title: Relationship between ultra-processed foods and metabolic syndrome in adolescents from a Brazilian Family Doctor Program.
abstract: OBJECTIVE
  To estimate the association between food intake and metabolic syndrome (MetS).
  
  
  METHODS
  Cross-sectional design conducted from July 2006 to December 2007.
  
  
  METHODS
  Adolescents assisted by the Family Doctor Program (FDP) in Niterói, a metropolitan area in Rio de Janeiro State, Brazil.
  
  
  METHODS
  Survey of 210 adolescents. Individuals with three or more of the following components of MetS were classified as having this syndrome: TAG ≥ 110 mg/dl; HDL cholesterol < 50 mg/dl for girls aged 12-19 years and boys aged 12-14 years or <45 mg/dl for boys aged 15-19 years; waist circumference ≥75th percentile; serum glucose >100 mg/dl; and blood pressure ≥90th percentile. A semi-quantitative FFQ was used, and foods were grouped as: unprocessed or minimally processed foods (Group 1), processed culinary and food industry ingredients (Group 2) and ultra-processed foods (Group 3). The associations between food consumption and MetS were adjusted for sociodemographic, behavioural and family history covariates and were estimated using generalized estimation equations with the Poisson regression model.
  
  
  RESULTS
  MetS was diagnosed in 6·7 % of the adolescents; the most frequent diagnostic criteria included the reduction of HDL cholesterol (46·7 %), elevated serum glucose (17·1 %) and the elevation of waist circumference (16·7 %). Crude analysis showed higher average daily intakes of energy, carbohydrates and ultra-processed foods among adolescents with MetS. After statistical adjustment, the intake of ultra-processed foods (≥3rd quartile) remained associated with MetS (prevalence ratio = 2·5; P = 0·012).
  
  
  CONCLUSIONS
  High consumption of ultra-processed foods was associated with the prevalence of MetS in this adolescents group.
authors.affiliation: Collective Health Postgraduate Program, Fluminense Federal University, Niterói, Brazil.
authors.forename: Letícia Ferreira
authors.initials: LF
authors.lastname: Tavares
authors.forename: Sandra Costa
authors.initials: SC
authors.lastname: Fonseca
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Garcia Rosa
authors.forename: Edna Massae
authors.initials: EM
authors.lastname: Yokoo
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001938:Brazil / Q000453:epidemiology; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet; D057140:Fast Foods; D005247:Feeding Behavior; D005260:Female; D005511:Food Handling; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL