Degree of food processing and its relationship with overweight and body adiposity in Brazilian adults


  • Danielle Cristina Guimarães da Silva Universidade Federal do Oeste da Bahia
  • Fabrícia Geralda Ferreira Universidade da Força Aérea
  • Dayana Ladeira Macedo Pereira Universidade Federal de Viçosa
  • Emanuele Louise Gomes de Magalhães Universidade Federal de Viçosa
  • Giana Zarbato Longo Universidade Federal de Santa Catarina


Adult, Eating, Food guide, Industrialized foods, Obesity


To check the relationship of the degree of food processing with overweight and body adiposity in Brazilian adults.
Cross-sectional study with 670 adults (334 women and 336 men) aged 20-59 years in Viçosa, Minas Gerais, Brazil, based on population data collected using a questionnaire, 24-hour dietary recall interview, and anthropometric evaluation.

Consumed foods were categorized into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Poisson regression models were used to assess the relationship between degree of food processing and overweight and body adiposity.
The contribution of unprocessed or minimally processed foods to total energy intake was a protective factor for overweight in all quartiles. The contribution of ultra-processed foods to total energy intake was a risk factor for overweight in the highest quartile (prevalence ratio, 1.308; 95% confidence interval, 1.085-1.577). High energy intake from ultra-processed foods was a risk factor for excess adiposity in the highest quartiles.
Consumption of ultra-processed foods is associated with overweight and excess adiposity, whereas consumption of unprocessed and minimally processed foods is a protective factor for overweight.


Bray GA, Kim KK, Wilding JPH, World Obesity Federation. Obesity: a chronic relapsing progressive disease process: a position statement of the World Obesity Federation. Obes Rev. 2017;18(7):715-23.,

Ng M, Fleming T, Robinson M, Blake TBA, Graetz NBS, Margono CBS, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-81.

Juul F, Martinez-Steele E, Parekh N, Monteiro CA, Chang VW. Ultra-processed food consumption and excess weight among US adults. ‎Br J Nutr. 2018;120(1):90-100.

Mendonça RD, Pimenta AM, Gea A, Fuente-Arrillaga C, Martinez-Gonzalez MA, Lopes ACS, et al. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study. Am J Clin Nutr. 2016;104(5):1433-40.

Passos CM, Maia EG, Levy RB, Martins APB, Claro RM. Association between the price of ultra-processed foods and obesity in Brazil. Nutr Metab Cardiovas. 2020;30(4):589-98.

Canella DS, Levy RB, Martins AP, Claro RM, Mourabac JC, Baraldi LG, et al. Ultra-processed food products and obesity in Brazilian households (2008-2009). Plos One. 2014;9(3):e92752.

Monteiro CA. Nutrition and health: the issue is not food, nor nutrients, so much as processing. Public Health Nutr. 2009;12(5):729-31.

Monteiro CA, Cannon G, Levy R, Mourabac JC, Jaime P, Martins AP, et al. NOVA the star shines bright. World Nutr. 2016;7(1-3):28-38.

Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MRC, Jaime PC. The UN decade of nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2017;21(1):5-17.

Nazmi A, Tseng M, Robinson D, Neill D, Walker J. A Nutrition education intervention using NOVA is more effective than my plate alone: a proof-of-concept randomized controlled trial. Nutrients. 2019;11(12):2965.

Moubarac JC, Batal M, Louzada ML, Martinez Steele E, Monteiro CA. Consumption of ultra-processed foods predicts diet quality in Canada. Appetite. 2016;108:512-20.

Louzada MLC, Ricardo CZ, Steele EM, Levy RB, Cannon G, Monteiro CA. The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr. 2017;21(1):94-102.

Steele EM, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metr. 2017;15(1):6.

Steele EM, Monteiro CA. Association between dietary share of ultra-processed foods and urinary concentrations of phytoestrogens in the US. Nutrients. 2017;9(3):E209.

Longo-Silva G, Menezes RCE, Souza CAN, Marinho PM, Toloni MHA, Oliveira MAA. Factors associated with regular consumption of obesogenic foods: national school-based student health Hurvey, 2012. Rev Nutr. 2016;29(5):609-33.

Machado PP, Steele EM, Levy RB, Sui Z, Rangan A, Woods J, et al. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. Br Med J Open. 2019;9(8):e029544.

Nakano S, Washizu A. Aiming for better use of convenience food: an analysis based on meal production functions at home. J Health Popul Nutr. 2020;39(3).

Martins APB, Levy RB, Claro RM, Moubarac JC, Monteiro CA. Increased contribution of ultra-processed food products in the Brazilian diet (1987-2009). Rev Saúde Pública. 2013;47(4):656-65. 910.2013047004968

Silva FM, Giatti L, Figueiredo RC, Molina MDCB, Cardoso LO, Duncan BB, et al. Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian longitudinal study of adult health (ELSA-Brasil) cohort (2008-2010). Public Health Nutr. 2018;21(12):2271-9.

Louzada MLC, Baraldi LG, Steele EM, Martins APB, Canella DS, Mourabac JC, et al. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9-15.

Canhada SL, Luft VC, Giatti L, Duncan BB, Chor D, Fonseca MJMD, et al. Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr. 2019;17:1-11.

Cunha DB, Costa THM, Veiga GV, Pereira RA, Sichieri R. Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study. Nutr Diabetes. 2018;8:28.

Melo ISV, Costa CACB, Santos JVLD, Santos AFD, Florêncio TMMT, Bueno NB. Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city. Plos One. 2017;12(11):e0188401.

Segheto W, Silva DCG, Coelho FA, Reis GV, Morais SHO, Marins JCB, et al. Body adiposity index and associated factors in adults: method and logistics of a population-based study. Nutr Hosp. 2015;32(1):101-9.

Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES Dietary Data: focus on collection, release, analytical considerations, and uses to inform public policy. Adv Nutr. 2016;7(1):121-34.

Lopes RPS, Botelho RBA. Álbum fotográfico de porções alimentares. São Paulo: Editora Metha; 2008.

Barufaldi LA, Abreu GA, Veiga GV, Sichieri R, Kuschnir MCCC, Cunha DB, et al. Programa para registro de recordatório alimentar de 24 horas: aplicação no Estudo de Riscos Cardiovasculares em Adolescentes. Rev Bras Epidemiol. 2016;19(2):464-8.

Lohman TG. Advances in body composition assessment. Champaign: Human Kinetics Publishers; 1992.

Bonikowske AR, Barillas Lara MI, Koepp KE, Inojosa JRM, Squires RW, Lopez-Jimenez F, et al. Fat mass index better identifies metabolic syndrome: insights from patients in early outpatient cardiac rehabilitation. J Clin Med. 2019;8(12):2147.

World Health Organization. Obesity and overweight. Geneva: Organization; 2018 [cited 2020 Jun 3]. Available from:

Stelmach R, Fernandes FLA, Carvalho-Pinto RM, Athanazio RA, Rached SZ, Prado GF, et al. Comparison between objective measures of smoking and self-reported smoking status in patients with asthma or COPD: are our patients telling us the truth? J Bras Pneumol. 2015;41(2):124-32.

Pardini R, Matsudo S, Araújo T, Matsudo V, Andrade E, Braggion G, et al. Validação do Questionário Internacional de Nível de Atividade Física (IPAQ-Versão 6): estudo piloto em adultos jovens brasileiros. Rev Bras Ciênc Mov. 2001;9:45-51.

Vasconcellos MB, Anjos LA, Vasconcellos MTL. Estado nutricional e tempo de tela de escolares do ensino fundamental do município de Niterói, RJ. Cad Saúde Pública. 2013;4(29):713-22.

Stata Statistical Software: Release 13.1. College Station: Stata Corp LLC; 2013.

Sartorelli DS, Crivellenti LC, Zuccolotto DCC, Franco LJ. Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus. Cad Saúde Pública. 2019;35(4):e00049318.

Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-processed foods and health outcomes: a narrative review. Nutrients. 2020;12(7):1955.

Pan American Health Organization. Ultra-processed food and drink products in Latin America: trends, impact on obesity, policy implications. Washington: Organization; 2015 [cited 2020 Apr 5] Available from:

Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 19 million participants. Lancet Glob Health. 2018;6(10):e1077-86. Erratum in: Lancet Glob Health. 2019;7(1):e36.

Costa CS, Flores TR, Wendt A, Neves RG, Assunção MCF, Santos IS. Comportamento sedentário e consumo de alimentos ultraprocessados entre adolescentes brasileiros: Pesquisa Nacional de Saúde do Escolar (PeNSE), 2015. Cad Saúde Pública. 2018;34(3):e00021017.

Zhao Y, Wang L, Xue H, Wang H, Wang Y. Fast food consumption and its associations with obesity and hypertension among children: results from the baseline data of the Childhood Obesity Study in China Mega-cities. Bmc Public Health. 2017;17(1):933.

Rauber F, Steele EM, Louzada MLDC, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016). Plos One. 2020;15(5):e0232676.

Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-processed diets cause excess calorie intake and weight gain: na inpatient randomized controlled trial of ad libitum food intake. Cell Metabol. 2019;30(1):67-77.

Monteiro C, Levy R, Claro R, Castro I, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saúde Pública. 2010;26(11):2039-49.

Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936-41.

Batalha MA, França AKTC, Conceição SIO, Santos AM, Silva FS, Padilha LL, et al. Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors. Cad Saúde Pública. 2017;33(11):e00152016.

Gonçalves VS, Duarte EC, Dutra ES, Barufaldi LA, Carvalho KM. Characteristics of the school food environment associated with hypertension and obesity in Brazilian adolescents: a multilevel analysis of the study of cardiovascular risks in adolescents (ERICA). Public Health Nutr. 2019;22(14):2625-34.

Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos familiares 2017-2018: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: Instituto; 2020.

Bielemann RM, Motta JVS, Minten GC, Horta BL, Gigante DP. Consumo de alimentos ultraprocessados e impacto na dieta de adultos jovens. Rev Saúde Pública. 2015;49:28.

Libanio IFF, Correa RS, Monteiro AS, Vallandro JP. Consumption of ultraprocessed foods in children attended by the basic attention service in the South region of Brazil. Int J Nutrology. 2019;12(1):35-40.

Marrón-Ponce JA, Flores M, Cediel G, Monteiro CA, Batis C. Associations between consumption of ultraprocessed foods and intake of nutrients related to chronic non-communicable diseases in Mexico. J Acad Nutr Diet. 2019;119(11):1852-65.

Parra DC, Costa-Louzada ML, Moubarac JC, Levy RB, Khandpur N, Cediel G, et al. Association between ultra-processed food consumption and the nutrient profile of the Colombian diet in 2005. Salud Publica Mex. 2019;61(12):147-54.




Como Citar

Guimarães da Silva, D. C., Ferreira, F. G., Ladeira Macedo Pereira, D., Gomes de Magalhães, E. L., & Zarbato Longo, G. (2022). Degree of food processing and its relationship with overweight and body adiposity in Brazilian adults. Revista De Nutrição, 34, 1–11. Recuperado de