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Blood pressure variation and ultra-processed food consumption in children with obesity

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Abstract

To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg.

   Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension.

What is Known:

• Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children.

• Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide.

What is New:

• Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight.

• The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).

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Data availability

The data supporting the results of this study are available from the corresponding author upon reasonable request.

Abbreviations

24hDR:

24-hour dietary recall

BMI:

Body mass index

BP:

Blood pressure

CVD:

Cardiovascular disease

DBP:

Diastolic blood pressure

IPAQ:

International physical activity questionnaire

kcal:

Kilocalories

kg:

Kilograms

mEq/L:

Milliequivalents per liter

mg:

Milligrams

mmHg:

Millimeters of mercury

Na/K:

Sodium-to-potassium

SBP:

Systolic blood pressure

UPF:

Ultra-processed food

WHO:

World Health Organization

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Acknowledgements

The investigators would like to thank all patients and parents for their participation in this study.

Funding

This study was supported by the National Council for Scientific and Technological Development (CNPq) and from Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro (FAPERJ).

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Authors and Affiliations

  1. Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Caroline Cortes, Joana Maia Brandão, Diana Barbosa Cunha, Vitor Barreto Paravidino & Rosely Sichieri

  2. Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Rio de Janeiro, Brazil

    Vitor Barreto Paravidino

Authors
  1. Caroline Cortes
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  2. Joana Maia Brandão
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  3. Diana Barbosa Cunha
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  4. Vitor Barreto Paravidino
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  5. Rosely Sichieri
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Contributions

Designed the experiments: Diana Barbosa Cunha and Rosely Sichieri. Conceived the experiments: Caroline Cortes and Joana Maia Brandão. Analyzed the data: Caroline Cortes, Vitor Barreto Paravidino and Rosely Sichieri. Wrote and approved the final version of the paper: Caroline Cortes, Joana Maia Brandão, Diana Barbosa Cunha, Vitor Barreto Paravidino and Rosely Sichieri.

Corresponding author

Correspondence to Caroline Cortes.

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Ethical approval

This study was conducted following the guidelines of the Consolidated Standards of Reporting Trials (CONSORT 2010). Approval was granted by the Research Ethics Committee of Pedro Ernesto University Hospital (CAAE: 87593118000005259).

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The Informed Consent Form was signed by the child's parents or legal guardians and the children signed the Informed Assent Form.

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The authors declare that they have no conflict of interest.

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Communicated by Gregorio Milani

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Cortes, C., Brandão, J.M., Cunha, D.B. et al. Blood pressure variation and ultra-processed food consumption in children with obesity. Eur J Pediatr 182, 4077–4085 (2023). https://doi.org/10.1007/s00431-023-05076-z

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  • DOI: https://doi.org/10.1007/s00431-023-05076-z

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