort study.

The study, published in JAMA Pediatrics, is the first to assess longitudinal associations between UPF (eg, frozen pizzas, mass-produced bread, fizzy drinks, ready meals) consumption and adiposity trajectories from childhood to early adulthood.

Researchers followed a cohort of 9025 children born in the early 1990s, from ages 7 up to 24 years. Three-day food and beverage diaries were completed at ages seven, 10 and 13 years. Data measures collected over 17 years included body mass index (BMI), weight, waist circumference and measurements of body fat.

The children were divided into five equally-sized groups based on their consumption of UPFs. In the lowest quintile, UPFs accounted for 23.2% of the total diet by weight, while the highest group consumed more than two-thirds of their intake (67.8%) as UPFs.

Analysis revealed that, on average, children in the higher consumption groups saw a more rapid progression of their BMI, weight, waist circumference and body fat into adolescence and early adulthood. By 24 years, those in the highest UPF group had, on average, a higher level of BMI by 1.2 kg/m2, body fat by 1.5%, weight by 3.7 kg and waist circumference by 3.1cm.

Insight into Child Obesity

Study co-author Professor Christopher Millett said in a news release: "We often ask why obesity rates are so high among British children and this study provides a window into this. Our findings show that an exceptionally high proportion of their diet is made up of ultra-processed foods, with one in five children consuming 78% of their calories from ultra-processed foods."

Robust public health measures that promote minimally processed foods and discourage UPF consumption among children are urgently needed to reduce obesity in England and globally, the study concludes.

Experts have commented via the Science Media Centre.

Gunter Kuhnle, professor of nutrition and food science, University of Reading, said: "The results of this study are not surprising: children who consume a lot of 'ultra-processed' foods are most likely to be less healthy and more obese than their peers with lower intake. The interpretation of these results are however much more difficult. Apart from the limitations of the definition of 'ultra-processed foods', the outcome of the study is heavily confounded by socio-economic factors: children living in more deprived areas and from families with lower educational attainment and lower socio-economic status had the highest intake of ultra-processed foods. Unfortunately, these children are also at highest risk of obesity and poor health, as there are still considerable health-inequalities in the UK and socio-economic status is an important determinant of health.

"The link between ultra-processed food consumption and child-health is therefore likely more complex and needs a more holistic approach: neither a reformulation nor a ban of ultra-processed foods will address health-inequalities. This can only be achieved by changing food systems and addressing the underlying causes of health inequalities."

Dr Duane Mellor, registered dietitian and senior teaching fellow, Aston Medical School, Aston University, said: "Overall, this study risks suggesting that all foods which are processed are bad, whereas this is probably only really the case when they are higher in fat, salt and sugar and lower in fibre. Also it makes a lot of assumptions about the 3 days of diet diary at the age of 7 and its association with the child’s growth and weight gain for the next decade."

Chang K, Khandpur N, Neri D, et al. Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort. JAMA Pediatr. Published online June 14, 2021. doi:10.1001/jamapediatrics.2021.1573

This article was adapted from Univadis, part of the Medscape Professional Network.

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