Associations of ultra-processed food and drink products with asthma and wheezing among Brazilian adolescents

Background: Although both consumptions of ultra-processed products and asthma are common during adolescence, the epidemiological evidence in regarding their association is unclear. We investigated the associations of ultra-processed products consumption with asthma and wheezing in a representative sample of Brazilian adolescents. Methods: We used data from a representative sample of 109 104 Brazilian adolescents enrolled in the National Survey of School Health, 2012. The consumption of ultra-processed products was based on the weekly consumption (0-2, 3-4, >= 5 d/wk) of sweet biscuits, salty biscuits, ultra-processed meats, sweets/candies, soft drinks, and packaged snacks over the previous 7 days. We also calculated an ultra-processed consumption score by adding partial scores corresponding to weekly frequency intake of each ultra-processed product. The ultra-processed consumption score ranged from 0 to 42, the higher score, the higher the intake of these products. The presence of wheezing in the previous 12 months and asthma at any time in the past was self-reported. Results: The adjusted odds ratios of asthma comparing the extreme categories ranged from 1.08 (95% CI 1.03-1.13) for sweets/candies to 1.30 (1.21-1.40) for ultraprocessed meats. Similar magnitude of associations was found for wheezing outcome. The ultra-processed consumption score was positively associated with the presence of asthma and wheezing in a dose-response manner. The adjusted OR of asthma and wheezing comparing highest to lowest quintile of ultra-processed consumption score was 1.27 (95% CI 1.15-1.41) and 1.42 (1.35-1.50), respectively. Conclusions: The consumption of ultra-processed products was positively associated with the presence of asthma and wheezing in adolescents.