Ultra-processed foods, changes in blood pressure and incidence of hypertension: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Public Health Nutr. 2021 Aug;24(11):3352-3360. doi: 10.1017/S136898002100094X. Epub 2021 Mar 4.


Objective: To estimate changes in blood pressure and the incidence of hypertension associated with consumption of ultra-processed foods (UPF) by Brazilian civil servants at a 4-year follow-up.

Design: Longitudinal analysis of the ELSA-Brasil with non-hypertensive individuals at baseline. We applied the FFQ at the baseline and categorised energy intake by degree of processing, using the NOVA classification. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at baseline (2008-2010) and again at first follow-up (2012-2014). Incidence of arterial hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or antihypertensive medication during the previous 2 weeks. A mixed-effect linear regression model and mixed-effect logistic regression model were used to estimate associations between UPF consumption and, respectively, changes in blood pressure and incidence of hypertension.

Setting: Brazil.

Participants: Civil servants of Brazilian public academic institutions in six cities (n 8754), aged 35-74 years at baseline (2008-2010).

Results: UPF consumption contributed 25·2 % (sd = 9·6) of total energies consumed. After adjustment, participants with high UPF consumption presented a 23 % greater risk of developing hypertension (OR = 1·23, 95 % CI 1·06, 1·44) than those with low UPF consumption. We did not find association between UPF consumption and changes in blood pressure over time.

Conclusions: The higher the UPF consumption, the higher the risk of hypertension in adults. Reducing UPF consumption is thus important to promote health and prevent hypertension.

Keywords: Blood pressure; Cardiovascular diseases; Hypertension; Ultra-processed food.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure
  • Brazil / epidemiology
  • Diet
  • Fast Foods
  • Health Promotion*
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / etiology
  • Incidence
  • Longitudinal Studies