High consumption of ultra-processed foods is associated with lower muscle mass in Brazilian adolescents in the RPS birth cohort

Objective The aim of this study was to investigate the association between percent contribution of ultra-processed foods to total dietary energy intake and measurements of body composition obtained using high-validity methods. Methods This was a cross-sectional study with 1525 adolescents 18 to 19 y of age from the second follow-up of the 1997/98 Sao Luis birth cohort, Brazil. To evaluate nutritional status and body composition, the body mass index (BMI)-for-age was used, along with waist circumference, total and android body fat percentage, muscle mass, and the lean mass index (LMI). Food consumption was evaluated by a food frequency questionnaire. Food items were grouped according to the level of processing as per the NOVA classification. Through semi-structured questionnaires, sociodemographic and lifestyle data were abstracted. Adjusted linear regression models were used to evaluate the associations between consumption of ultra-processed foods and body composition measurements. Results Total average energy consumption was 2919.7 kcal, with 58% (1634.9 kcal) derived from natural or minimally processed foods and 37% (1136.5 kcal) from ultra-processed products. In the adjusted analyses, BMI, muscle mass, and LMI were inversely associated with consumption of ultra-processed foods. A 1% increase in the percent contribution of ultra-processed items to total dietary energy intake was associated with a 0.04 kg decrease in muscle mass (β = –0.04; 95% confidence interval [CI], –0.06 to –0.02; P Conclusion The contribution of ultra-processed foods to total dietary energy intake of Brazilian adolescents was associated with body composition, especially with decreasing lean body mass.