Higher consumption of ultra-processed foods is associated with higher odds of overweight and obesity amongst under-five children: A national cross-sectional study in Lebanon

Introduction: Limited evidence exists on the relationship between ultra-processed food (UPF) consumption and overweight/obesity amongst young children. This study aimed to assess UPF consumption, its socioeconomic correlates and its association with overweight/obesity amongst under-five children in Lebanon. Materials and Methods: Data pertinent to children aged 6 months to 4.9 years (n = 893) from a cross-sectional national survey were used. Anthropometric measurements were obtained, and multi-component questionnaires were administered to mothers. Dietary intake was assessed using the 24-h recall approach. NOVA classification was used to assign food items into four groups according to the extent of industrial processing. Contributions of each group to total energy intake (EI) and macronutrient and micronutrient intakes were estimated. Regression models were conducted to explore the correlates of UPF consumption as well as the association between UPF consumption and overweight/obesity status. Results: UPFs were found to contribute 47% of daily EI. Girls and children with higher household income had significantly higher UPF intakes. Children whose mothers had an intermediate, high school, or technical diploma and were employed and whose fathers had higher education levels consumed significantly less EI from UPFs. Children whose %EI fell within the second and third tertiles of UPF intake had significantly higher odds of overweight/obesity as compared to those in the first tertile (adjusted odds ratio [AOR]: 1.21, 95% confidence interval [CI]: 1.09, 1.32 and AOR: 1.61, 95% CI: 1.47, 1.76, respectively), after adjusting for confounders. Conclusion: The high intake of UPFs coupled with its association with overweight/ obesity call for public health nutrition interventions aimed at improving feeding and dietary practices in this age group.