Abstract
Background
Longitudinal studies have shown significant dose–response associations between dietary
share of ultraprocessed foods and the incidence of several noncommunicable 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.
Keywords
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Biography
L. G. Baraldi is a research scientist, Center for Food Studies, University of Campinas, Campinas, Brazil.
Biography
E. M. Steel is an associate researcher, Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
M. L. C. Louzada is a lecturer, Department of Nutrition, School of Public Health, Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
Biography
C. A. Monteiro is a full professor, Department of Nutrition, School of Public Health, Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
Article info
Publication history
Published online: March 18, 2021
Accepted:
February 8,
2021
Received:
July 15,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo(FAPESP; grant number 2015/14900-9 and FAPESP; grant number 2018/17972-9). The conclusions and opinions in this article are those of the authors and do not necessarily reflect those of FAPESP.
AUTHOR CONTRIBUTIONS C. A. Monteiro, L. G. Baraldi, M. L. Da Costa Louzada, and E. M. Steele designed the research; L. G. Baraldi, and E. M. Steele took care of data management and analyses; C. A. Monteiro, L. G. Baraldi, E. M. Steele interpreted the data; L. G. Baraldi wrote the first draft of the manuscript and E. M. Steele contributed substantially to the intellectual content of the first draft; C. A. Monteiro, L. G. Baraldi, E. M. Steele and M. L. Da Costa Louzada revised each draft for important intellectual content. All authors read and approved the final manuscript.
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© 2021 by the Academy of Nutrition and Dietetics.
