The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study

Population Health Metrics

Research

Carlos A. Monteiro¹  Euridice Martínez Steele¹  Barry M. Popkin²  Boyd Swinburn³ 

[1] Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, 01246-907, São Paulo, Brazil;Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil;Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;School of Population Health, University of Auckland, Auckland, New Zealand;

关键词: NHANES;    Ultra-processed;    Dietary nutrient profile;    PCA;    Dietary patterns;    Diet quality;    Macronutrients;    Micronutrients;   

DOI  :  10.1186/s12963-017-0119-3

 received in 2016-05-27, accepted in 2017-01-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRecent population dietary studies indicate that diets rich in ultra-processed foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients, individually and overall.MethodsWe evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-processed foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-processed foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment.ResultsThe average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-processed foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose–response association was found between ultra-processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars.ConclusionsThis study suggests that decreasing the dietary share of ultra-processed foods is a rational and effective way to improve the nutritional quality of US diets.

【 授权许可】

CC BY   
© The Author(s). 2017