Ultra-processed food consumption and obesity among children and adolescents in China-Findings from China Health and Nutrition Survey.

Background: Children and adolescents are increasingly exposed to processed food in China, however, its association with obesity has not been investigated.

Objective: To assess the consumption of ultra-processed food (UPF) and its association with overweight/obesity among children and adolescents in China.

Methods: A total of 3437 children and adolescents aged 6-18 years, participating at least twice in the China Nutrition and Health Survey, were included. Food intake was collected using a 3-day 24-h dietary recall method at home visits. Body weight, height and waist circumference (WC) were measured during the survey. UPF was defined by food process levels using NOVA classification. Overweight/obesity was defined by the international age- and sex-specific BMI and WC cut-offs. The association between UPF consumption and overweight/obesity was assessed using mixed effect logistic regression analyses adjusted for socio-demographic, economic, behavioural, dietary and health factors.

Results: The mean daily UPF consumption of the study population (mean age 9.3 years) increased from 9.7 in 1997 to 60.0 grams in 2011. The adjusted odds ratios (OR) (95% CI) for overweight/obesity (using BMI) for UPF consumption of 0, 1-49, 50-99 and ≥ 100 g/day were 1.00, 1.38 (0.98-1.94), 2.01 (1.25-3.24) and 1.53 (0.82-2.86), respectively (p-trend =0.013). Similarly, the corresponding adjusted ORs (95% CI) for central obesity (using WC) were 1.00, 1.84 (1.30-2.60), 2.13 (1.30-3.48) and 2.15 (1.14-4.05) (p-trend<0.001).

Conclusions: Higher long-term UPF consumption was associated with an increased risk of overweight/obesity among children and adolescents in China.