Abstract
Objective
To assess the association between consumption of ultra-processed foods and obesity, diabetes, hypertension and heart disease in a nationally representative sample of Canadian adults.
Methods
This study used cross-sectional data from 13,608 adults (aged 19+ years) from the 2015 Canadian Community Health Survey–Nutrition. The survey provided data on food consumption (from 24-h recall) and prevalent obesity (BMI ≥ 30 kg/m2) and self-reported diabetes, hypertension and heart disease. All foods and drinks consumed were classified according to the extent and purpose of industrial processing using the NOVA classification. Ultra-processed food consumption was estimated as proportion of total daily energy intake. Multivariable logistic regression models assessed the association between ultra-processed food consumption and obesity, diabetes, hypertension and heart disease, adjusting for a range of socio-demographic and lifestyle factors.
Results
In 2015, ultra-processed food contributed, on average, to 24% of total daily energy intake in the lowest tertile of ultra-processed food consumption and 73% in the highest tertile. Compared with those in the lowest tertile, adults in the highest tertile of ultra-processed food consumption had 31% higher odds of obesity (OR = 1.31, 95% CI: 1.06–1.60), 37% higher odds of diabetes (OR = 1.37, 95% CI: 1.01–1.85) and 60% higher odds of hypertension (OR = 1.60, 95% CI: 1.26–2.03), adjusting for a range of covariates.
Conclusion
Higher consumption of ultra-processed foods is associated with higher prevalence of obesity, diabetes and hypertension among Canadian adults. A comprehensive set of strategies and policies is needed to discourage consumption of ultra-processed foods in Canada and to make unprocessed or minimally processed foods more affordable, available and appealing.
Résumé
Objectif
Évaluer l’association entre la consommation d’aliments ultra-transformés et l’obésité, le diabète, l’hypertension et les maladies cardiaques dans un échantillon nationalement représentatif d’adultes canadiens.
Méthodes
Cette étude a utilisé des données transversales provenant de 13 608 participants adultes (âgés de 19+ ans) dans le cadre de l’Enquête sur la santé dans les collectivités canadiennes 2015–nutrition. L’enquête a fourni des données sur la consommation alimentaire (rappel de 24h) et la prévalence de l’obésité mesurée (IMC ≥ 30 kg/m2), et le diabète, l’hypertension et les maladies cardiaques auto-rapportés. Tous les aliments et boissons consommés ont été classés selon la classification NOVA. La consommation d’aliments ultra-transformés a été estimée en utilisant l’apport énergétique relatif des aliments ultra-transformés. Des modèles de régression logistique multiple ont été utilisés pour vérifier l’association entre la consommation d’aliments ultra-transformés et l’obésité, le diabète, l’hypertension et les maladies cardiaques, en ajustant pour plusieurs facteurs sociodémographiques et comportementaux.
Résultats
En 2015, les aliments ultra-transformés ont contribué, en moyenne, à 24 % de l’apport énergétique quotidien total dans le tertile le plus bas de la consommation d’aliments ultra-transformés et 73 % dans le tertile le plus élevé. Comparativement au premier tertile, les adultes du tertile supérieur de la consommation d’aliments ultra-transformés avaient de chance 31 % plus élevée d’avoir l’obésité (RC = 1,31, IC 95% : 1,06-1,60), 37 % plus élevée d’avoir le diabète (RC = 1,37, IC 95% : 1,01-1,85), et 60 % plus élevée d’avoir l’hypertension (RC = 1,60, IC 95% : 1,26-2,03), en ajustant pour une gamme de variables.
Conclusion
Une consommation plus élevée d’aliments ultra-transformés est associée à une prévalence plus élevée d’obésité, de diabète et d’hypertension chez les adultes canadiens. Des stratégies et des politiques sont nécessaires pour décourager la consommation d’aliments ultra-transformés au Canada, ainsi que des stratégies qui rendent les aliments non transformés ou peu transformés plus abordables, disponibles et attrayants.
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Funding
This study was funded by the Heart and Stroke Foundation of Canada.
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All authors contributed to the study conception and design. Material preparation and analysis were performed by Milena Nardocci, Jane Y. Polsky and Jean-Claude Moubarac. The first draft of the manuscript was written by Milena Nardocci and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Nardocci, M., Polsky, J.Y. & Moubarac, JC. Consumption of ultra-processed foods is associated with obesity, diabetes and hypertension in Canadian adults. Can J Public Health 112, 421–429 (2021). https://doi.org/10.17269/s41997-020-00429-9
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DOI: https://doi.org/10.17269/s41997-020-00429-9