These results remained statistically significant after adjustment for the nutritional quality of the diet and energy intake. UPF intake was associated with a higher risk of overweight ( n = 7,063 overweight participants hazard ratio (HR) for an absolute increase of 10% of UPFs in the diet = 1.11, 95% CI: 1.08–1.14 P < 0.001) and obesity ( n = 3,066 incident obese participants HR 10% = 1.09 (1.05–1.13) P < 0.001). After adjusting for age, sex, educational level, marital status, physical activity, smoking status, alcohol intake, number of 24-hour dietary records, and energy intake, we observed a positive association between UPF intake and gain in BMI (β Time × UPF = 0.02 for an absolute increment of 10 in the percentage of UPF in the diet, P < 0.001). Associations with risk of overweight and obesity were assessed using Cox proportional hazard models. ![]() ![]() Associations between the proportion of UPF in the diet and BMI change during follow-up were assessed using linear mixed models. Dietary intakes were collected at baseline using repeated and validated 24-hour dietary records linked to a food composition database that included >3,500 different food items, each categorized according to their degree of processing by the NOVA classification. A total of 110,260 adult participants (≥18 years old, mean baseline age = 43.1 years 78.2% women) from the French prospective population-based NutriNet-Santé cohort (2009–2019) were included.
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