The role of ultra-processed food intake and development of dyslipidemia and obesity in middle-aged and older adults: A longitudinal community-based study

초록

Background: Impact of ultra-processed foods (UPF) consumption is an emerging issue on nutrition and health. How to prevent and manage obesity and dyslipidemia better is still the topic that the publics concerned. The consumption of UPF has increased steadily in South Korea. However, the long-term effect of UPF consumption on the development of obesity or dyslipidemia in South Korea is unknown. Besides, compared to other well-known diet quality index, whether UPF consumption is a useful tool to assessed diet quality need to be confirmed. Objective: We aimed to investigate the association between UPF intake and the risk of obesity or dyslipidemia and to evaluate the validity of UPF consumption in assessing the diet quality. Methods: We studied 17,310 adults aged ≧ 40 years in the Health Examinee cohort study from 38 community sites of South Korea. UPF consumption was classified by NOVA system. After an average five-year follow-up, we examined the incidence of obesity or dyslipidemia and investigated the association between UPF consumption and risk for incident obesity or dyslipidemia. To evaluate UPF validity in assessing the diet quality, we made a comparison using alternative Mediterranean Diet (AMED) Score which developed for Korean based on Mediterranean Diet Score. Results: The incidence of dyslipidemia was 35.41% and 43.04% in men and women, respectively, and that of obesity was 8.28% and 7.39% in men and women, respectively. There was a positive association between the UPF consumption and the risk for dyslipidemia development: the Q4 group was almost 20% higher than the Q1 group (men, adjusted HR=1.209 [95% CI 1.039 – 1.407], women, adjusted HR=1.195 [95% CI 1.096 – 1.303]. For obesity, only women demonstrated a significant positive association (model 3, HR=1.360 [95% CI 1.072 – 1.725]). There was no significant association between other NOVA food group consumption and dyslipidemia was found. After calculating AMED scores, only UPF consumption showed a significant negative association with AMED score (p value<0001). Conclusion: Higher UPF intakes were associated with increased incidence of dyslipidemia and obesity. Furthermore, UPF consumption showed the statistically significant negative association with AMED score indicating a poor diet quality.

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