Ultra-processed Foods Consumption and Increased Risk of Metabolic Syndrome in Adults – the ELSA-Brasil

   Objective: To investigate the association between ultra-processed food (UPF) consumption and the incidence of metabolic syndrome. Research Design and Methods: From 2008 to 2010, we enrolled 15105 adults, aged 35-74 years, employees from six public education/research institutions to assemble the Longitudinal Study of Adult Health (ELSA-Brasil). We used a food frequency questionnaire to assess UPF consumption (grams/day) at baseline. We then assessed the outcomes of those returning to visits between 2012-2014 and 2017-2019. We defined incident metabolic syndrome by the presence of at least three of the five abnormalities – high fasting glucose, high triglycerides, low HDL cholesterol, high blood pressure, and abdominal obesity, after excluding those meeting such criteria at baseline. We excluded additionally those who had missing data or an implausible energy intake, leaving 8065 participants. Results: The median age was 49, 59% were women, and the median consumption of UPFs was 366 g/day. After eight years, there were 2508 new cases of metabolic syndrome. In robust Poisson regression, adjusting for socio-demographics, behavioral factors, and energy intake, we found a 7% (RR=1.07, 95%CI 1.05-1.08) higher risk of incident metabolic syndrome for an increase of 150 g/day in UPF consumption. Similarly, those in the 4th quartile (compared to the 1st quartile) had a 33% increased risk (RR=1.33; 95%CI 1.20-1.47). Further adjustment for BMI attenuated these associations (respectively, RR=1.04; 95%CI 1.02-1.06; RR=1.19, 95%CI 1.07-1.32). Conclusions: Greater consumption of UPFs is associated with an increased risk of metabolic syndrome. These findings have important implications for diabetes and cardiovascular disease prevention and management.</p

Consumption of ultra-processed foods and eight-year risk of death from all causes and noncommunicable diseases in the ELSA-Brasil cohort

Increased consumption of ultra-processed foods (UPF) is associated with higher incidences of many noncommunicable diseases (NCDs) and death from all causes. However, the association between UPF and cardiovascular disease (CVD) mortality remains controversial. Our study investigated whether UPF consumption is associated with a higher risk of death from all causes, NCDs, and CVD. This study includes 14,747 participants from the ELSA-Brasil cohort followed up over an eight-year period. The NOVA classification was used to estimate the proportion of UPF (grams/day) in one’s diet. Cox regression was also applied. After adjustment for sociodemographic, health, and behavioural factors, a 10% increase in UPF in participants’ diets raised the risk of death from all causes and NCDs by 10% (95%CI: 1.01-1.19) and 11% (95%CI:1.02-1.21), respectively. However, UPF consumption was not associated with CVD mortality. The findings support public policies aimed at reducing UPF consumption in an attempt to reduce the NCD burden.</p

Additional file 1: of Association between perceived neighbourhood characteristics, physical activity and diet quality: results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Items included in the neighbourhood scales. This additional file presents the items included in the neighbourhood scales, which report the participants’ perception of the walking environment and availability of healthy foods. (PDF 40 kb

Median CRP Levels (interquartile range) according to the presence or absence of health-risk behavior and metabolic alterations among men and women.

<p>Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.</p><p>Median CRP Levels (interquartile range) according to the presence or absence of health-risk behavior and metabolic alterations among men and women.</p

Parameters estimates from the structural equation model of cumulative SEP on CRP levels in adulthood, according to gender.

<p>Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.</p>1<p>Of the 6,654 men participants, 5128 (77.1%) had complete data available on all covariates used in the structural equation model.</p>2<p>Of the 6,717 women participants, 4534 (67.5%) had complete data available on all covariates used in the structural equation model</p>3<p>The significance levels shown here are for the standardized solution (*p<0.05, **p<0.01, ***p<0.001). The absence of overlap in the 95%CI was interpreted as evidence of a significant gender difference in a given path (“bolded” in the table).</p>4<p>CFI: comparative fit index. RMSEA: root mean square error of approximation. SRMR: standardized root mean squared residual.</p><p>Parameters estimates from the structural equation model of cumulative SEP on CRP levels in adulthood, according to gender.</p

Adjusted geometric means (95% confidence interval) for levels of CRP by SEP indicators throughout the life course.

<p>Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.</p><p>Adjusted geometric means (95% confidence interval) for levels of CRP by SEP indicators throughout the life course.</p

Age adjusted geometric means (95% confidence interval) of C-reactive protein among men and women by the cumulative SEP score that ranged between zero to nine, with higher values reflecting worse life course SEP.

<p>Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.</p

Prevalence of health-risk behavior and metabolic alteration according to cumulative socioeconomic position (SEP) score (higher values reflecting worse life course SEP) among men and women.

<p>Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.</p><p>Prevalence of health-risk behavior and metabolic alteration according to cumulative socioeconomic position (SEP) score (higher values reflecting worse life course SEP) among men and women.</p

Effects of calcium, magnesium, and potassium concentrations on ventricular repolarization in unselected individuals.

Background: Subclinical changes on the electrocardiogram are risk factors for cardiovascular mortality. Recognition and knowledge of electrolyte associations in cardiac electrophysiology are based on only in vitro models and observations in patients with severe medical conditions.Objectives: This study sought to investigate associations between serum electrolyte concentrations and changes in cardiac electrophysiology in the general population.Methods: Summary results collected from 153,014 individuals (54.4% women; mean age 55.1 ± 12.1 years) from 33 studies (of 5 ancestries) were meta-analyzed. Linear regression analyses examining associations between electrolyte concentrations (mmol/l of calcium, potassium, sodium, and magnesium), and electrocardiographic intervals (RR, QT, QRS, JT, and PR intervals) were performed. The study adjusted for potential confounders and also stratified by ancestry, sex, and use of antihypertensive drugs.Results: Lower calcium was associated with longer QT intervals (-11.5 ms; 99.75% confidence interval [CI]: -13.7 to -9.3) and JT duration, with sex-specific effects. In contrast, higher magnesium was associated with longer QT intervals (7.2 ms; 99.75% CI: 1.3 to 13.1) and JT. Lower potassium was associated with longer QT intervals (-2.8 ms; 99.75% CI: -3.5 to -2.0), JT, QRS, and PR durations, but all potassium associations were driven by use of antihypertensive drugs. No physiologically relevant associations were observed for sodium or RR intervals.Conclusions: The study identified physiologically relevant associations between electrolytes and electrocardiographic intervals in a large-scale analysis combining cohorts from different settings. The results provide insights for further cardiac electrophysiology research and could potentially influence clinical practice, especially the association between calcium and QT duration, by which calcium levels at the bottom 2% of the population distribution led to clinically relevant QT prolongation by >5 ms.</p