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

Steele, Euridice Martínez, Popkin, Barry M., Swinburn, Boyd and Monteiro, Carlos A. 2017, 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, vol. 15, pp. 1-11, doi: 10.1186/s12963-017-0119-3.

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Title The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study
Author(s) Steele, Euridice Martínez
Popkin, Barry M.
Swinburn, Boyd
Monteiro, Carlos A.
Journal name Population health metrics
Volume number 15
Article ID 6
Start page 1
End page 11
Total pages 11
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2017-02-14
ISSN 1478-7954
Keyword(s) Diet quality
Dietary nutrient profile
Dietary patterns
Macronutrients
Micronutrients
NHANES
PCA
Ultra-processed
Adolescent
Adult
Aged
Child
Child, Preschool
Cross-Sectional Studies
Diet
Dietary Fiber
Dietary Proteins
Energy Intake
Fast Foods
Feeding Behavior
Female
Food Handling
Humans
Infant
Linear Models
Male
Middle Aged
Nutrition Surveys
Nutritive Value
Principal Component Analysis
Young Adult
Summary BACKGROUND: Recent 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.

METHODS: We 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.

RESULTS: The 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.

CONCLUSIONS: This 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.
Language eng
DOI 10.1186/s12963-017-0119-3
Field of Research 1117 Public Health And Health Services
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30099430

Document type: Journal Article
Collections: School of Health and Social Development
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.