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. 2023 Apr 26;47(4):547–558. doi: 10.4093/dmj.2022.0026

Table 3.

Associations between dietary energy contribution of ultra-processed food and obesity, stratified by sex, age, and overall diet quality (n=6,894)

Variable Mean±SD or n (%) Sex-specific quartiles of UPF consumption, % TEa
Per UPF consumption, 10% TE
Quartile 1 Quartile 2 Quartile 3 Quartile 4 P trendb β or OR P valuec
Male sex
 BMI, kg/m2 25.1±2.8 0 0.39 (0.06 to 0.71) 0.18 (–0.15 to 0.51) 0.52 (0.18 to 0.87) 0.014 0.15 (0.03 to 0.26) 0.011
 Obesityd 1,174 (49.5) 1 1.26 (1.00 to 1.58) 1.04 (0.82 to 1.32) 1.31 (1.02 to 1.67) 0.120 1.06 (0.98 to 1.15) 0.176
 Waist circumference, cm 87.7±7.8 0 0.92 (0.04 to 1.80) 0.72 (–0.19 to 1.62) 1.57 (0.63 to 2.51) 0.003 0.55 (0.24 to 0.87) <0.001
 Abdominal obesitye 900 (38.0) 1 1.35 (1.06 to 1.72) 1.29 (1.00 to 1.65) 1.45 (1.12 to 1.88) 0.010 1.13 (1.04 to 1.23) 0.004
Female sex
 BMI, kg/m2 23.6±3.0 0 0.07 (–0.18 to 0.31) 0.46 (0.21 to 0.71) 0.36 (0.10 to 0.62) <0.001 0.15 (0.05 to 0.25) 0.004
 Obesity 1,270 (28.1) 1 1.05 (0.87 to 1.27) 1.30 (1.08 to 1.57) 1.26 (1.03 to 1.54) 0.004 1.11 (1.03 to 1.20) 0.009
 Waist circumference, cm 79.5±8.4 0 0.24 (–0.42 to 0.90) 1.10 (0.43 to 1.78) 1.03 (0.32 to 1.73) <0.001 0.37 (0.10 to 0.64) 0.008
 Abdominal obesity 1,185 (26.2) 1 1.22 (1.01 to 1.48) 1.44 (1.19 to 1.75) 1.34 (1.09 to 1.66) 0.001 1.11 (1.02 to 1.20) 0.013
30–49 years
 BMI, kg/m2 23.9±3.3 0 0.19 (–0.26 to 0.63) 0.47 (0.05 to 0.90) 0.52 (0.10 to 0.94) 0.007 0.16 (0.03 to 0.30) 0.014
 Obesity 788 (34.0) 1 1.11 (0.80 to 1.53) 1.30 (0.96 to 1.76) 1.39 (1.03 to 1.87) 0.016 1.10 (1.00 to 1.21) 0.038
 Waist circumference, cm 80.9±9.6 0 0.19 (–1.00 to 1.34) 0.85 (–0.25 to 1.96) 1.16 (0.08 to 2.24) 0.011 0.44 (0.10 to 0.78) 0.011
 Abdominal obesity 570 (24.6) 1 1.09 (0.77 to 1.55) 1.17 (0.84 to 1.63) 1.30 (0.94 to 1.79) 0.082 1.12 (1.01 to 1.23) 0.027
50–64 years
 BMI, kg/m2 24.2±2.9 0 0.19 (–0.03 to 0.40) 0.31 (0.08 to 0.54) 0.34 (0.09 to 0.59) 0.002 0.13 (0.04 to 0.22) 0.007
 Obesity 1,656 (36.2) 1 1.14 (0.97 to 1.34) 1.15 (0.97 to 1.36) 1.21 (1.01 to 1.46) 0.040 1.07 (1.00 to 1.15) 0.064
 Waist circumference, cm 83.1±8.7 0 0.58 (–0.01 to 1.18) 1.00 (0.36 to 1.62) 1.00 (0.31 to 1.68) <0.001 0.38 (0.12 to 0.64) 0.004
 Abdominal obesity 1,515 (33.1) 1 1.32 (1.11 to 1.56) 1.46 (1.22 to 1.74) 1.32 (1.08 to 1.60) <0.001 1.10 (1.03 to 1.18) 0.008
Low diet qualityf
 BMI, kg/m2 24.4±3.2 0 0.25 (–0.06 to 0.56) 0.31 (0.00 to 0.61) 0.46 (0.16 to 0.76) 0.003 0.14 (0.04 to 0.24) 0.006
 Obesity 1,355 (39.2) 1 1.25 (1.01 to 1.55) 1.28 (1.04 to 1.58) 1.42 (1.16 to 1.75) 0.001 1.10 (1.03 to 1.18) 0.007
 Waist circumference, cm 84.5±9.4 0 0.47 (–0.36 to 1.30) 0.64 (–0.17 to 1.46) 1.24 (0.44 to 2.05) 0.003 0.48 (0.20 to 0.75) <0.001
 Abdominal obesity 1,161 (33.6) 1 1.22 (0.98 to 1.52) 1.23 (0.99 to 1.52) 1.40 (1.14 to 1.74) 0.003 1.13 (1.05 to 1.21) 0.001
High diet quality
 BMI, kg/m2 23.8±2.9 0 0.13 (–0.12 to 0.38) 0.40 (0.14 to 0.67) 0.18 (–0.11 to 0.48) 0.040 0.10 (–0.02 to 0.23) 0.096
 Obesity 1,089 (31.6) 1 1.03 (0.84 to 1.26) 1.10 (0.89 to 1.36) 1.05 (0.83 to 1.32) 0.520 1.03 (0.94 to 1.14) 0.053
 Waist circumference, cm 81.2±8.6 0 0.54 (–0.15 to 1.24) 1.24 (0.51 to 1.96) 0.57 (–0.24 to 1.38) 0.029 0.18 (–0.16 to 0.52) 0.303
 Abdominal obesity 924 (26.8) 1 1.36 (1.10 to 1.68) 1.56 (1.26 to 1.95) 1.15 (0.89 to 1.48) 0.051 1.04 (0.94 to 1.15) 0.435

Values are presented as β or OR (95% confidence interval). All analyses adjusted for sex (not in sex-stratified analyses), age, research center, economic status, marital status, smoking, drinking, sitting time, family history of diseases.

SD, standard deviation; UPF, ultra-processed food; TE, total energy intake; OR, odds ratio; BMI, body mass index.

a

The sex-specific cutoffs of UPF consumption (% TE) were 13.9%, 21.2%, and 28.4% in male and 9.0%, 14.5%, and 21.2% for female,

b

P for the linear trends by quartiles of sex-specific quartiles of UPF consumption (% TE),

c

Odds ratio for a 10 % increase in UPF consumption (% TE),

d

Defined as a BMI ≥25.0 kg/m2,

e

Defined as a waist circumference ≥90 cm for male and ≥85 cm for female, respectively,

f

Using the median point of Korean Healthy Eating Index (KHEI) of the study participants, <74.3 KHEI was defined as low diet quality and ≥74.3 KHEI as high diet quality.