Ultraprocessed Food Intake Is Associated With Poor Cardiovascular Fitness in US Children and Adolescents

OBJECTIVES: Ultraprocessed food intake is an established risk factor for cardiovascular disease in adults, however few studies have examined the association between intake of ultraproecssed foods during childhood and risk for cardiovascular disease. The objective of this study was to determine the association between eating patterns, specifically consumption of ultraprocessed foods, and markers of physical fitness in a nationally representative sample of children and youth. METHODS: Using data from NHANES National Youth Fitness Survey, the association between ultraprocessed food consumption and cardiovascular fitness level was evaluated. During the NNYFS, cardiovascular fitness was assessed in adolescents aged 12–15 y and locomotor development was assessed in children age 3–5. Dietary intake information was collected using 24-hour recall; recalled foods were classified using the NOVA classification system and NOVA Category 4 (ultraprocessed) were identified. Cardiovascular fitness level was categorized based on gender-age specific cut-points of estimated VO2max. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the. RESULTS: In older children, we observed a significant positive association between consumption of ultraprocessed foods and cardiovascular fitness level after controlling for age, sex, race, and household income. Children with cardiovascular fitness levels categorized as “high risk” consumed approximately 200kcal more/day of ultraprocessed foods than children in the “healthy fitness zone”, p = 0.002. In younger children, greater intake of ultraprocessed foods was associated with lower locomotor development score; children with the lowest locomotor development scores consumed 273kcal/more day of ultraprocessed foods than children with the highest locomotor development scores, p = 0.0006. CONCLUSIONS: These findings expand on previous work from our group evaluating the association between childhood eating behaviors and fitness indicators. Interventions that aim to educate families about cost-effective methods of reducing ultraprocessed food intake may assist in decreasing risk for cardiovascular health problems in adulthood. FUNDING SOURCES: None.