title: Ultra-processed food products and obesity in Brazilian households (2008-2009).
abstract: BACKGROUND
  Production and consumption of industrially processed food and drink products have risen in parallel with the global increase in overweight and obesity and related chronic non-communicable diseases. The objective of this study was to analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight (overweight plus obesity) and obesity in Brazil.
  
  
  METHODS
  The study was based on data from the 2008-2009 Household Budget Survey involving a probabilistic sample of 55,970 Brazilian households. The units of study were household aggregates (strata), geographically and socioeconomically homogeneous. Multiple linear regression models were used to assess the relationship between the availability of processed and ultra-processed products and the average of Body Mass Index (BMI) and the percentage of individuals with excess weight and obesity in the strata, controlling for potential confounders (socio-demographic characteristics, percentage of expenditure on eating out of home, and dietary energy other than that provided by processed and ultra-processed products). Predictive values for prevalence of excess weight and obesity were estimated according to quartiles of the household availability of dietary energy from processed and ultra-processed products.
  
  
  RESULTS
  The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% (lower quartile) to 39.4% (upper quartile). Adjusted linear regression coefficients indicated that household availability of ultra-processed products was positively associated with both the average BMI and the prevalence of excess weight and obesity, whereas processed products were not associated with these outcomes. In addition, people in the upper quartile of household consumption of ultra-processed products, compared with those in the lower quartile, were 37% more likely to be obese.
  
  
  CONCLUSIONS
  Greater household availability of ultra-processed food products in Brazil is positively and independently associated with higher prevalence of excess weight and obesity in all age groups in this cross-sectional study.
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Daniela Silva
authors.initials: DS
authors.lastname: Canella
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Renata Bertazzi
authors.initials: RB
authors.lastname: Levy
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Ana Paula Bortoletto
authors.initials: AP
authors.lastname: Martins
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Rafael Moreira
authors.initials: RM
authors.lastname: Claro
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Moubarac
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Larissa Galastri
authors.initials: LG
authors.lastname: Baraldi
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Cannon
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Monteiro
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004435:Eating; D002149:Energy Intake; D005260:Female; D005511:Food Handling; D006801:Humans; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012959:Socioeconomic Factors