Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study

Aug 30, 2019BMJ open

Ultra-processed foods and nutrient intake linked to chronic diseases in Australia: findings from a national survey

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Abstract

Ultra-processed foods accounted for 42.0% of energy intake among 12,153 Australian participants.

A positive trend was found between higher consumption of ultra-processed foods and increased intake of free sugars, total fats, saturated fats, trans fats, sodium, and diet energy density.
Higher quintiles of ultra-processed food consumption were associated with a decrease in dietary fibre and potassium intake.
The prevalence of non-recommended nutrient intake levels rose significantly across quintiles of ultra-processed food intake, with free sugars increasing from 22% to 82%.
The dietary contributions of unprocessed or minimally processed foods, processed foods, and processed culinary ingredients were lower at 35.4%, 15.8%, and 6.8%, respectively.
These findings suggest that reducing ultra-processed food consumption may enhance diet quality and help meet nutrient recommendations.

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OBJECTIVE: This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs).

DESIGN: Cross-sectional study.

SETTING: National Nutrition and Physical Activity Survey (2011-2012).

PARTICIPANTS: 12,153 participants aged 2+ years.

MAIN OUTCOME MEASURES: Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs.

DATA ANALYSIS: Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined.

RESULTS: Ultra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p<0.001); total (β 0.08, p<0.001), saturated (β 0.18, p<0.001) and trans fats (β 0.10, p<0.001); sodium (β 0.21, p<0.001) and diet energy density (β 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (β -0.21, p<0.001) and potassium (β -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile.

CONCLUSION: The high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.

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Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study

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