{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:42:57Z","timestamp":1789695777859,"version":"4.0.1"},"reference-count":60,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2023,4,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPF were categorised using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high <jats:italic>v<\/jats:italic>. low cardiovascular risk). UPF contributed 40\u00b769 % (<jats:sc>sd<\/jats:sc> 6\u00b721) to total energy intake. The main UPF groups were ready-to-eat and take-away\/fast foods (22\u00b72 % energy from UPF). The multivariable logistic regression revealed that an absolute increase of 10 % in UPF intake (OR = 1\u00b790; 95 % CI: 1\u00b701;3\u00b758) was associated with central adiposity. An absolute increase of 10 % in UPF intake (OR = 3\u00b777; 95 % CI: 1\u00b780, 7\u00b787) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered as a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.<\/jats:p>","DOI":"10.1017\/s0007114522002240","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T09:15:30Z","timestamp":1658308530000},"page":"1163-1171","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors"],"prefix":"10.1017","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6460-0572","authenticated-orcid":false,"given":"Michele","family":"Honicky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2773-0815","authenticated-orcid":false,"given":"Silvia Meyer","family":"Cardoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4211-9133","authenticated-orcid":false,"given":"Francilene Gracieli","family":"Kunradi Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9348-8513","authenticated-orcid":false,"given":"Patricia de Fragas","family":"Hinnig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4056-9528","authenticated-orcid":false,"given":"Isabela de Carlos","family":"Back","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-2911","authenticated-orcid":false,"given":"Yara Maria Franco","family":"Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"S0007114522002240_ref52","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmz075"},{"key":"S0007114522002240_ref21","unstructured":"21. Fisberg, RMVBS (2002) Manual of recipes and homes measures for calculating food surveys: Manual designed to assist in the procedure of food surveys. S\u00e3o Paulo Signus. https:\/\/repositorio.usp.br\/item\/001557478 (accessed December 2021)."},{"key":"S0007114522002240_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.05.132"},{"key":"S0007114522002240_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2018.11.003"},{"key":"S0007114522002240_ref53","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105861"},{"key":"S0007114522002240_ref59","first-page":"1","article-title":"Reducing ultra-processed foods and increasing diet quality in affordable and culturally acceptable diets: a study case from Brazil using linear programming","volume":"4","author":"Verly","year":"2020","journal-title":"Br J Nutr"},{"key":"S0007114522002240_ref43","doi-asserted-by":"publisher","DOI":"10.1590\/S1415-52732006000200009"},{"key":"S0007114522002240_ref22","volume-title":"Brazilian Table of Food Composition \u2013 TACO","year":"2011"},{"key":"S0007114522002240_ref3","doi-asserted-by":"publisher","DOI":"10.1590\/1413-81232021264.04422019"},{"key":"S0007114522002240_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2015.07.018"},{"key":"S0007114522002240_ref46","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.116.135004"},{"key":"S0007114522002240_ref50","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2019.02.02"},{"key":"S0007114522002240_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.08.024"},{"key":"S0007114522002240_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016048"},{"key":"S0007114522002240_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2004.01.007"},{"key":"S0007114522002240_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.09.023"},{"key":"S0007114522002240_ref31","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2015.160"},{"key":"S0007114522002240_ref36","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199710000-00011"},{"key":"S0007114522002240_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-019-02152-w"},{"key":"S0007114522002240_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017001331"},{"key":"S0007114522002240_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195122978.001.0001"},{"key":"S0007114522002240_ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-018-1870-3"},{"key":"S0007114522002240_ref49","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114520003712"},{"key":"S0007114522002240_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12563"},{"key":"S0007114522002240_ref42","doi-asserted-by":"publisher","DOI":"10.1038\/s41387-018-0043-z"},{"key":"S0007114522002240_ref55","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114520001233"},{"key":"S0007114522002240_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017000891"},{"key":"S0007114522002240_ref10","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-021-01081-3"},{"key":"S0007114522002240_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-8-98"},{"key":"S0007114522002240_ref37","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497"},{"key":"S0007114522002240_ref56","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-016-0178-9"},{"key":"S0007114522002240_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2017.10.003"},{"key":"S0007114522002240_ref1","volume-title":"Dietary Guidelines for the Brazilian Population","year":"2014"},{"key":"S0007114522002240_ref18","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12623"},{"key":"S0007114522002240_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2013.12.005"},{"key":"S0007114522002240_ref48","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12107"},{"key":"S0007114522002240_ref44","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092877"},{"key":"S0007114522002240_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.09.012"},{"key":"S0007114522002240_ref26","doi-asserted-by":"publisher","DOI":"10.1590\/1678-98652017000100008"},{"key":"S0007114522002240_ref41","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjr.0000224483.72726.1a"},{"key":"S0007114522002240_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105955"},{"key":"S0007114522002240_ref29","first-page":"631","article-title":"Subclinical atherosclerosis in children and adolescents with congenital heart disease","volume":"4","author":"Cardoso","year":"2020","journal-title":"Cardiol Young"},{"key":"S0007114522002240_ref57","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980011001571"},{"key":"S0007114522002240_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2014.08.001"},{"key":"S0007114522002240_ref40","first-page":"38","article-title":"Ultra-processed foods and the nutritional dietary profile in Brazil","volume":"49","author":"da Costa Louzada","year":"2015","journal-title":"Rev Sa\u00fade P\u00fablica"},{"key":"S0007114522002240_ref58","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114520002688"},{"key":"S0007114522002240_ref23","first-page":"484","volume-title":"Brazilian Regional Foods. Ministry of Healthy, Department of Health Care, Department of Primary Care","year":"2015"},{"key":"S0007114522002240_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2006.07.011"},{"key":"S0007114522002240_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-381479-1.00010-1"},{"key":"S0007114522002240_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.06.044"},{"key":"S0007114522002240_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-14-271"},{"key":"S0007114522002240_ref60","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118353"},{"key":"S0007114522002240_ref47","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.1573"},{"key":"S0007114522002240_ref25","doi-asserted-by":"publisher","DOI":"10.3390\/nu9030276"},{"key":"S0007114522002240_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l1451"},{"key":"S0007114522002240_ref33","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2107C"},{"key":"S0007114522002240_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa141"},{"key":"S0007114522002240_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951116002080"},{"key":"S0007114522002240_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2007.11.011"},{"key":"S0007114522002240_ref45","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab795"}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114522002240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T13:48:35Z","timestamp":1678715315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114522002240\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":60,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,4,14]]}},"alternative-id":["S0007114522002240"],"URL":"https:\/\/doi.org\/10.1017\/s0007114522002240","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,20]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}