Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study

Author(s)

Machado, Priscila P. ^{[1, 2]} ; Steele, Euridice M. ^[1] ; Levy, Renata B. ^{[3, 1]} ; Sui, Zhixian ^[4] ; Rangan, Anna ^[5] ; Woods, Julie ^[6] ; Gill, Tim ^[7] ; Scrinis, Gyorgy ^[8] ; Monteiro, Carlos A. ^{[9, 1]}

Affiliation

^[1] Univ Sao Paulo, Ctr Epidemiol Res Nutr & Hlth, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Sch Publ Hlth, Grad Program Nutr Publ Hlth, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Prevent Med, Sao Paulo, SP - Brazil

^[4] Univ New South Wales, Sch Publ Hlth & Community Med, Sydney, NSW - Australia

^[5] Univ Sydney, Sch Life & Environm Sci, Charles Perkins Ctr, Sydney, NSW - Australia

^[6] Deakin Univ, Inst Phys Act & Nutr, Sch Exercise & Nutr Sci, Geelong, Vic - Australia

^[7] Univ Sydney, Charles Perkins Ctr, Boden Inst Obes Nutr Exercise & Eating Disorders, Sydney, NSW - Australia

^[8] Univ Melbourne, Sch Agr & Food, Melbourne, Vic - Australia

^[9] Univ Sao Paulo, Sch Publ Hlth, Dept Nutr, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: BMJ OPEN; v. 9, n. 8 AUG 2019.
• Web of Science Citations: 2

Abstract

Objective This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs). Design Cross-sectional study. Setting National Nutrition and Physical Activity Survey (2011-2012). Participants 12,153 participants aged 2+ years. Main outcome measures Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. Data analysis Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined. Results Ultra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised beta 0.43, p<0.001); total (<beta> 0.08, p<0.001), saturated (<beta> 0.18, p<0.001) and trans fats (<beta> 0.10, p<0.001); sodium (<beta> 0.21, p<0.001) and diet energy density (<beta> 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (<beta> -0.21, p<0.001) and potassium (<beta> -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile. Conclusion The high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs. (AU)

• FAPESP's process: 16/13168-5 - Consumption of ultra-processed foods, dietary nutrient profile and obesity in seven countries. An Australian population study
• Grantee: Priscila Pereira Machado
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 15/14900-9 - Consumption of ultra-processed foods, dietary nutrient profile diet and obesity in seven countries
• Grantee: Carlos Augusto Monteiro
• Support Opportunities: Research Projects - Thematic Grants