Associations between ultraprocessed food consumption and total water intake in the US population

Author(s)

Baraldi, Larissa Galastri ^[1] ; Steele, Euridice Martinez ^[2] ; Louzada, Maria Laura C. ^[3] ; Monteiro, Carlos A. ^[3]

Affiliation

^[1] Univ Estadual Campinas, Ctr Food Studies, Albert Einsten Ave 291, BR-13083852 Campinas - Brazil

^[2] Univ Sao Paulo, Ctr Epidemiol Studies Hlth & Nutr, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Ctr Epidemiol Studies Hlth & Nutr, Sch Publ Hlth, Dept Nutr, Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS; v. 121, n. 9, p. 1695-1703, SEP 2021.
• Web of Science Citations: 1

Abstract

Background Longitudinal studies have shown significant dose-response associations between dietary share of ultraprocessed foods and the incidence of several non communicable diseases and all-cause mortality. Several attributes of ultraprocessed foods are potential mechanisms for their link with health outcomes, including their typically unbalanced nutrient profile, high glycemic loads, high energy intake rate, and the presence of food additives, neoformed substances, and substances released by synthetic packaging materials. However, no studies have assessed the plausibility of reduced water intake as an additional association of diets rich in ultraprocessed foods. Objective To assess the association between ultraprocessed food consumption and total water intake. Design This cross-sectional secondary analysis used data from the National Health and Nutrition Examination Survey, cycles 2011 to 2016, in the United States. Participants/settings This study included 24,505 participants aged >1 year who completed the first 24-hour dietary recall interview. Main outcomes measures The main outcome evaluated was the mean of total water intake. Statistical analysis Crude and adjusted linear regressions were applied to investigate the association between quintiles of the dietary share of ultraprocessed foods and the total water intake. Results A significant linear reduction in the daily mean total water intake was observed across ultraprocessed food quintiles, amounting to 706 mL between the lower and the upper quintiles. Important increases across quintiles were observed for the intake of sugar-sweetened and artificially sweetened drinks, whereas important reductions occurred for unsweetened drinks, plain water, and water present in solid foods and dishes. Conclusions Reduced total water intake and an imbalance between sources of water that favors energy-dense and nutrient-poor sources were associated with increased consumption of ultraprocessed food, suggesting that decreased total water consumption might be a negative outcome of diets rich in ultraprocessed foods. This relationship should be further investigated in longitudinal or clinical trials. J Acad Nutr Diet. 2021;121(9):1695-1703. (AU)

• FAPESP's process: 15/14900-9 - Consumption of ultra-processed foods, dietary nutrient profile diet and obesity in seven countries
• Grantee: Carlos Augusto Monteiro
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 18/17972-9 - Ultra-processed foods and 'protein leverage hypothesis': a study in seven countries
• Grantee: Eurídice Martínez Steele
• Support Opportunities: Scholarships in Brazil - Post-Doctoral