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@ARTICLE{Cordova:170431,
      author       = {R. Cordova and N. Kliemann and I. Huybrechts and F. Rauber
                      and E. P. Vamos and R. B. Levy and K.-H. Wagner and V.
                      Viallon and C. Casagrande and G. Nicolas and C. C. Dahm and
                      J. Zhang and J. Halkjær and A. Tjønneland and M.-C.
                      Boutron-Ruault and F. R. Mancini and N. Laouali and V.
                      Katzke$^*$ and B. Srour$^*$ and F. Jannasch and M. B.
                      Schulze and G. Masala and S. Grioni and S. Panico and Y. T.
                      van der Schouw and J. W. G. Derksen and C. Rylander and G.
                      Skeie and P. Jakszyn and M. Rodriguez-Barranco and J. M.
                      Huerta and A. Barricarte and L. Brunkwall and S. Ramne and
                      S. Bodén and A. Perez-Cornago and A. K. Heath and P. Vineis
                      and E. Weiderpass and C. A. Monteiro and M. J. Gunter and C.
                      Millett and H. Freisling},
      title        = {{C}onsumption of ultra-processed foods associated with
                      weight gain and obesity in adults: {A} multi-national cohort
                      study.},
      journal      = {Clinical nutrition},
      volume       = {40},
      number       = {9},
      issn         = {0261-5614},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2021-01924},
      pages        = {5079 - 5088},
      year         = {2021},
      abstract     = {There is a worldwide shift towards increased consumption of
                      ultra-processed foods (UPF) with concurrent rising
                      prevalence of obesity. We examined the relationship between
                      the consumption of UPF and weight gain and risk of
                      obesity.This prospective cohort included 348 748 men and
                      women aged 25-70 years. Participants were recruited between
                      1992 and 2000 from 9 European countries in the European
                      Prospective Investigation into Cancer and Nutrition (EPIC)
                      study. Two body weight measures were available, at baseline
                      and after a median follow-up time of 5 years. Foods and
                      drinks were assessed at baseline by dietary questionnaires
                      and classified according to their degree of processing using
                      NOVA classification. Multilevel mixed linear regression was
                      used to estimate the association between UPF consumption and
                      body weight change (kg/5 years). To estimate the relative
                      risk of becoming overweight or obese after 5 years we used
                      Poisson regression stratified according to baseline body
                      mass index (BMI).After multivariable adjustment, higher UPF
                      consumption (per 1 SD increment) was positively associated
                      with weight gain (0·12 kg/5 years, $95\%$ CI 0·09 to
                      0·15). Comparing highest vs. lowest quintile of UPF
                      consumption was associated with a $15\%$ greater risk
                      $(95\%$ CI 1·11, 1·19) of becoming overweight or obese in
                      normal weight participants, and with a $16\%$ greater risk
                      $(95\%$ CI 1·09, 1·23) of becoming obese in participants
                      who were overweight at baseline.These results are supportive
                      of public health campaigns to substitute UPF for less
                      processed alternatives for obesity prevention and weight
                      management.},
      keywords     = {Adults (Other) / Europe (Other) / NOVA (Other) / Obesity
                      (Other) / Ultra-processed foods (Other) / Weight gain
                      (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34455267},
      doi          = {10.1016/j.clnu.2021.08.009},
      url          = {https://inrepo02.dkfz.de/record/170431},
}