Ultra‐processed food consumption and obesity among children and adolescents in China—Findings from China Health and Nutrition Survey

Summary Background Children and adolescents are increasingly exposed to processed food in China, however, its association with obesity has not been investigated. Objectives To assess the consumption of ultra‐processed food (UPF) and its association with overweight/obesity among children and adolescents in China. Methods A total of 3437 children and adolescents aged 6–18 years, participating at least twice in the China Nutrition and Health Survey, were included. Food intake was collected using a 3‐day 24‐h dietary recall method at home visits. Body weight, height and waist circumference (WC) were measured during the survey. UPF was defined by food process levels using NOVA classification. Overweight/obesity was defined by the international age‐ and sex‐specific BMI and WC cut‐offs. The association between UPF consumption and overweight/obesity was assessed using mixed effect logistic regression analyses adjusted for socio‐demographic, economic, behavioural, dietary and health factors. Results The mean daily UPF consumption of the study population (mean age 9.3 years) increased from 9.7 in 1997 to 60.0 grams in 2011. The adjusted odds ratios (OR) (95% CI) for overweight/obesity (using BMI) for UPF consumption of 0, 1–49, 50–99 and ≥ 100 g/day were 1.00, 1.38 (0.98–1.94), 2.01 (1.25–3.24) and 1.53 (0.82–2.86), respectively ( p ‐trend =0.013). Similarly, the corresponding adjusted ORs (95% CI) for central obesity (using WC) were 1.00, 1.84 (1.30–2.60), 2.13 (1.30–3.48) and 2.15 (1.14–4.05) ( p ‐trend<0.001). Conclusions Higher long‐term UPF consumption was associated with an increased risk of overweight/obesity among children and adolescents in China.