Association between consumption of ultra-processed foods and serum C-reactive protein levels

cross-sectional results from the ELSA-Brasil study

Autores

Palavras-chave:

Diet, C-reactive protein, Inflammation, Obesity, Cross-sectional studies

Resumo

BACKGROUND: There may be a direct association between consumption of ultra-processed foods and C-reactive protein (CRP) levels, under the assumption that the high glycemic index of these food products could stimulate the entire chronic inflammation cascade, along with an indirect association mediated by obesity. The types of food consumed, including ultra-processed products, strongly influence obesity, and are also associated with higher serum CRP levels. OBJECTIVE: Our aim was to investigate whether the caloric contribution of ultra-processed foods to diet is associated with CRP levels, independent of body mass index (BMI). DESIGN AND SETTING: Cross-sectional analysis on the Longitudinal Study of Adult Health (ELSA-Brasil) baseline cohort (2008-2010). METHODS: Dietary information, obtained through a food frequency questionnaire, was used to esti-mate the percentage of energy contribution from ultra-processed food to individuals’ total caloric intake. CRP levels were the response variable. Sex-specific associations were estimated using generalized linear models with gamma distribution and log-link function. RESULTS: Ultra-processed food accounted for 20% of total energy intake. Among men, after adjustments for sociodemographic characteristics, there was no association between ultra-processed food intake and CRP levels. Among women, after adjustment for sociodemographic characteristics, smoking and physical activity, the highest tercile of ultra-processed food intake was associated with mean CRP levels that were 14% higher (95% confidence interval: 1.04-1.24) than those of the lowest tercile. However, after consider-ing BMI, this association lost statistical significance. CONCLUSION: Our findings suggest that the positive association of ultra-processed food consumption with CRP levels among women seems to be mediated by the presence of adiposity.

Downloads

Não há dados estatísticos.

Biografia do Autor

Aline Ester da Silva Cruz Lopes, Universidade Federal de Ouro Preto (UFOP)

MSc. Dietitian, Postgraduate Program on Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil. orcid.org/0000-0003-0947-8185.

Larissa Fortunato Araújo, Universidade Federal do Ceará (UFC); Universidade Federal de Minas Gerais (UFMG)

MSc. Dietitian and Adjunct Professor, School of Medicine, Universidade Federal do Ceará (UFC), Fortaleza (CE), and Research Group on Epidemiology of Chronic and Occupational Diseases (GERMINAL), School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.  orcid.org/0000-0001-6695-0365

Renata Bertazzi Levy, Universidade de São Paulo, São Paulo (SP)

PhD. Scientific Researcher VI, Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de São Paulo, São Paulo (SP), Brazil.  orcid.org/0000-0001-5388-7002

Sandhi Maria Barreto, Universidade Federal de Minas Gerais (UFMG)

MD. Physician and Full Professor, Research Group on Epidemiology of Chronic and Occupational Diseases (GERMINAL), School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil. orcid.org/0000-0001-7383-7811

Luana Giatti, Universidade Federal de Minas Gerais (UFMG)

MD. Physician and Adjunct Professor, Research Group on Epidemiology of Chronic and Occupational Diseases (GERMINAL), School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil. orcid.org/0000-0001-5454-2460

Referências

Barrea L, Di Somma C, Muscogiuri G, et al. Nutrition, inflammation and liver-spleen axis. Crit Rev Food Sci Nutr. 2017; 11:1-18. PMID: 28799803; doi: 10.1080/10408398.2017.1353479.

Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev. 2013;71(8):511-27. PMID: 23865797; doi: 10.1111/ nure.12035.

Nanri H, Nakamura K, Hara M, et al. Association between dietary pattern and serum C-reactive protein in Japanese men and women. J Epidemiol. 2011;21(2):122-31. PMID: 21325731; doi: 10.2188/jea.JE20100110.

Poggio R, Elorriaga N, Gutierrez L, et al. Associations between dietary patterns and serum lipids, apo and C-reactive protein in an adult population: evidence from a multi-city cohort in South America. Br J Nutr. 2017;117(4):548-55. PMID: 28382894; doi: 10.1017/S0007114517000514.

Lee Y, Kang D, Lee SA. Effect of dietary patterns on serum C-reactive protein level. Nutr Metab Cardiovasc Dis. 2014;24(9):1004-11. PMID: 24998076; doi: 10.1016/j.numecd.2014.05.001.

Alkerwia A, Shivappab N, Crichtona G, Hébert JR. No significant independent relationships with cardiometabolic biomarkers were detected in the Observation of Cardiovascular Risk Factors in Luxembourg study population. Nutr Res. 2014;34(12):1058-65. PMID: 25190219; doi: 10.1016/j.nutres.2014.07.017.

AlEssa HB, Malik VS, Yuan C, et al. Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women. Am J Clin Nutr. 2017;105(2):432-41. PMID: 27974312; doi: 10.3945/ajcn.116.143016.

Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14(2):21-8. PMID: 24102801; doi: 10.1111/obr.12107.

Monteiro CA, Moubarac JC, Levy RB, et al. Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr. 2018;21(1):18-26. PMID: 28714422; doi: 10.1017/ S1368980017001379.

Louzada ML, Baraldi LG, Steele EM, et al. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9-15. PMID: 26231112; doi: 10.1016/j.ypmed.2015.07.018.

Mendonça RD, Pimenta AM, Gea A, et al. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study. Am J Clin Nutr. 2016;104(5):1433-40. PMID: 27733404; doi: 10.3945/ajcn.116.135004.

Canella DS, Levy RB, Martins AP, et al. Ultra-processed food products and obesity in Brazilian households (2008-2009). PLoS One. 2014;9(3):e92752. PMID: 24667658; doi: 10.1371/journal.pone.0092752.

Silva FM, Giatti L, de Figueiredo RC, et al. Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008-2010). Public Health Nutr. 2018;21(12):2271-9. PMID: 29642958; doi: 10.1017/ S1368980018000861.

Tavares LF, Fonseca SC, Garcia Rosa ML, Yokoo EM. Relationship between ultra-processed foods and metabolic syndrome in adolescents from a Brazilian Family Doctor Program. Public Health Nutr. 2012;15(1):82-7. PMID: 21752314; doi: 10.1017/S1368980011001571.

Rauber F, Campagnolo PD, Hoffman DJ, Vitolo MR. Consumption of ultra-processed food products and its effects on children’s lipid profiles:a longitudinal study. Nutr Metab Cardiovasc Dis. 2015;25(1):116-22. PMID: 25240690; doi: 10.1016/j.numecd.2014.08.001.

Mendonça RD, Lopes AC, Pimenta AM, et al. Ultra-Processed Food Consumption and the Incidence of Hypertension in a Mediterranean Cohort: The Seguimiento Universidad de Navarra Project. Am J Hypertens. 2017;30(4):358-66. PMID: 27927627; doi: 10.1093/ajh/hpw137.

O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008;51(3):249-55. PMID: 18206731; doi: 10.1016/j. jacc.2007.10.016.

Calder PC, Ahluwalia N, Brouns F, et al. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr. 2011;106 Suppl 3:S5-78. PMID: 22133051; doi: 10.1017/S0007114511005460.

Aquino EM, Barreto SM, Bensenor IM, et al. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): objectives and design. Am J Epidemiol. 2012;175(4):315-24. PMID: 22234482; doi: 10.1093/aje/kwr294.

Schmidt MI, Duncan BB, Mill JG, et al. Cohort Profile: Longitudinal Study of Adult Health (ELSA-Brasil). Int J Epidemiol. 2015;44(1):68-75. PMID: 24585730; doi: 10.1093/ije/dyu027.

Molina Mdel C, Benseñor IM, Cardoso Lde O, et al. Reprodutibilidade e validade relativa do questionário de frequência alimentar do ELSA-Brasil [Reproducibility and relative validity of the Food Frequency Questionnaire used in the ELSA-Brasil]. Cad Saude Publica, 2013;29(22):379-89. PMID: 23459823; doi: 10.1590/S0102-311X2013000200024.

Molina M del C, Faria CP, Cardoso LO, et al. Avaliação da dieta no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil): Desenvolvimento do Questionário de Frequência Alimentar [Diet assessment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Development of a food frequency questionnaire]. Rev Nutr. 2013;26(2):167-76. doi: 10.1590/ S1415-52732013000200005.

Monteiro CA, Cannon G, Levy R, et al. NOVA The star shines bright. [Food classification. Public health] World Nutrition. 2016; 7(1-3):28-38. Available from: https://worldnutritionjournal.org/index.php/wn/article/view/5. Accessed in 2018 (Sep 6).

Simões BDS, Barreto SM, Molina MDCB, et al. O consumo de alimentos ultraprocessados e nível socioeconômico: uma análise transversal do Estudo Longitudinal de Saúde do Adulto, Brasil [Consumption of ultra-processed foods and socioeconomic position: Cross sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).] Cad. Saúde Pública. 2018;34(3):e00019717. PMID: 29513858; doi: 10.1590/0102-311X00019717.

IPAQ, Research Committee. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ) – short and long forms. Retrieved 2005 17(2008). Available from: https://www.researchgate.net/file.PostFileLoader.html?id=5641f4c36143250eac8b45b7&assetKey=AS%3A294237418606593%401447163075131. Accessed in 2019 (May 10).

WHO Expert Committee on Physical Status: the use and interpretation of anthropometry: Report of a WHO Expert Committee (TechnicalReport series). Geneva: WHO; 1995. ISBN-10: 9241208546; ISBN-13: 978-9241208543.

Ishii S, Karlamangla AS, Bote M, et al. Gender, obesity and repeated elevation of C-reactive protein: data from the CARDIA cohort. PLoS One. 2012;7(4):360-2. PMID: 22558327; doi: 10.1371/journal. pone.0036062.

Nanri H, Nakamura K, Hara M, et al. Association between dietary pattern and serum C-reactive protein in Japanese men and women. J Epidemiol. 2011;21(2):122-31. PMID: 21325731; doi: 10.2188/jea. JE20100110.

Juul F, Martinez-Steele E, Parekh N, et al. Ultra-processed food consumption and excess weight among US adults. Br J Nutr. 2018; 120(1):90-100. PMID: 29729673; doi: 10.1017/S0007114518001046

Centritto F, Iacoviello L, di Giuseppe R, et al. Dietary patterns, cardiovascular risk factors and C-reactive protein in a healthy Italian population. Nutr Metab Cardiovasc Dis. 2009;19(10):697-706. PMID: 19303267; doi: 10.1016/j.numecd.2008.11.009.

Khera A, McGuire DK, Murphy SA, et al. Race and gender differences in C-reactive protein levels. J Am Coll Cardiol. 2005;46(3):464-9. PMID: 16053959; doi: 10.1016/j.jacc.2005.04.051.

Ahmadi-Abhari S, Luben RN, Wareham NJ, Khaw KT. Distribution and determinants of C-reactive protein in the older adult population: European Prospective Investigation into Cancer-Norfolk study. Eur J Clin Invest. 2013;43(9):899-911. PMID: 23786220; doi: 10.1111/ eci.12116.

Rudnicka AR, Rumley A, Whincup PH, Lowe GD, Strachan DP. Sex differences in the relationship between inflammatory and hemostatic biomarkers and metabolic syndrome: British 1958 Birth Cohort. J Thromb Haemost. 2011;9(12):2337-44. PMID: 22099170; doi: 10.1111/j.1538-7836.2011.04517.x.

Lakoski SG, Cushman M, Criqui M, et al. Gender and C-reactive protein: data from the Multiethnic Study of Atherosclerosis (MESA) cohort. Am Heart J. 2006;152(3):593-8. PMID: 16923436; doi: 10.1016/j. ahj.2006.02.015.

Mirrahimi A, Chiavaroli L, Srichaikul K, et al. The role of glycemic index and glycemic load in cardiovascular disease and its risk factors: a review of the recent literature. Curr Atheroscler Rep. 2014;16(1):381. PMID: 24271882; doi: 10.1007/s11883-013-0381-1.

Ko BJ, Park KH, Shin S, Zaichenko L, Davis CR, Crowell JA. Diet quality and diet patterns in relation to circulating cardiometabolic biomarkers. Clin Nutr. 2016; 35(2):484-490.doi: 10.1016/j.clnu.2015.03.022.

Esmaillzadeh A, Kimiagar M, Mehrabi Y, et al. Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr. 2007;137(4):992-8. PMID: 17374666; doi: 10.1093/jn/137.4.992.

Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106(1):56-61. PMID: 20609648; doi: 10.1016/j.amjcard.2010.02.017.

Martínez Steele E, Baraldi LG, Louzada ML, et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016; 6(3):e009892. PMID: 26962035; doi: 10.1136/bmjopen-2015-009892.

Klop B, Proctor SD, Mamo JC, Botham KM, Castro Cabezas M. Understanding postprandial inflammation and its relationship to lifestyle behavior and metabolic diseases. Int J Vasc Med. 2012:2012:947417. PMID: 21961070; doi: 10.1155/2012/947417.

Santos S, Oliveira A, Lopes C. Systematic review of saturated fatty acids on inflammation and circulating levels of adipokines. Nutr Res. 2013;33(9):687-95. PMID: 24034567; doi: 10.1016/j. nutres.2013.07.002.

Willett WC. Diet and Health: What Should We Eat? Science.1994;264(5158):532-7. Available from: http://www.jstor.org/stable/2883698. Accessed in 2019 (Jan 17).

Downloads

Publicado

2019-04-04

Como Citar

1.
Lopes AE da SC, Araújo LF, Levy RB, Barreto SM, Giatti L. Association between consumption of ultra-processed foods and serum C-reactive protein levels: cross-sectional results from the ELSA-Brasil study. Sao Paulo Med J [Internet]. 4º de abril de 2019 [citado 14º de março de 2025];137(2):169-76. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/821

Edição

Seção

Artigo Original