Consumption of Unprocessed and Ultraprocessed Foods in Adolescents with Obesity: Associations with Neuroendocrine Mediators of Appetite Regulation and Binge Eating Symptoms

Background/Objectives: Obesity is a multifactorial disease associated with increased consumption of ultraprocessed foods and reduced intake of unprocessed foods. Binge eating, one of the most prevalent eating disorders among adolescents, is closely linked to obesity. Food intake is regulated by both the hedonic system, responsible for reward responses, and the physiological system, which controls hunger and satiety through hormones, such as ghrelin and leptin. The present study aimed to investigate associations between the intake of unprocessed and ultraprocessed foods, neuroendocrine mediators of appetite regulation, and binge eating in adolescents with obesity. Methods: This cross-sectional study included 96 adolescents with obesity who were recruited in São Paulo, Brazil, between 2010 and 2012. Anthropometric and body composition assessments were performed. Binge eating symptoms were evaluated using the binge eating scale (BES), and dietary intake was assessed with a validated Food Frequency Questionnaire, with items classified according to the Nova system. Frequency data were converted into annual consumption scores. Serum levels of ghrelin, leptin, neuropeptide Y (NPY), agouti-related peptide (AgRP), melanin-concentrating hormone (MCH), and alpha-melanocyte-stimulating hormone (α-MSH) were analyzed. Results: Lower consumption of unprocessed foods was associated with higher ghrelin concentrations (p = 0.023), accompanied by a greater percentage of body fat (p = 0.047) and a reduced percentage of lean mass (p=0.047) compared with adolescents in the second tertile. AgRP was a positive predictor of annual consumption score of ultraprocessed food (β = 0.30; p = 0.04), independent of age, body fat, and binge eating symptoms. Conclusions: In conclusion, lower intake of unprocessed foods was associated with alterations in orexigenic and anorexigenic mediators, suggesting that dietary patterns in adolescents with obesity may influence the neuroendocrine mediators of appetite regulation.