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Ultra-processed foods: Cross-sectional and longitudinal association with uric acid and hyperuricemia in ELSA-Brasil

  • Virgínia Capistrano Fajardo
    Affiliations
    Post-graduate Program in Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Sandhi Maria Barreto
    Affiliations
    Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Carolina Gomes Coelho
    Affiliations
    Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Maria de Fátima Haueisen Sander Diniz
    Affiliations
    Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Maria del Carmen Bisi Molina
    Affiliations
    Universidade Federal de Ouro Preto, Ouro Preto, Brazil

    Universidade Federal do Espírito Santo, Vitória, Brazil
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  • Antônio Luiz Pinho Ribeiro
    Affiliations
    Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Telehealth Center, Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Rosa Weiss Telles
    Correspondence
    Corresponding author. Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190 – sala 246, Santa Efigênia, 30130100, Belo Horizonte, MG, Brazil.
    Affiliations
    Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Rheumatology Service, Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Published:October 10, 2022DOI:https://doi.org/10.1016/j.numecd.2022.09.020

      Highlights

      • Findings show that the greater the consumption of UPFs, the higher the level of uric acid.
      • Increased UPFs intake is associated with greater prevalence of hyperuricemia (HU).
      • Increased UPFs intake is associated with greater 4 years cumulative incidence of HU.

      Abstract

      Background and aims

      Food intake influences uric acid (UA) levels and hyperuricemia (HU), but evidence on the role of ultra-processed foods (UPFs) are scarce. The association between UPFs consumption and (1) HU prevalence and UA levels; (2) HU cumulative incidence; and (3) UA level change over a 4-year period was investigated.

      Methods and results

      Cross-sectional and longitudinal analyses were performed using baseline (2008–2010, aged 35–74 years) and second visit (2012–2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants with glomerular filtration rate <60 mL/min/1.73 m2, bariatric surgery, implausible caloric intake, and using urate-lowering therapy (ULT) at baseline were excluded (all analyses). Participants with HU at baseline were excluded from longitudinal analyses. UPFs consumption was assessed using a food frequency questionnaire (FFQ) and categorized by the NOVA classification system (100 g/day). HU was defined as UA≥6.8 mg/dL. Linear, logistic, and mixed-effect linear regressions investigated the associations between UPFs consumption and UA/HU, adjusted for covariates. The final samples included 13,923 (cross-sectional) and 10,517 (longitudinal) individuals. The prevalence of HU was 18.7%, and the cumulative incidence was 4.9%. Greater UPFs consumption was associated with a greater prevalence of HU (OR:1.025 95%CI: 1.006; 1.044) and higher UA levels (β:0.024 95%CI: 0.016; 0.032). Every additional consumption of 100 g/day of UPFs raised the 4-year cumulative incidence of HU by 5.6% (95%CI: 1.021; 1.092). However, UPFs were not associated with the pace of UA level changes during the study period.

      Conclusion

      The present study shows that greater UPFs consumption is associated with another deleterious health consequence: higher UA levels and the risk of having HU.

      Keywords

      Abbreviations:

      AGE's (Advanced glycation end-products), CVD (cardiovascular disease), DAG (Directed Acyclic Graph), DM (diabetes mellitus), ELSA-Brasil (Brazilian Longitudinal Study of Adult Health), FFQ (food frequency questionnaire), GFR (glomerular filtration rate), HU (hyperuricemia), IR (interquartile range), OR (Odds ratio), SD (standard deviation), UA (uric acid), ULT (urate-lowering therapy), UPFs (ultra-processed food), 95%CI (confidence intervals of 95%)
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