Table 2.
Association between dietary contribution of ultra-processed food (% of total energy) and indicators of obesity in the UK Biobank cohort
| Ultra-processed food consumption (% of total energy) | ||||||
|---|---|---|---|---|---|---|
| Sex-specific quartersa | p for trendα | Continuous (10% increase in the consumption) | ||||
| HR (95% CI) | ||||||
| 1 | 2 | 3 | 4 | HR (95% CI) | ||
| For being obeseb | ||||||
| n for cases/non-cases | 194/4361 | 231/4324 | 220/4335 | 302/4251 | 947/17,271 | |
| Crudec | 1 | 1.21 (1.00–1.46) | 1.17 (0.97–1.43) | 1.63 (1.36–1.96) | < 0.001 | 1.11 (1.07–1.16) |
| Model 1c,d | 1 | 1.19 (0.99–1.45) | 1.16 (0.96–1.41) | 1.60 (1.33–1.92) | < 0.001 | 1.11 (1.07–1.15) |
| Model 2c,f | 1 | 1.21 (1.00–1.47) | 1.17 (0.97–1.42) | 1.62 (1.35–1.94) | < 0.001 | 1.11 (1.07–1.15) |
| Model 3c,e | 1 | 1.50 (0.87–2.58) | 1.03 (0.58–1.83) | 1.79 (1.06–3.03) | 0.068 | 1.10 (0.99–1.22) |
| For high WCg | ||||||
| n for cases/non-cases | 413/3866 | 472/3806 | 483/3795 | 532/3746 | 1900/15,213 | |
| Crudec | 1 | 1.16 (1.02–1.33) | 1.23 (1.08–1.40) | 1.40 (1.23–1.60) | < 0.001 | 1.07 (1.04–1.10) |
| Model 1c,d | 1 | 1.16 (1.01–1.32) | 1.23 (1.08–1.40) | 1.39 (1.22–1.58) | < 0.001 | 1.08 (1.05–1.10) |
| Model 2c,e | 1 | 1.16 (1.02–1.33) | 1.23 (1.08–1.41) | 1.39 (1.22–1.59) | < 0.001 | 1.07 (1.04–1.10) |
| Model 3c,f | 1 | 1.17 (1.03–1.34) | 1.21 (1.06–1.38) | 1.30 (1.14–1.48) | < 0.001 | 1.06 (1.03–1.08) |
| For having a ≥ 5% BMI increaseh | ||||||
| n for cases/non-cases | 890/4713 | 947/4654 | 917/4684 | 1117/4484 | 3871/18,535 | |
| Crudec | 1 | 1.08 (0.98–1.18) | 1.06 (0.97–1.17) | 1.31 (1.19–1.43) | < 0.001 | -i |
| Model 1c,d | 1 | 1.06 (0.97–1.17) | 1.06 (0.96–1.16) | 1.29 (1.18–1.41) | < 0.001 | -i |
| Model 2c,e | 1 | 1.07 (0.98–1.18) | 1.07 (0.97–1.17) | 1.31 (1.19–1.43) | < 0.001 | -i |
| Model 3c,f | 1 | 1.07 (0.98–1.18) | 1.07 (0.97–1.17) | 1.31 (1.20–1.43) | < 0.001 | -i |
| For having a ≥ 5% WC increaseh | ||||||
| n for cases/non-cases | 1343/4318 | 1516/4145 | 1510/5151 | 1612/4048 | 5981/16,662 | |
| Crudec | 1 | 1.14 (1.06–1.23) | 1.18 (1.10–1.27) | 1.30 (1.21–1.40) | < 0.001 | 1.05 (1.03–1.06) |
| Model 1c,d | 1 | 1.14 (1.06–1.22) | 1.18 (1.09–1.27) | 1.30 (1.20–1.39) | < 0.001 | 1.05 (1.04–1.07) |
| Model 2c,e | 1 | 1.14 (1.06–1.22) | 1.18 (1.10–1.27) | 1.30 (1.21–1.40) | < 0.001 | 1.05 (1.04–1.07) |
| Model 3c,f | 1 | 1.13 (1.05–1.22) | 1.18 (1.10–1.27) | 1.35 (1.25–1.45) | < 0.001 | 1.06 (1.05–1.08) |
| For having a ≥ 5% BF increaseh | ||||||
| n for cases/non-cases | 783/1378 | 841/1319 | 836/1324 | 880/1279 | 3340/5300 | |
| Crudec | 1 | 1.07 (0.97–1.18) | 1.06 (0.96–1.17) | 1.13 (1.03–1.24) | 0.023 | 1.03 (1.01–1.05) |
| Model 1c,d | 1 | 1.07 (0.97–1.18) | 1.06 (0.96–1.17) | 1.13 (1.02–1.24) | 0.024 | 1.03 (1.01–1.05) |
| Model 2c,e | 1 | 1.08 (0.98–1.19) | 1.07 (0.97–1.18) | 1.14 (1.04–1.25) | 0.016 | 1.03 (1.01–1.05) |
| Model 3c,f | 1 | 1.05 (0.96–1.16) | 1.05 (0.95–1.16) | 1.14 (1.03–1.25) | 0.014 | 1.03 (1.01–1.05) |
BMI body mass index, WC waist circumference, BF body fat
Mean follow-up times were 5.6 for obesity (97,090 person-years), 5.6 for high waist circumference (91,380 person-years), 5.8 for having a ≥ 5% BMI increase (119,108 person-years), 5.8 for having a ≥ 5% WC increase (121,067 person-years) and 1.8 for having a ≥ 5% body fat increase (17,660 person-years)
aSex-specific cut-offs for quarters of ultra-processed food consumption—ranged from 25.5% of total energy intake (1st quartile) to 71.5% (5th quartile)
bDefined as Body Mass Index ≥ 30 kg/m2 (World Health Organization, 2003)
cAge used as timescale in the Cox models
d Model 1: adjusted for sex and Index of Multiple Deprivation (quintile and missing category)
eModel 2: adjusted for Model 1 + physical activity (low, moderate, high and missing category), smoking status (never, previous and current) and sleep duration (≤ 6 h/day, 7–8 h/day, ≥ 9 h/day)
fModel 3: adjusted for Model 1 + Model 2 + BMI, WC or BF at baseline (according to the outcome)
gDefined as waist circumference ≥ 102/88 cm for men and women, respectively (World Health Organization, 2008)
hParticipants who had a 5% increase in BMI/WC/body fat from baseline to follow-up
iNon-linear association in restricted cubic spline regression