Was household availability of ultra-processed food linked to obesity in Brazil?

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Production and consumption of industrially processed food and drink products have risen alongside the global increase in overweight, obesity and related chronic non-communicable diseases. This study examined the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight, meaning overweight plus obesity, and obesity in Brazil.

The cross-sectional study used the 2008–2009 Household Budget Survey, which included a probability sample of 55,970 Brazilian households. Its units of study were household aggregates, or strata, that were geographically and socioeconomically homogeneous. Researchers used multiple linear regression models to assess relationships between product availability and the average body mass index (BMI) and percentages of individuals with excess weight and obesity in the strata. They controlled for potential confounders: sociodemographic characteristics, the percentage of expenditure on eating out of home, and dietary energy from sources other than processed and ultra-processed products. They also estimated predicted prevalence of excess weight and obesity by quartiles of household availability of dietary energy from processed and ultra-processed products.

The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% in the lower quartile to 39.4% in the upper quartile. Adjusted linear regression coefficients showed that household availability of ultra-processed products was positively associated with average BMI and the prevalence of excess weight and obesity, while processed products were not associated with these outcomes. People in the upper quartile of household consumption of ultra-processed products were 37% more likely to be obese than those in the lower quartile. The authors concluded that greater household availability of ultra-processed food products in Brazil was positively and independently associated with higher prevalence of excess weight and obesity across all age groups in this cross-sectional study.