Effectiveness and metabolic impacts of restricting the consumption of ultra-processed foods in individuals with obesity submitted to energy restriction: a randomized clinical trial.

UPF restriction combined with energy restriction produced greater weight loss than generic energy restriction alone over 12 months.

• Final bodyweight values were 82.9 [79.6; 86.2] kg in the ER-UPF group vs. 86.3 [83.0; 89.7] kg in the ER-G group (p = 0.01).
• Monthly bodyweight data analysis showed the ER-UPF group lost more weight compared to the ER-G group.
• The authors characterized this difference as statistically but non-clinically significant.
• 148 individuals were included in the 12-month randomized parallel clinical trial.

The UPF restriction intervention reduced the NOVA-UPF Score significantly more than the generic energy restriction group.

• ER-UPF group reduced the NOVA-UPF Score from 2.74 [2.28; 3.20] to 1.86 [1.18; 2.53] at 12 months.
• ER-G group NOVA-UPF Score changed from 2.62 [2.15; 3.09] to 2.47 [1.76; 3.17] at 12 months.
• The between-group difference in NOVA-UPF Score was statistically significant (p = 0.03).

UPF consumption as a percentage of total diet decreased in both groups but the difference between groups was not statistically significant.

• Baseline UPF intake was 21.16 [18.42; 23.90]% in the ER-UPF group and 23.70 [20.92; 26.48]% in the ER-G group.
• At 12 months, UPF intake decreased to 13.86% in the ER-UPF group and to 20.02% in the ER-G group.
• The between-group difference in UPF percentage intake at 12 months was not statistically significant (p = 0.08).
• The decreases in UPF intake were described as significantly smaller than expected.

No significant between-group differences were observed in anthropometric, body composition, metabolic, or biochemical outcomes other than body weight.

• Despite greater weight loss in the ER-UPF group, no changes were observed in the other outcomes measured.
• Outcomes assessed included anthropometric, dietary, body composition, metabolic, and biochemical data.
• Energy requirements were determined using calorimetry and accelerometry data.

Participants had relatively low baseline UPF intake, which the authors suggest may have limited the effectiveness of the UPF restriction intervention.

• Baseline UPF intake ranged from approximately 21% to 24% of total dietary intake across groups.
• The authors stated that the findings 'may be partially explained by the fact that individuals had low UPF intake in the baseline.'
• The authors recommend that future studies should focus on populations with higher basal UPF intake.
• The trial was 12 months in duration with 148 participants randomly allocated to two parallel groups.