Ultra-processed food consumption among university students: application of front-of-package-based nutrient profiling scores and associations with physical activity and body composition

BACKGROUND: Recent modernization of food processes and Westernized lifestyles have raised concerns about the increased consumption of Ultra-Processed Foods (UPF). Evidence links UPF consumption to the prevalence of several chronic diseases. Higher UPF consumption correlates with higher fat mass (FM) and lower fat-free mass (FFM), alongside with higher levels of sedentary behavior and lower levels of physical activity (PA) in adults. However, the evidence in university students is still scarce. This study aimed to characterize UPF consumption in university students from the School of Medicine, University of Lisbon and test its association with body composition (BC) and PA. Additionally, these associations were also investigated in regard to UPF nutritional content. METHODS: This is a cross-sectional observational study with a sample of 163 Portuguese university students. Dietary intake was assessed through two non-consecutive 24-hour dietary recalls. UPF were classified using the NOVA system and front-of-package-based nutrient profiling systems (Nutri-Score and Traffic Light). BC was assessed through anthropometry and bioelectrical impedance, and PA and sedentary time (ST) through accelerometry. Independent-sample t-tests/Mann-Whitney tests and Chi-square tests assessed differences between groups. Associations were examined using Spearman’s correlations. RESULTS: UPF contributed to 24.8% of total energy intake (TEI). There were no associations between UPF and BC or PA. FSAm-NPS DI-NS and FSAm-NPS DI-TL were negatively associated with FFM (rho=-0.232, p = 0.003; rho=-0.237, p = 0.003; respectively) and positively associated with ST (rho = 0.238, p = 0.002; rho = 0.245, p = 0.002; respectively). CONCLUSIONS: One-quarter of students’ TEI comes from UPF, aligning with national data. Our findings suggest that the consumption of UPF with worse nutrient profiles is related to lower FFM and higher ST. Enhancing nutrition literacy among university students may foster healthier food choices, potentially improving BC and ST.