Ultra-processed food consumption, appetitive traits and BMI in children: a prospective study

This study aimed to investigate the association of ultra-processed food consumption at 4 and 7 years of age with appetitive traits at 7 years and BMI at 10 years of age. Participants were 1175 children of the population-based birth cohort Generation XXI, who provided food diaries and complete data on socio-demographic variables, anthropometric measures and the Portuguese Children's Eating Behaviour Questionnaire (P-CEBQ). Foods were grouped according to NOVA classification into: 'unprocessed, minimally or moderately processed, and culinary preparations'; 'processed' and 'ultra-processed'. To assess tracking of groups' consumption, Pearson's correlation coefficient (r) and the intraclass correlation coefficient (ICC) were calculated. Generalised linear models were fitted to test main associations, mediators and interactions among the variables. Ultra-processed consumption exhibited a fair level of stability between ages 4 and 7 years (r 0 center dot 34; ICC = 0 center dot 32; 95 % CI 0 center dot 25, 0 center dot 39), corresponding, respectively, to 27 center dot 3 % (1881 center dot 9 (SD 908 center dot 8) kJ/d) and 29 center dot 3 % (2204 center dot 5 (SD 961 center dot 1) kJ/d) of total energy intake. After adjusting for maternal and child characteristics, higher ultra-processed consumption at 4 years was associated directly with 'Food Responsiveness' (beta = 0 center dot 019; 95 % CI 0 center dot 007, 0 center dot 037) and indirectly through energy intake with avoidant traits: 'Food Fussiness' (beta = -0 center dot 007; 95 % CI 0 center dot 002, 0 center dot 012) and 'Satiety Responsiveness' (beta = -0 center dot 007; 95 % CI 0 center dot 003, 0 center dot 012). Ultra-processed consumption at 4 years old was associated with BMI at 10 years old, but appetitive behaviours were not powerful mediators of this association. The results suggest a path by which ultra-processed products may impact on later appetitive traits and higher BMI in children.

Automated summary

The study found that there was a level of stability in ultra-processed food consumption between ages 4 and 7, and consumption at 4 years old was associated with appetitive traits at 7 years old and BMI at 10 years old. However, appetitive traits were not powerful mediators of the association between consumption at 4 years old and BMI at 10 years old.