• Aline Ester da Silva Cruz Lopes, Larissa Fortunato Araújo, Renata Bertazzi Levy, Sandhi Maria Barreto, and Luana Giatti.
• MSc. Dietitian, Postgraduate Program on Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.
• Sao Paulo Med J. 2019 Jul 15; 137 (2): 169176169-176.

BackgroundThere may be a direct association between consumption of ultra-processed foods and C-reactive protein (CRP) levels, under the assumption that the high glycemic index of these food products could stimulate the entire chronic inflammation cascade, along with an indirect association mediated by obesity. The types of food consumed, including ultra-processed products, strongly influence obesity, and are also associated with higher serum CRP levels.ObjectiveOur aim was to investigate whether the caloric contribution of ultra-processed foods to diet is associated with CRP levels, independent of body mass index (BMI).Design And SettingCross-sectional analysis on the Longitudinal Study of Adult Health (ELSA-Brasil) baseline cohort (2008-2010).MethodsDietary information, obtained through a food frequency questionnaire, was used to estimate the percentage of energy contribution from ultra-processed food to individuals' total caloric intake. CRP levels were the response variable. Sex-specific associations were estimated using generalized linear models with gamma distribution and log-link function.ResultsUltra-processed food accounted for 20% of total energy intake. Among men, after adjustments for sociodemographic characteristics, there was no association between ultra-processed food intake and CRP levels. Among women, after adjustment for sociodemographic characteristics, smoking and physical activity, the highest tercile of ultra-processed food intake was associated with mean CRP levels that were 14% higher (95% confidence interval: 1.04-1.24) than those of the lowest tercile. However, after considering BMI, this association lost statistical significance.ConclusionOur findings suggest that the positive association of ultra-processed food consumption with CRP levels among women seems to be mediated by the presence of adiposity.

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