Abstract P181: Processed food intake is adversely associated with multiple indicators of cardiometabolic health in US adults: Findings from the National Health and Nutrition Examination Surveys (2005-2008)
Authors: Lipsky Leah , Nansel Tonja , Quick Virginia 
Published: July 2021

Introduction:
Reducing intake of ingredients characteristic of processed foods is vital to improving ideal cardiovascular dietary behaviors described in the American Heart Association 2020 Strategic Impact Goals.

Hypothesis:
We sought to develop an indicator of processed food intake and evaluate its hypothesized adverse relationships with biomarkers of cardiometabolic health in a nationally representative sample of US adults.

Methods:
Data from two 24 hour recalls were examined for US adults (>=18y) in NHANES (2005-2008). An index of processed food intake (PFI) was developed using the mean of the standardized (mean=0, standard deviation=1), energy-adjusted (per 1000 kcal) intakes of refined grains, processed meat, discretionary oils, discretionary solid fat, added sugar and sodium. We evaluated bivariate associations of PFI with demographics (sex, poverty-income ratio, education) and behavioral factors (smoking, nutritional supplement use). Multivariable linear regressions were used to examine associations of PFI with BMI (kg/m2), waist circumference (cm), and biomarkers for cardiometabolic health (total cholesterol, HDL-C, LDL-C, triglycerides, apo-b and c-reactive protein), adjusting for demographic and behavioral covariates. We tested for potential interactions between PFI and weight status, sex, and smoking.

Results:
PFI was higher in smokers than never smokers (p<.001). PFI was lower for those with at least a college degree than those with less education (p=.004) and for NH White vs. NH Black adults (p=.04). Adjusting for covariates, higher PFI was associated with greater BMI (p<.001) and waist circumference (p<.001), lower HDL-C (p<.001), and higher c-reactive protein (p=.01). Interactions (p<.05) were observed between PFI and sex for predicting BMI, and between PFI and smoking for predicting TC and HDL-C. The magnitude of associations was larger for female vs. male and for current and former smokers vs. non-smokers. No interactions were observed between PFI and weight status.

Conclusion:
Intake of components characteristic of processed foods is adversely associated with a variety of cardiometabolic biomarkers. Positive associations of PFI with BMI were greater for females vs. males, while associations of PFI with TC and HDL-C were greater for current and former smokers vs. never smokers. The nutritional value of dietary components of PFI is primarily restricted to energy, protein, and sodium, none of which are considered lacking in the diets of US adults. These findings underscore the rationale for encouraging replacing such components with foods that promote cardiovascular health including fruit, vegetables, whole grains, fish, legumes, nuts and seeds.

Acknowledgment: This research was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.