# Association of ultra-processed food patterns with overweight and obesity in the German health interview and examination survey for children and adolescents (KiGGS): a longitudinal study

## TL;DR

This study found that eating more ultra-processed foods is linked to a higher risk of overweight and obesity in German children and adolescents over time.

## Contribution

This is one of the few longitudinal studies showing a strong link between ultra-processed food consumption and obesity in children and adolescents.

## Key findings

- Each 10% increase in ultra-processed food consumption was linked to a 12% higher risk of overweight.
- Children in the highest quartile of ultra-processed food intake had 49% higher odds of becoming overweight.
- Obesity risk more than doubled for children in the third quartile of ultra-processed food consumption.

## Abstract

Ultra-processed foods (UPF) consumption has been linked to adverse health outcomes, but evidence in children and adolescents from longitudinal studies remains limited. This study aimed to investigate the prospective associations between exposure to an UPF pattern and the incidence of overweight and obesity among German children and adolescents.

We analyzed 4,762 participants aged 3–17 years from a national cohort with baseline dietary data and anthropometric measures, followed for an average of 11 years. UPF intake was estimated from a Food Frequency Questionnaire using the Nova classification. Logistic regression models assessed associations with incident overweight and obesity, adjusting for age, sex, socioeconomic status, physical activity, and baseline BMI z score.

Each 10% increase in UPF consumption was associated with 12% higher odds of overweight (OR 1.12, 95% CI 1.03–1.23). Compared with the lowest quartile, participants in the highest quartile had 49% greater odds of overweight (OR 1.49, 95% CI 1.05–2.11). For obesity, odds were more than doubled in the third quartile (OR 2.32, 95% CI 1.38–3.88) and 74% higher in the fourth quartile (OR 1.74, 95% CI 1.06–2.84).

Higher exposure to UPF in childhood and adolescence was associated with greater risk of developing overweight and obesity. Strategies to limit UPF exposure may contribute to obesity prevention in this age group and later in life.

The online version contains supplementary material available at 10.1186/s12889-025-25181-y.