Consumption of Ultraprocessed Foods and Diet Quality Among US Children and Adult

Author(s)

Liu, Junxiu ^{[1, 2]} ; Steele, Euridice Martinez ^{[3, 4]} ; Li, Yan ^{[1, 5]} ; Karageorgou, Dimitra ^[2] ; Micha, Renata ^[2] ; Monteiro, Carlos A. ^{[3, 4]} ; Mozaffarian, Dariush ^[2]

Affiliation

^[1] Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, 1 Gustave L Levy Pl, New York, NY 10029 - USA

^[2] Tufts Univ, Gerald J & Dorothy R Friedman Sch Nutr Sci & Poli, Boston, MA 02111 - USA

^[3] Univ Sao Paulo, Sch Publ Hlth, Dept Nutr, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Ctr Epidemiol Studies Hlth & Nutr, Sao Paulo - Brazil

^[5] Icahn Sch Med Mt Sinai, Dept Obstet Gynecol & Reprod Sci, New York, NY 10029 - USA

• Document type: Journal article
• Source: AMERICAN JOURNAL OF PREVENTIVE MEDICINE; v. 62, n. 2, p. 252-264, FEB 2022.
• Web of Science Citations: 0

Abstract

Introduction: Consumption of ultraprocessed foods has been linked with higher intake of added sugars, sodium, and unhealthful fats, but the associations of ultraprocessed foods with overall diet quality and major food groups are not well known. Methods: Data were derived from the National Health and Nutrition Examination Survey (2015 -2018), including 9,758 adults (aged >20 years) and 5,280 children (aged 2-19 years) with 24hour dietary recalls (>1), with analysis performed in 2020. Ultraprocessed foods were identified using the NOVA classification, with intake (% energy) assessed in quintiles. Diet quality was assessed using the validated American Heart Association 2020 continuous primary and secondary diet scores and Healthy Eating Index 2015. Poor diet was defined as <40% adherence to the American Heart Association secondary score. Generalized linear regressions estimated relationships between ultraprocessed food intake and diet quality. Results: Compared with the lowest quintile of ultraprocessed food consumption (<39.1% energy), the American Heart Association primary score in adults was progressively lower in Quintile 2 (-1.99, 95% CI= -2.73, -1.25), Quintile 3 (-3.60, 95% CI= -4.47, -2.72), Quintile 4 (-5.29, 95% CI= -6.28, -4.30), and Quintile 5 (-7.24, 95% CI= -8.13, -6.36; >70.7% energy). Corresponding values in children were -2.05 (95% CI= -3.01, -1.09), -2.97 (95% CI= -4.16, -1.79), -3.82 (95% CI= -5.20, -2.44), and -6.22 (95% CI= -7.20, -5.25; >79.0% energy). The estimated proportion of children having poor diet progressively increased from 31.3% (95% CI=26.2%, 36.5%) in Quintile 1 up to 71.6% (95% CI=68.1%, 75.1%) in Quintile 5. Corresponding proportions of adults having poor diet increased from 18.1% (95% CI=14.3%, 22.0%) in Quintile 1 up to 59.7% (95% CI=55.3%, 64.1%) in Quintile 5. Findings were similar using the American Heart Association secondary score and Healthy Eating Index 2015 score. Conclusions: Higher ultraprocessed food consumption is associated with substantially lower diet quality among children and adults. (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
• 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