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Ultra-processed food intake is associated with grip strength decline in middle-aged and older adults: a prospective analysis of the TCLSIH study

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Abstract

Purpose

Ultra-processed foods make up more than 50% of daily energy consumed in Western countries and are rapidly increasing in China. However, little is known about the association between ultra-processed food intake and muscle strength, a predictor for physical disability in senior years. We aimed to investigate the association of ultra-processed food intake with longitudinal changes in grip strength among middle-aged and older Chinese adults.

Methods

This prospective cohort study included a total of 5409 adults aged 40 years and over (61.3% men). Ultra-processed food intake was obtained by means of a validated food frequency questionnaire and classified according to the NOVA classification system. Grip strength was measured annually using a handheld digital dynamometer. Multivariable linear regression models were used to examine the association between ultra-processed food intake and annualized change in grip strength and weight-adjusted grip strength.

Results

In the fully adjusted models, annualized changes in grip strength and weight-adjusted grip strength per 10% increment in the proportion of ultra-processed foods in the diet were − 0.3708 kg (95% confidence interval − 0.5687, − 0.1730; P < 0.001) and − 0.0057 kg/kg (95% confidence interval − 0.0086, − 0.0029; P < 0.0001), respectively. In analyses stratified by age, sex, body mass index, physical activity, hypertension, hyperlipidemia, diabetes, and healthy diet score, such associations were largely consistent in most subgroups (all P for interaction > 0.05).

Conclusions

Our data indicate that higher ultra-processed food intake was associated with faster grip strength decline in middle-aged and older Chinese adults.

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Data availability

Data of the present research is available from the corresponding authors on reasonable request.

Code availability

The SAS programs will be made available upon request, pending application and approval.

Abbreviations

AGEs:

Advanced glycation end products

BMI:

Body mass index

CI:

Confidence interval

CVD:

Cardiovascular disease

FFQ:

Food frequency questionnaire

HR:

Hazard ratio

MET:

Metabolic equivalent task

PAR:

Population attributable risk

TCLSIH:

Tianjin Chronic Low-grade Systemic Inflammation and Health

UPF:

Ultra-processed food

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Acknowledgements

The authors gratefully acknowledge all the people that have made this study.

Funding

This study was supported by grants from the National Natural Science Foundation of China (No. 81872611), National Key Research and Development Project-Study on Diet and Nutrition Assessment and Intervention Technology (Nos. 2020YFC2006304, 2020YFC2006302, and 2020YFC2006300), National Health Commission of China (No. SPSYYC 2020015) and 2014 and 2016 Chinese Nutrition Society (CNS) Nutrition Research Foundation—DSM Research Fund (Nos. 2016-046, 2014-071 and 2016-023). SZ is a recipient of a scholarship under the China Scholarship Council to pursue his study in Sweden (202006940030).

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Author notes

  1. Shunming Zhang and Yeqing Gu have contributed equally to this work.

Authors and Affiliations

  1. Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China

    Shunming Zhang, Yeqing Gu & Kaijun Niu

  2. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China

    Shunming Zhang, Sabina Rayamajhi, Amrish Thapa, Ge Meng, Hongmei Wu, Tingjing Zhang, Xuena Wang, Jun Dong, Xiaoxi Zheng, Zhixia Cao, Xu Zhang, Xinrong Dong & Kaijun Niu

  3. Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China

    Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song & Kaijun Niu

  4. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China

    Jian Huang, Junsheng Huo, Bing Zhang & Gangqiang Ding

  5. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA

    Lu Qi

  6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Lu Qi

  7. Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China

    Kaijun Niu

  8. Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China

    Kaijun Niu

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  1. Shunming Zhang
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Contributions

SZ and YG analyzed the data and wrote the paper. SZ, YG, GM, QZ, LL, HW, TZ, XW, SS, XW, MZ, QJ, KS, JH, JH, BZ, and GD conducted the research. SZ, LQ, and KN designed the research. LQ and KN reviewed and edited the manuscript, and had primary responsibility for the final content. All authors had full access to all the data in the study and read and approved the final manuscript.

Corresponding authors

Correspondence to Lu Qi or Kaijun Niu.

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The authors declare that they have no conflict of interest.

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This study was approved by the Institution Review Board of Tianjin Medical University (Ethics Approval Number: TMUhMEC 201430), and written informed consent was obtained from all participants.

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Written informed consent was obtained from each participant prior to enrollment.

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Zhang, S., Gu, Y., Rayamajhi, S. et al. Ultra-processed food intake is associated with grip strength decline in middle-aged and older adults: a prospective analysis of the TCLSIH study. Eur J Nutr 61, 1331–1341 (2022). https://doi.org/10.1007/s00394-021-02737-3

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