ltra-processed food consumption among US adults from 2001 to 201

Author(s)

Juul, Filippa ^[1] ; Parekh, Niyati ^{[2, 1, 3]} ; Martinez-Steele, Euridice ^{[4, 5]} ; Monteiro, Carlos Augusto ^{[4, 5]} ; Chang, Virginia W. ^{[2, 1]}

Affiliation

^[1] NYU, Sch Global Publ Hlth, New York, NY 10012 - USA

^[2] NYU, Grossman Sch Med, New York, NY - USA

^[3] NYU, Rory Meyers Sch Nursing, New York, NY - USA

^[4] Univ Sao Paulo, Sch Publ Hlth, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Ctr Epidemiol Studies Hlth & Nutr, Sao Paulo - Brazil

• Document type: Journal article
• Source: AMERICAN JOURNAL OF CLINICAL NUTRITION; v. 115, n. 1, p. 211-221, JAN 2021.
• Web of Science Citations: 1

Abstract

Background: Accumulating evidence links ultra-processed foods to poor diet quality and chronic diseases. Understanding dietary trends is essential to inform priorities and policies to improve diet quality and prevent diet-related chronic diseases. Data are lacking, however, for trends in ultra-processed food intake. Objectives: We examined US secular trends in food consumption according to processing level from 2001 to 2018. Methods: We analyzed dietary data collected by 24-h recalls from adult participants (aged >19 y; N = 40,937) in 9 cross-sectional waves of the NHANES (2001-2002 to 2017-2018). We calculated participants' intake of minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods as the relative contribution to daily energy intake (%kcal) using the NOVA framework. Trends analyses were performed using linear regression, testing for linear trends by modeling the 9 surveys as an ordinal independent variable. Models were adjusted for age, sex, race/ethnicity, education level, and income. Consumption trends were reported for the full sample and stratified by sex, age groups, race/ethnicity, education level, and income level. Results: Adjusting for changes in population characteristics, the consumption of ultra-processed foods increased among all US adults from 2001-2002 to 2017-2018 (from 53.5 to 57.0 %kcal; P-trend < 0.001). The trend was consistent among all sociodemographic subgroups, except Hispanics, in stratified analyses. In contrast, the consumption of minimally processed foods decreased significantly over the study period (from 32.7 to 27.4 %kcal; P-trend < 0.001) and across all sociodemographic strata. The consumption of processed culinary ingredients increased from 3.9 to 5.4 %kcal (P-trend < 0.001), whereas the intake of processed foods remained stable at similar to 10 %kcal throughout the study period (P-trend = 0.052). Conclusions: The current findings highlight the high consumption of ultra-processed foods in all parts of the US population and demonstrate that intake has continuously increased in the majority of the population in the past 2 decades. (AU)

• FAPESP's process: 18/17972-9 - Ultra-processed foods and 'protein leverage hypothesis': a study in seven countries
• Grantee: Eurídice Martínez Steele
• Support Opportunities: Scholarships in Brazil - Post-Doctoral