Journal Article

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

Sui, Zhixian, Machado, Priscila P, Rangan, Anna, Monteiro, Carlos A, Woods, Julie, Steele, Euridice M, Levy, Renata B, Gill, Tim, Scrinis, Gyorgy

2019

Overview

ObjectiveThis 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).DesignCross-sectional study.SettingNational Nutrition and Physical Activity Survey (2011-2012).Participants12,153 participants aged 2+ years.Main outcome measuresAverage dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs.Data analysisFood 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.ResultsUltra-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.ConclusionThe 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.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Australia / Beverages / Cereals / Classification / Cross-sectional studies / Descriptive labeling / Diet / Energy intake / Families & family life / Fast food / food consumption / food processing / Health care / Households / Interviews / Nutrients / Nutrition research / Obesity / Processed foods / Public Health / quality of diet / Soft drinks