Karlijn A.M. Geurts¹, Renate E.H. Meeusen¹, Kirsten A.C. Berk¹, Elisabeth F.C. Rossum van¹

¹Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Rationale: High consumption of Ultra processed Foods (UPF) is associated with an increased risk of obesity. The objective of this study is to investigate the association of UPF intake on body composition and metabolic parameters, after 1.5 years of a combined lifestyle intervention (CLI).

Methods: Data of 121 adults living with obesity undergoing a CLI with cognitive behavioural therapy at the Obesity Centre CGG, Rotterdam, The Netherlands was collected at start, 10 weeks and 1.5 years. Food intake was obtained by a 3-day food diary. To quantify UPF intake, the records were classified into the four NOVA categories. Then, the percentage of energy consumed from the UPF categories compared to the total energy consumed was calculated. Weight (kg), waist circumference (cm), body composition (% fat mass and fat free mass), glucose (mmol/l) and insulin (pmol/l) were measured at the outpatient clinic. Marginal mixed models were performed to explore associations between UPF intake and the outcomes at all three timepoints, corrected for age and sex.

Results: After CLI, the participants lost a mean of 6.6 kg of weight (p<0.001). UPF intake changed significantly from 57,5% at baseline to 52.8% (p=0.002). Also, an increase of unprocessed food was observed from 29.0% to 35.9% (p<0.001). UPF intake was positively associated with weight (Estimate=0.093, p<0.001) and percentage fat mass (Estimate=0.041, p=0.010), these associations did not change over time. Waist circumference was also associated with UPF intake (Estimate=0.134, p<0.001) but changed significantly over time (p=0.008). No associations were found for UPF intake and blood pressure, glucose, insulin and percentage lean mass.

Conclusion: We found that a CLI led to significant weight loss, which was associated with reduction in UPF intake. A lower UPF intake was also associated with lower fat mass and waist circumference. Whether recommending UPF in a CLI can lead to better outcomes deserves further study.