The impact of ultra-processed foods on obesity and cardiometabolic comorbidities in children and adolescents: a systematic review

Evgenia Petridi; Kalliopi Karatzi; Emmanuella Magriplis; Evelina Charidemou; Elena Philippou; Antonis Zampelas

doi:10.1093/nutrit/nuad095

The impact of ultra-processed foods on obesity and cardiometabolic comorbidities in children and adolescents: a systematic review

Nutr Rev. 2023 Aug 7:nuad095. doi: 10.1093/nutrit/nuad095. Online ahead of print.

Authors

Evgenia Petridi¹, Kalliopi Karatzi², Emmanuella Magriplis², Evelina Charidemou^{1

3}, Elena Philippou^{1

4}, Antonis Zampelas²

Affiliations

¹ Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus.
² Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece.
³ Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus.
⁴ Department of Nutritional Sciences, King's College London, London, United Kingdom.

PMID: 37550263
DOI: 10.1093/nutrit/nuad095

Abstract

Context: Over the past few decades, traditional foods have been displaced by ultra-processed foods (UPFs), with the latter being associated with health problems.

Objective: This scoping systematic review aimed to identify the relationship between UPF intake and overweight/obesity as well as other cardiometabolic risk factors during childhood and adolescence.

Data sources: The guidance for this protocol is the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P). A systematic search was undertaken on PubMed, Scopus, and Cochrane Library electronic databases based on prespecified inclusion and exclusion criteria up to 6 February 2022.

Data extraction: A total of 17 observational studies-9 cross-sectional, 7 cohort-longitudinal, and 1 study reporting both cross-sectional and longitudinal outcomes-among children and adolescents aged ≤18 years were eligible for inclusion in this review. Fourteen studies evaluated the consumption of UPFs in association with overweight/obesity and 9 studies examined the association of UPF consumption and cardiometabolic-related risk factors.

Data analysis: Most studies (14/17) showed that an increase in UPFs was associated with a higher prevalence of overweight/obesity and cardiometabolic comorbidities among children and adolescents, whereas 4 of 17 studies (3 cross-sectional and 1 cohort) found no association. Most cohort and cross-sectional studies showed good quality according to the National Institutes of Health and Newcastle-Ottawa quality assessment, respectively.

Conclusion: The positive association found between UPFs and overweight/obesity and cardiometabolic comorbidities among children and adolescents raises concerns for future health. Further investigation is recommended to explore the role of specific types of UPFs on cardiometabolic conditions and to identify the amount of daily intake that increase risk in order to shape appropriate public health policies.

Systematic review registration: PROSPERO registration no. CRD42022316432.

Keywords: adolescence; cardiometabolic risk; childhood obesity; ultra-processed foods.