Impacto da restrição de alimentos ultraprocessados na resistência à insulina e colesterol não-HDL de indivíduos adultos com obesidade submetidos à restrição energética : um ensaio clínico aleatório

Abstract

Ultra-processed food (UPF) consumption is associated with metabolic deterioration and chronic non-communicable diseases. The Dietary Guidelines for the Brazilian Population recommend avoiding the consumption of these foods in order to prevent diseases, but evidence from randomized clinical trials in this regard is scarce. This project aims to investigate the impact of UPF restriction on insulin resistance by HOMA-IR and non-HDL cholesterol in obese individuals undergoing energy restriction (ER). This study is a 12-month randomized clinical trial with two research arms. Both groups underwent ER to lose 10% of their initial weight, based on indirect calorimetry and accelerometry. However, one underwent CR with UPF restriction (CR-UPF) and the other generic CR (CR-G), both with periodic nutritional follow ups for 12 months. Blood samples were obtained by a trained professional before the intervention, at 6 and 12 months, with the participants fasting for 12 hours. An accredited laboratory was hired to carry out the analyses. The data was analyzed using generalized linear mixed models with the fixed factors being the group (RE-UPF or RE-G) and the time of measurement (0, 6, and 12 months). The dependent variables were HOMA-IR and non-HDL cholesterol (md/dl). A total of 149 individuals started the interventions, but only 91 finished the study. UPF onsumption decreased over time in RE-UPF compared to RE-G according to the NOVA score. HOMA-IR and non-HDL cholesterol decreased significantly over time, but there were no differences between the groups for either HOMA-IR or non-HDL cholesterol. These results deny the hypothesis that UPF restriction, together with RE, is superior to RE-G in improving insulin resistance and non-HDL cholesterol in obese individuals. This research will likely contribute to scientific advances on the impact of UPF on metabolic health, contributing to guidelines in clinical practice and public health decisions in relation to this group of foods.