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

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dc.contributor.author Martínez Steele, Euridice en
dc.contributor.author Popkin, Barry M en
dc.contributor.author Swinburn, Boyd en
dc.contributor.author Monteiro, Carlos A en
dc.date.accessioned 2018-11-28T21:32:45Z en
dc.date.issued 2017-02-14 en
dc.identifier.citation Population health metrics 15(1):6 14 Feb 2017 en
dc.identifier.issn 1478-7954 en
dc.identifier.uri http://hdl.handle.net/2292/44656 en
dc.description.abstract 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.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.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.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. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries Population health metrics en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Humans en
dc.subject Micronutrients en
dc.subject Dietary Proteins en
dc.subject Diet en
dc.subject Nutrition Surveys en
dc.subject Linear Models en
dc.subject Cross-Sectional Studies en
dc.subject Feeding Behavior en
dc.subject Energy Intake en
dc.subject Nutritive Value en
dc.subject Principal Component Analysis en
dc.subject Food Handling en
dc.subject Dietary Fiber en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Middle Aged en
dc.subject Child en
dc.subject Child, Preschool en
dc.subject Infant en
dc.subject Female en
dc.subject Male en
dc.subject Young Adult en
dc.subject Fast Foods en
dc.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. en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12963-017-0119-3 en
pubs.issue 1 en
pubs.begin-page 6 en
pubs.volume 15 en
dc.rights.holder Copyright: The authors en
dc.identifier.pmid 28193285 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 614026 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Epidemiology & Biostatistics en
dc.identifier.eissn 1478-7954 en
pubs.record-created-at-source-date 2017-02-14 en
pubs.dimensions-id 28193285 en


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