Blood pressure is associated with ultra-processed food intake in a sex- and age-specific manner during the transition to adulthood in Cebu, Philippines

Progression towards elevated blood pressure (BP) may begin as early as adolescence. In low- and middle-income countries (LMICs), consumption of ultra-processed foods (UPFs), which are linked to poor cardiometabolic health, is often highest in adolescence. We examined sex- and age-specific associations of systolic and diastolic BP (SBP and DBP) with concurrent and lagged UPF intake from age 15 to 25 in a Filipino cohort. We used data from the 1998-2009 waves of the Cebu Longitudinal Health and Nutrition Survey (<i>n</i> 2124, 52 % male); participants were 15, 18, 21 and 25 years old. UPFs (% daily kilocalories) were classified using NOVA. Linear mixed-effects models estimated differences in SBP and DBP associated with a 5-percentage point difference in concurrent and lagged UPF intake (3-4 years earlier). Mean UPF intake was 10-11 % of total energy intake among males and 14-17 % among females over the study period. At age 21, intake of ultra-processed meats and fish was positively associated with DBP (<i>β</i> = 0·48 (95 % CI: 0·02, 0·94)) among males and intake of ultra-processed sugary beverages was positively associated with SBP (0·80 (0·13, 1·48)) and DBP (0·93 (0·34, 1·51)) among females. Among females only, SBP at age 18 was positively associated with total UPF intake at age 15 (0·25 (0·00, 0·50)). In this cohort, there were modest, positive associations between BP and UPF intake, which varied by sex and age. UPF intake during the transition to adulthood may be linked to higher BP, supporting efforts to limit adolescents' intake in LMICs.