Ultra-processed food consumption associates with higher cardiovascular risk in rheumatoid arthritis

• Published in: Clinical rheumatology 2020-05, Vol.39 (5), p.1423-1428
• Main Authors: Smaira, Fabiana Infante, Mazzolani, Bruna Caruso, Peçanha, Tiago, dos Santos, Kamila Meireles, Rezende, Diego Augusto Nunes, Araujo, Maria Eugênia, Bonfiglioli, Karina, Scagliusi, Fernanda Baeza, Benatti, Fabiana Braga, de Sá Pinto, Ana Lúcia, Lima, Fernanda Rodrigues, Pereira, Rosa Maria R., Roschel, Hamilton, Gualano, Bruno, Pinto, Ana Jéssica
• Format: Article
• Language: English
• Subjects: Aged; Arthritis, Rheumatoid - complications; Brazil; Brief Report; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cross-Sectional Studies; Diet - adverse effects; Diet - methods; Diet - standards; Energy Intake; Fast Foods - adverse effects; Female; Food; Food consumption; Food processing; Health risk assessment; Heart Disease Risk Factors; Hemoglobin; Humans; Linear Models; Low density lipoprotein; Male; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Nutrition Surveys; Processed foods; Regression analysis; Rheumatoid arthritis; Rheumatology; Risk Assessment; Risk factors; Socioeconomic Factors
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-019-04916-4

To investigate the association between food consumption stratified by processing level and cardiovascular risk factors in rheumatoid arthritis. In this cross-sectional study, 56 patients (age: 62.5 ± 7.9 years, BMI: 28.4 ± 5.1 kg/m 2 ) had food consumption evaluated according to the processing level (e.g., unprocessed or minimally processed foods, processed foods, and ultra-processed foods) and associated with cardiovascular risk factors. The most prevalent food processing level was unprocessed or minimally processed foods (42.6 ± 12.6% of total energy intake [TEI]), followed by processed (24.2 ± 11.9%TEI), ultra-processed (18.1 ± 11.8%TEI), and culinary ingredients (15.1 ± 6.4%TEI). Adjusted regression models showed that higher consumption of ultra-processed foods was positively associated with Framingham risk score (β = 0.06, CI: 95% 0.001, 0.11, p  = 0.045) and glycated hemoglobin (β = 0.04, CI: 95% 0.01, 0.08, p  = 0.021). In contrast, higher consumption of unprocessed or minimally processed foods was associated with lower 10-year risk of developing cardiovascular diseases (β = −0.05, CI: 95% −  0.09, −0.003, p  = 0.021) and LDL (β = −1.09, CI: 95% −  1.94, −0.24, p  = 0.013). Patients with rheumatoid arthritis consuming more ultra-processed foods showed worse metabolic profile, whereas those consuming more unprocessed or minimally processed foods had lower cardiovascular risks. A food pattern characterized by a high ultra-processed food consumption appears to emerge as a novel, modifiable risk factor for cardiovascular diseases in rheumatoid arthritis. Key-Points • Higher ultra-processed food consumption was associated with worse metabolic profile and increased cardiovascular risk, whereas higher unprocessed or minimally processed food consumption was associated with lower 10-year risk of developing cardiovascular diseases. • A food pattern characterized by a high ultra-processed food consumption appears to emerge as a novel, modifiable risk factor for cardiovascular diseases in rheumatoid arthritis.