Ultra-processed foods consumption and the risk of metabolically unhealthy phenotype in normal-weight and overweight/obese adults: a prospective investigation

Abstract

This study investigated the association between ultra-processed foods (UPF) and the risk of metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obese (MUO). We included 512 normal-weight and 787 overweight/obese adults with a metabolically healthy phenotype from the Tehran and Lipid Glucose Study, who were followed from the third (baseline) to the sixth study examinations. Each 10% increase in energy intake from UPF was related to a 54% (95% CI = 21–96%) and 2% (95% CI = 1–3%) higher risk of MUNW and MUO, respectively. The risk of MUNW was significantly higher in quartile 4 compared to quartile 1. The restricted cubic splines suggested that the risk of MUNW increases monotonically when UPF accounts for at least 20% of energy intake. No non-linear association was observed between UPF and the risk of MUO. Energy intake from UPF was positively related to the risk of MUNW and MUO.

Keywords:

• Metabolically unhealthy normal weight
• metabolically healthy obese
• food processing
• NOVA
• ultra-processed foods
• food classification
• cardio-metabolic

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by Shahid Beheshti University Medical Sciences, Tehran, Iran.