AIMS: Ultra-processed foods (UPFs; industrially produced foods typically containing unnaturally elevated levels of refined carbohydrates and/or added fats) became more widely introduced into the United States (US) food environment in the 1980s and have proliferated since. UPFs have been shown to trigger an addictive-like response. This study examines the prevalence of ultra-processed food addiction (UPFA) in older US adults and its association with various health domains.
DESIGN: In July 2022, a cross-sectional online and telephone survey was conducted using the University of Michigan National Poll on Healthy Aging (NPHA). Gender-stratified analyses examined the association between UPFA and perceptions of physical and mental health, and social isolation. Prevalence ratios were calculated, unadjusted and adjusted for age, race/ethnicity, education, and income.
SETTING: Nationally representative sample of older adults (aged 50-80 years) in the United States.
PARTICIPANTS: The sample included 2038 older adults (49.4% aged 50-64 years and 50.6% aged 65-80 years, 51.2% women, M age = 63.6, standard deviation = 8.1).
MEASUREMENTS: The modified Yale Food Addiction Scale 2.0 (validated measure that applies the diagnostic criteria for substance use disorder to the overconsumption of UPFs) was used to assess diagnostic criteria for UPFA. Various self-reported items were used to assess health-related domains (i.e., physical and mental health, social isolation).
FINDINGS: The overall prevalence of UPFA was 12.4%, higher among women (16.9%) than men (7.5%), with the highest rate in women aged 50-64 (21%). Men reporting being overweight were 19.14 (95% confidence interval [CI] [5.26-69.66]) times more likely to meet the criteria for UPFA. Women reporting being overweight were 11.44 (95% CI [4.56-28.71]) times more likely to meet UFPA criteria. Women and men reporting worse physical health were 1.93 (95% CI [1.26-2.98]) times and 2.99 (95% CI [1.70-5.26]) times more likely to meet the criteria for UPFA, respectively. Similarly, women reporting worse mental health were 2.78 (95% CI [1.79-4.32]) times more likely to meet the criteria for UPFA, with men 4.02 (95% CI [2.19-7.38]) times more likely. Lastly, women and men reporting feelings of social isolation were 3.40 (95% CI [2.16-5.34]) times and 3.35 (95% CI [1.83-6.14]) times more likely to meet UFPA criteria.
CONCLUSION: Ultra-processed food addiction appears to be prevalent among older adults in the United States, particularly among women who were in adolescence and early adulthood when the nutrient quality of the US food supply worsened. Addictive patterns of UPF intake appear to be associated with poorer physical health, mental health, and social well-being.
