Purpose

Studies of the association between ultraprocessed foods (UPF) and cardiovascular disease risk factors have been mainly focused on the adult population. This study examined the association between usual percentage of calories (%kcal) from UPF and the American Heart Association's seven cardiovascular health (CVH) metrics among U.S. adolescents aged 12–19 years.

Methods

We used data from the National Health and Nutrition Examination Survey 2007–2018 (n = 5,565). The NOVA food system was used to classify UPF according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 (poor, intermediate, or ideal health, respectively). Scores of six metrics were summed (excluding diet) to categorize CVH as low (0–7), moderate (8–10), or high (11–12). The National Cancer Institute's methods were used to estimate usual %kcal from UPF. Multivariable linear regression and multinomial logistic regression were used to evaluate the association between UPF and CVH.

Results

Among youth, 12.1% had low CVH, 56.3% moderate, and 31.6% high. The mean usual %kcal from UPF was 65.7%. Every 5% increase in calories from UPF was associated with .13 points lower CVH scores (p < .001). Comparing Q2, Q3, and Q4 to Q1 of UPF intake, the adjusted odds ratios for low versus high CVH were 1.43 (95% confidence interval 1.16–1.76), 1.86 (1.29–2.66), and 2.59 (1.49–4.55), respectively. The pattern of association was largely consistent across subgroups.

Conclusions

U.S. adolescents consume about two thirds of daily calorie from UPF. There was a graded inverse association between %kcal from UPF and CVH score.

中文翻译：

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美国青少年超加工食品摄入量与心血管健康的关系：2007-2018 年全国健康与营养检查调查结果

目的

超加工食品 (UPF) 与心血管疾病危险因素之间关联的研究主要集中在成年人群上。本研究调查了 12-19 岁美国青少年中 UPF 卡路里的通常百分比 (%kcal) 与美国心脏协会的七项心血管健康 (CVH) 指标之间的关联。

方法

我们使用了 2007-2018 年全国健康和营养检查调查的数据（n = 5,565）。NOVA 食品系统用于根据食品加工的程度和目的对 UPF 进行分类。每个 CVH 指标的得分为 0、1 或 2（分别为差、中等或理想的健康状况）。将六个指标的分数相加（不包括饮食），将 CVH 分为低 (0-7)、中等 (8-10) 或高 (11-12)。国家癌症研究所的方法被用来估计来自 UPF 的通常 %kcal。多变量线性回归和多项逻辑回归用于评估 UPF 和 CVH 之间的关联。

结果

在年轻人中，12.1% 的 CVH 低，56.3% 中等，31.6% 高。UPF 的平均 %kcal 为 65.7%。UPF 卡路里每增加 5%，CVH 分数就会降低 0.13 分 ( p < .001)。将 UPF 摄入量的 Q2、Q3 和 Q4 与 Q1 进行比较，低 CVH 与高 CVH 的调整后优势比分别为 1.43（95% 置信区间 1.16–1.76）、1.86 (1.29–2.66) 和 2.59 (1.49–4.55) . 关联模式在各个亚组中基本一致。

结论

美国青少年每天从 UPF 中消耗大约三分之二的卡路里。UPF 的 %kcal 与 CVH 分数之间存在分级逆相关。