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Effect of reducing ultraprocessed food consumption on obesity among US children and adolescents aged 7–18 years: evidence from a simulation model
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  • Published on:
    Erroneous assumptions invalidate the calculated effects of reducing ultra-processed food consumption on child and adolescent obesity
    • Kevin D Hall, Senior Investigator National Institutes of Health

    The manuscript by Livingston et al. presents a simulation study to estimate changes in prevalence of child and adolescent overweight and obesity in the USA if ultra-processed foods were eliminated. The main assumptions of the study can be traced to two publications from my research group at the National Institutes of Health (1, 2). Unfortunately, the assumptions used by the authors are very likely to be invalid.

    The first assumption regards calculating the changes in energy intake that would result from eliminating ultra-processed food. The data used to estimate energy intake changes derive from our study where we admitted 20 adult volunteers to the metabolic ward at the NIH Clinical Center and randomized them to receive either a diet with ~88% of energy from ultra-processed foods (NOVA category 4) or a diet with 0% ultra-processed foods and ~81% unprocessed foods (NOVA category 1) for 2 weeks followed immediately by the alternate diet for an additional 2 weeks (1). Mean ad libitum energy intake was observed to be ~500 kcal/d greater during the ultra-processed diet period. Livingston et al. used these data and made the following assumptions: a) our results in a small number of adults participating in an inpatient controlled feeding study could be quantitatively extrapolated to a large population of free-living children and adolescents; b) energy intake differences are linearly related to the percentage of energy from ultra-processed foods; and c) the calculated ene...

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    Conflict of Interest:
    None declared.