Associação entre o consumo de alimentos ultraprocessados, indicadores antropométricos e perfil lipídico em fator de risco cardiometabólico em adolescentes com excesso de peso

Abstract

Evidence have pointed to a high prevalence of obesity and lipid alterations associated with high consumption of ultra-processed foods (AUP) in children and adolescents. The aim of the study was to quantify food consumption by level of processing and its influence on anthropometric and lipid profile indicators in overweight adolescents. This is a cross-sectional study carried out by non-probabilistic sampling, with adolescents between 10 and 19 years old, of both sexes, diagnosed with excess weight, attended for the first time at the pediatric outpatient clinic in Natal/RN, in October/2016 to August/2019. Clinical, anthropometric, biochemical, food and dietary consumption data were evaluated. Anthropometric nutritional status was assessed using BMI-for-age, PP, PC, RCQ, RCA and Ic. And CT, HDL, TG, LDL and non-HDL cholesterol for the lipid profile. Food and dietary intake was assessed using a 24-hour recall. Food was classified according to the type of processing, according to the “NOVA Classification”, proposed by Monteiro et al (2010). The Kolmogorov-Smirnov tests, Student t, Mann-Whitney U test, Pearson's chi-square test, Fisher's exact test, Poisson regression and the Omnibus test were used for statistical analysis. The sample consisted of 158 adolescents, with a higher percentage (50,6%) being male. There were statistically significant differences for the altered variables of PP (P = 0.01), IC (P=0.04), RCA (P=0,017) and TG (P=0,047). We recorded anthropometric averages above the cutoff point for HF (1,29±0,06) and RCA (0,59±0,05) in males, and for biochemical variables, TG (105±50,44), no -HDL-c (132±30,65) and the average TG/HDL (2,76±1,54) and CT/HDL (4,32±1,04) ratios above the recommended. We verified means of PP (33,00±2,22), IC (1,23±0,07) and RCA (0,57±0,06) and CT (173±30,28), TG (122±61,32), without HDL-c (133±28,38) and the TG/HDL (3,22±1,96) and CT/HDL (4,44±0,95) ratios above that recommended in women. The average caloric intake of the total sample was 1.731,3 ± 635,4 kcal/day. Male adolescents had a higher caloric intake compared to girls (1.835,9 ± 671,2 vs. 1.621,1 ± 579,5 kcal/day; P = 0,034). There was a greater relative caloric contribution of fresh foods and AUP in both sexes. It was found that adolescents with high non-HDL-c had increased mean values for IC (P = 0,029), TG (P < 0,001), CT (P < 0,001) e não-HDL-c (P < 0,001). In the crude and adjusted regression model, an association was identified between elevated non-HDL-c and RCQ (RP: 1,4; IC 95%: 1,1 a 1,9), TG/HDL ratio (RP: 1,9; IC 95%: 1,2 a 3,0), and CT/HDL ratio (RP: 5,3; IC 95%: 2,6 a 10,6) in the crude analysis and only the CT/HDL ratio remained associated with elevated non-HDL-c in the adjusted analysis. We conclude that the anthropometric indicators of HF and RCA were more evident in male adolescents and changes in TC, TG, non-HDL-c and TG / HDL, CT / HDL ratios in women. Although we did not find associations between AUPs and cardiometabolic disorders, non-HDL-c is a cardiometabolic risk in these adolescents.