Consumption of ultra-processed products and wheezing respiratory diseases in children: The SENDO project

Introduction: The consumption of ultra-processed products (UP) is associated with many diseases in the adult, such as arterial hypertension, diabetes, or asthma. Objective: To determine whether the consumption of UP in children is associated with wheezing respiratory diseases (asthma or bronchitis/recurrent wheezing). Material and methods: A cross-sectional study was conducted within the Follow-up of the Child for Optimal Development (SENDO) project (an open, multidisciplinary and multiple outcome study of Spanish children). The consumption of UP was calculated using semi-quantitative questionnaires on the frequency of food consumption. The foods were grouped according to the NOVA classification, and the daily consumption was estimated along with the percentage of Kilocalories from the UP. The exposure was grouped into “high” and “low” from the median consumption. Odds Ratios and 95% confidence intervals were calculated for wheezing respiratory diseases associated with the high consumption UP, using low consumption as a reference. Crude and multi-adjusted estimators were calculated, and mixed regression models were used to take into account the correlation between siblings. Results: In the 513 children studied (51.8% males, mean age 5.2 years), the mean consumption of UP was 446.76 g/day, representing 39.9% of the total calories ingested. A high consumption of UP was associated with an increase of 87% in the prevalence of wheezing respiratory diseases (OR: 1.87, 95% CI: 1.01–3.45). It was found that a higher consumption of UP multiplied by 2.12 (95% CI: 1.10–4.05) the prevalence of bronchitis/recurrent wheezing. Conclusions: The results of this study show a direct relationship between UP consumption and the prevalence of wheezing diseases in children. Resumen: Introducción: El consumo de productos ultraprocesados (UP) se relaciona con múltiples enfermedades en el adulto, como hipertensión arterial, diabetes o asma. Objetivo: Estudiar si el consumo de UP en niños se asocia con enfermedades respiratorias sibilantes (asma, o bronquitis/sibilancias de repetición). Material y métodos: Estudio transversal dentro del proyecto SEguimiento del Niño para un Desarrollo Óptimo (SENDO), una cohorte abierta, multidisciplinar y multipropósito de niños españoles. El consumo de UP se calculó mediante cuestionarios semicuantitativos de frecuencia de consumo de alimentos. Los alimentos se agruparon según la clasificación NOVA y se estimó el consumo diario y el porcentaje de