Ultra-processed Foods Consumption and Increased Risk of Metabolic Syndrome in Adults – the ELSA-Brasil

Objective: To investigate the association between ultra-processed food (UPF) consumption and the incidence of metabolic syndrome.

Research Design and Methods: From 2008 to 2010, we enrolled 15105 adults, aged 35-74 years, employees from six public education/research institutions to assemble the Longitudinal Study of Adult Health (ELSA-Brasil). We used a food frequency questionnaire to assess UPF consumption (grams/day) at baseline. We then assessed the outcomes of those returning to visits between 2012-2014 and 2017-2019. We defined incident metabolic syndrome by the presence of at least three of the five abnormalities – high fasting glucose, high triglycerides, low HDL cholesterol, high blood pressure, and abdominal obesity, after excluding those meeting such criteria at baseline. We excluded additionally those who had missing data or an implausible energy intake, leaving 8065 participants.

Results: The median age was 49, 59% were women, and the median consumption of UPFs was 366 g/day. After eight years, there were 2508 new cases of metabolic syndrome. In robust Poisson regression, adjusting for socio-demographics, behavioral factors, and energy intake, we found a 7% (RR=1.07, 95%CI 1.05-1.08) higher risk of incident metabolic syndrome for an increase of 150 g/day in UPF consumption. Similarly, those in the 4th quartile (compared to the 1st quartile) had a 33% increased risk (RR=1.33; 95%CI 1.20-1.47). Further adjustment for BMI attenuated these associations (respectively, RR=1.04; 95%CI 1.02-1.06; RR=1.19, 95%CI 1.07-1.32).

Conclusions: Greater consumption of UPFs is associated with an increased risk of metabolic syndrome. These findings have important implications for diabetes and cardiovascular disease prevention and management.