Consumption of Ultra-Processed Foods and Sustainable Lifestyles: A Multicenter Study

Global rates of overweight and obesity have increased considerably over the past 40 years [1,2], leading researchers to explore the mechanisms that contribute to this phenomenon. While numerous biological (e.g., genetic and hormonal) and behavioral (e.g., sedentary lifestyle) factors are known to be associated with obesity [3], one of the key systemic changes in our environment, which has followed the rise in obesity rates, has been the exponential increase in ultra-processed foods (UPFs) in our food system since the 1980s [4,5]. UPFs are not found in nature and have been developed to improve the organoleptic characteristics, safety and shelf life of foods, among other purposes, by adding fats, sugars, salt and non-caloric sweeteners [6]. Some examples of UPF are packaged snacks (sweet and salty), fast food and sugary beverages [5,6]. Many of these products, while they may contain certain nutrients, have an intrinsic nutritional imbalance, compared to unprocessed foods, positioning them as products of low nutritional quality and with a potential negative impact on health. And although some may be fortified, they generally contain low levels of fiber, vitamins or minerals, to mention a few of their nutritional deficiencies [7].

Latin America and Spain share common cultural and dietary patterns and are undergoing similar nutritional transition processes. However, these regions have experienced rapid dietary changes driven by urbanization, market globalization and the aggressive marketing of packaged foods. The food price crisis has further contributed to poor diet quality, food insecurity and malnutrition [8]. While the association between ultra-processed food consumption and non-communicable diseases (NCDs) is well established, less is known about how these consumption patterns relate to sustainable lifestyle behaviors, including dietary, transport and environmental practices. Understanding this relationship is essential for designing integrated interventions that promote both health and sustainability [9,10].

In this sense, a sustainable lifestyle is considered to be a set of consumption patterns and habits that minimize negative environmental impact. The growing body of scientific evidence on sustainability increasingly highlights the importance of transforming food systems; therefore, there is currently more talk of sustainable diets than individual dietary prescriptions [11]. However, the current challenge is to address measurement aspects with indicator options that allow the assessment of sustainable lifestyles related to food in all its facets [12].

At the regional level, various studies have analyzed the consumption of UPF, finding high consumption in various age groups such as adults, university students, children and adolescents [13,14,15,16,17]. The results of this research highlight that excessive consumption of UPF is associated with middle to high incomes, obesity, lower quality of life and lower quality of sleep [18].

Furthermore, other regional studies have shown that UPF consumption is detrimental to the consumption of foods that are considered healthy; associated with increased blood glucose levels; negatively associated with sleep quality and overall diet quality; and associated with weight gain and consequently high rates of overweight and obesity, as well as increased consumption of fried foods [19,20,21,22,23].

There is growing evidence of the impact of our food choices on health and the environment [24]. Furthermore, the current production and consumption patterns of UPFs are estimated to contribute substantially to total greenhouse gas emissions and waste generation, and are considered a major cause of biodiversity loss, deforestation, water extraction and pollution [25,26]. Given that they are not nutritionally essential, are associated with adverse health effects, and generate significant economic and social costs, reducing their consumption could simultaneously benefit public health and environmental sustainability [27,28,29,30]. Nevertheless, existing reviews do not consider the diversity of terms used to classify foods such as UPFs, which can influence the interpretation of their environmental impacts in studies [31].

Recently, our research group at the Latin American Food and Nutrition Network (RedLIAN) found that people with plant-based diets showed a positive association with sustainable lifestyles, while people with Western dietary patterns showed a negative association, meaning that they had less sustainable lifestyles [32]. Despite the growing evidence linking UPF consumption to adverse health outcomes, its relationship with sustainable lifestyle behaviors remains largely unexplored. Addressing this gap is essential to inform integrated public health and sustainability strategies, particularly in regions undergoing rapid nutrition transitions.

Our hypothesis is that people who consume a high amount of UPF have lower sustainable lifestyle scores than those who consume less. Therefore, the objective of this study is to estimate the association of the frequency of UPF consumption with sustainable lifestyles in Latin America and Spain.

An observational, analytical, multicenter, cross-sectional survey-based study was conducted with a total of 6009 participants. The study took place between March 2023 and January 2024. The questionnaire was disseminated through social media (Instagram, Facebook, LinkedIn and X) and used non-probability snowball sampling.

Overall, most of the study participants were female (78.5%) and younger than 60 years (95.2%), with an average age of 34.98 ± 12.55 years, and had a high school educational level (70.6%). The overall mean BMI was 25.30 ± 5.20 kg/m². Among those with higher UPF intake, the BMI was significantly higher than among those with lower intake (25.91 ± 6.22 kg/m²). Furthermore, it was found that those with higher UPF intake were significantly younger (˂30 years). Furthermore, among subjects with a higher educational level, most of them had lower or no UPF intake. Furthermore, it can be noted that residents of rural areas have significantly lower UPF consumption than residents of urban areas. In almost all countries, residents of each of them predominantly consumed UPF moderately (Table 1).

Figure 1 shows the analysis of ultra-processed food (UPF) consumption by food group and country, revealing that El Salvador, Peru and Bolivia have the highest consumption of salty snacks, with percentages of 26.9%, 22.8% and 19%, respectively. Costa Rica, El Salvador and Guatemala had the highest consumption of sweet snacks (38.9%, 33.9% and 32.0% respectively). The countries with the highest fast food consumption profile were Guatemala, Paraguay and Costa Rica (89.8%, 84.5% and 83.1%, respectively). Regarding beverages and juices, El Salvador and Bolivia had the highest consumption (42.9% and 33.2%, respectively).

In general, moderate consumption was most prevalent in all food groups (). Supplementary Table S1

According to sociodemographic variables, it was observed that occasional fast food consumption was higher among those with basic education (78.6%), those younger than 30 years of age (79.7%) and women (76.4%). Beverages and juices were consumed mostly occasionally, specifically by people with a basic education level (46.3%), those younger than 30 years of age (47.4%) and men (43.4%). Sweet snacks were also consumed mostly occasionally by those with basic education (46.3%), those younger than 30 years of age (46.3%) and women (42.7%). On the other hand, it is highlighted that the consumption of salty snacks was lower in people with a medium academic level (51.4%), in those under 60 years of age (68.9%) and in women (50.3%) (Table 2).

Compared with non-consumers, moderate fast food consumption was associated with 75% higher odds of having a worse SLE (OR = 1.97; 95% CI: 1.70–2.29; p < 0.001), while daily (excessive) consumption almost doubled the odds (OR = 2.51; 95% CI: 1.79–3.54; p < 0.001). Moderate consumption of sugary drinks and juices was associated with 55% higher odds of having a less sustainable lifestyle (OR = 1.61; 95% CI: 1.41–1.84; p < 0.001), while these odds increased to 82% with daily consumption (OR = 1.82; 95% CI: 1.50–2.22; p < 0.001). Regarding the moderate consumption of salty snacks, 51% increased odds of having a low EVS score were observed (OR = 1.51; 95% CI: 1.32–1.73; p < 0.001). Furthermore, those who consumed sweet snacks moderately had 27% increased odds of having a poor EVS profile (OR = 1.27; 95% CI: 1.11–1.46; p < 0.001). This probability increased to almost 42% in excessive consumers of this UPF group (OR = 1.42; 95% CI: 1.20–1.67; p < 0.001) (Table 3).

Unlike previous studies focusing exclusively on health outcomes, this study empirically links ultra-processed food consumption with multidimensional sustainable lifestyle behaviors across multiple countries. In this study, which examined the association between UPF consumption and sustainable lifestyles, it was found that participants with moderate to excessive UPF consumption were more likely to be in the least sustainable quartile compared to the most sustainable quartile.

Behaviorally, individuals with high UPF consumption may be more prone to impulsive food choices, lower environmental awareness and sedentary routine factors that contribute to unsustainable lifestyles. From an environmental perspective, UPFs are resource-intensive, relying heavily on energy, packaging and long-distance transportation, which increases their ecological footprint. These findings are aligned with previous studies highlighting the dual burden of UPFs: worsening population health and exacerbating climate and environmental damage [34,35].

The results of this study regarding BMI show that excessive consumption of UPF is associated with an increase in this parameter; in this case, the participants who exhibit this pattern were classified as overweight. Two prospective cohorts (n = 1827 and n = 8451) have demonstrated an approximately 20–30% higher risk of large increases in weight and waist circumference and a higher incidence of overweight/obesity. Participants in the highest quartile of ultra-processed food consumption had a higher risk of developing overweight or obesity than those in the lowest quartile [36,37].

We have also observed that the highest consumption of UPF was found in the young adult population, as observed in the studies by Andrade et al. and Silveira et al. [38,39]. We have also noticed that people with a higher educational level consumed them in lower proportions, a result supported by those obtained by Marrón-Ponce et al., in whose study it was confirmed that people with less education have a higher consumption of this type of food product [40]. The high consumption of UPF recorded in the younger population could be explained, in part, by their greater willingness to adopt new dietary patterns and innovations [41], as well as by the intense marketing strategy for industrialized products aimed at this age group [42].

It should be noted that trends in ultra-processed food consumption vary by country. However, it should be noted that the growing popularity of ultra-processed foods in Latin America is significantly associated with the prevalence of non-communicable diseases in this region. This association is gradual and reflects the growing urbanization and interaction with external markets in the Latin American economy [10].

Being over 60 years old, having a basic education level, and being female were determining factors for consuming fast food, sweet snacks, beverages and juices, with the exception of the latter, where men consumed them the most. Specifically, it was found that consumption of sugary drinks and juices is determined by sex (male), being over 40 years of age and having a primary education level, as seen in a previous study in 12 Latin American countries [43]. On the other hand, lower consumption of salty snacks was found among women, those under 60 years of age and those with a medium educational level. In this regard, a study found that gender, academic level and age are factors that influence the consumption of salty snacks. People with lower income and education and men consumed substantially more calories from these sources according to the study by Cohen et al. [44]. This may be because women consumed significantly fewer of these calories than men, considering their lower energy needs, and higher educational attainment and age may be considered strong predictors of lower total and relative calorie intake from these sources.

The main and most notable result we obtained in this study is that a higher consumption of UPF, in all its food groups (fast food, sugary drinks, sweet and salty snacks) was significantly associated with lower scores on the sustainable lifestyle index; that is, people with moderate to excessive consumption are more likely to be in the least sustainable quartile of lifestyles (Q1) than in the most sustainable (Q4). These findings indicate a clear inverse association between the frequency of UPF consumption and adherence to sustainable lifestyle behaviors in a large sample from Latin America and Spain. This supports the growing body of literature suggesting that dietary patterns high in UPFs are detrimental not only to individual health but also to environmental sustainability [45].

The fact that fast food and sugary drinks and juices were most likely to be in the least sustainable quartile is consistent with their well-documented environmental and health costs, including plastic packaging waste, water use, and links to obesity and metabolic diseases [46].

Reducing the intake of ultra-processed foods could yield substantial benefits for both individual health and planetary well-being. From a health perspective, lowering UPF consumption has been linked to reduced risks of obesity, metabolic syndrome and other non-communicable diseases. Such dietary shifts could help alleviate the growing burden on healthcare systems in the region. Environmentally, a population-level reduction in UPF demand could significantly decrease greenhouse gas emissions, plastic waste and the overexploitation of natural resources associated with industrial food production. It would also foster greater demand for locally produced, minimally processed foods, potentially supporting regional food sovereignty and biodiversity. Moreover, such changes could help realign food systems with sustainability targets outlined in global frameworks such as the UN Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 12 (Responsible Consumption and Production) [47].

In summary, our findings support the need to model food environments that guarantee food security, while ensuring food sovereignty and sustainable food systems, contextually appropriate and culturally accepted by each region for the benefit of health and the environment.

This multicenter study shows that high UPF consumption is inversely associated with sustainable lifestyles. Our results reinforce the need to integrate environmental criteria into dietary guidelines and policy actions. Reducing UPF intake should be prioritized in sustainability and public health agendas, particularly in countries undergoing rapid nutrition transitions. These findings suggest that reducing UPF consumption could serve as a dual strategy to promote both healthier and more sustainable lifestyles, supporting integrated public health and environmental policies. The approach to sustainable lifestyles must be based on objective assessments of eating patterns and their impact on them, and with this, we are opening an emerging line of research in this area.

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/nu18020365/s1↗. Table S1: UPF consumption of total population

Conceptualization: E.R.M.-M., S.P.-S., L.L.-D., P.P.-A., T.V.C.-A., M.J.N., B.M.C., G.G., I.R.-C., J.A.-F., K.C.-A., C.R.-C., A.G.M., G.M., M.M.-D., A.M.A., A.O., E.J.N.-G., J.J.B.-R., B.N.-M., J.P.M.L., J.d.A.C., J.T., S.M., S.C., G.M.M. and S.D.-A.; methodology: E.R.M.-M., S.P.-S., L.L.-D., P.P.-A., T.V.C.-A., M.J.N., B.M.C., G.G., I.R.-C., J.A.-F., C.R.-C., A.G.M., G.M., M.M.-D., A.M.A., A.O., E.J.N.-G., J.J.B.-R., B.N.-M., J.P.M.L., J.d.A.C., J.T., S.M., S.C., G.M.M. and S.D.-A.; data curation: C.V.-C.; formal analysis: E.R.M.-M., S.P.-S. and S.D.-A.; writing—original draft preparation: E.R.M.-M., S.P.-S., T.V.C.-A. and S.D.-A.; writing—review and editing: E.R.M.-M., S.P.-S., L.L.-D., P.P.-A., T.V.C.-A., M.J.N., B.M.C., G.G., I.R.-C., J.A.-F., K.C.-A., C.V.-C., C.R.-C., A.G.M., G.M., M.M.-D., A.M.A., A.O., E.J.N.-G., J.J.B.-R., B.N.-M., J.P.M.L., J.d.A.C., J.T., S.M., S.C., G.M.M. and S.D.-A. All authors have read and agreed to the published version of the manuscript.

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Universidad San Sebastián (code 25-23 and date of approval 23 June 2023).

All study participants read and signed informed consent.

The original contributions presented in this study are included in the article/. Further inquiries can be directed at the corresponding author. Supplementary Materials

The authors declare no conflicts of interest.

This research received no external funding. S.P.-S. acknowledges the funding provided by the International Event Participation Support Fund (FAPEI) of the Universidad del Bío-Bío, under grant code FP2531812.