Replacing UPFs with whole foods helps lower BP in children

The consumption of ultraprocessed foods (UPFs) is high among preschool-age children, which can lead to an increase in their diastolic blood pressure (DBP), a study in Canada has shown.

Specifically, higher UPF intake at age 3 years shows a significant association with higher DBP at age 8 years. However, this association shifts towards a lower DBP when UPFs are replaced by minimally processed foods (MPFs; eg, whole foods).

“UPFs contributed to half of the daily energy intake in Canadian preschoolers,” said Dr Kozeta Miliku, assistant professor at University of Toronto, Ontario, Canada. “Substituting UPF with MPF was associated with lower blood pressure.”

Miliku and her team collected dietary data at age 3 years in the Canadian CHILD Cohort Study, a prospective population-based pregnancy cohort. Data was obtained using food frequency questionnaires completed by the caregiver.

The NOVA system was used to identify MPFs (group 1) and UPFs (group 4). During the 8-year visit, the research team measured systolic blood pressure (SBP) and DBP in triplicate using a validated automatic sphygmomanometer and analysed the average of the last two readings.

Multivariable-adjusted linear mixed models were used to explore the relationship between UPF intake and SBP or DBP. Miliku and colleagues also generated a substitution model that includes UPFs and MPRs as continuous variables. They used the difference in β estimates, variances, and covariance to derive the β estimate for the link between SBP or DBP and substituting 10-percent energy from UPFs with MPFs.

A total of 1,337 children aged 3 years had available data for analysis. Nearly half (45 percent) of the total daily energy intake in this population was contributed by UPFs. [Mousavi S, et al, PAS 2025]

Elevated BP

Children in the middle (β, 0.93 mm Hg, 95 percent confidence interval [CI], 0.17‒1.68) and highest (β , 0.98 mm Hg, 95 percent CI, 0.19‒1.78) tertiles of UPF intake showed higher DBP at age 8 years compared to those in the lowest tertile. The same trend was observed for SBP, but this did not reach statistical significance.

Notably, substituting 10 percent of energy derived from UPFs with MPFs resulted in a 0.42-mm Hg reduction in DBP (95 percent CI, ‒0.73 to ‒0.11). However, no significant associations for SBP were seen.

“Aligning with the ‘food as medicine’ approach, replacing UPFs with MPFs, such as whole foods, during preschool may prevent the development of elevated BP in later life, and ultimately reduce cardiovascular disease risk,” Miliku said.

“These results hold implications in the clinical setting where tailored dietary recommendations can be provided for high BP prevention and for public health settings in terms of dietary interventions and improving diet quality,” she added.

In adults, high consumption of UPFs, such as fast foods and plant-based beverages, contributes to an increase in BP, according to the researchers.

“UPFs are displacing MPFs that provide essential micronutrients for optimal growth. Given that BP tracks from early life, it is critical to understand UPF’s effect on childhood BP and potential mitigation effects of replacing UPFs with MPFs,” they said.