This paper finds that consumption of ultra-processed foods - as defined by the NOVA food classification system - has risen from 53.5% to 57.0% of calorie intake among adults in the United States, over the time period 2001 to 2018. Consumption of minimally processed foods has fallen from 32.7% to 27.4% of caloric intake over the same period. It also assesses these trends by social factors including age, sex, ethnicity, education and income.
Accumulating evidence links ultra-processed foods to poor diet quality and chronic diseases. Understanding dietary trends is essential to inform priorities and policies to improve diet quality and prevent diet-related chronic diseases. Data are lacking, however, for trends in ultra-processed food intake.
We examined US secular trends in food consumption according to processing level from 2001 to 2018.
We analysed dietary data collected by 24-h recalls from adult participants (aged >19 y; N = 40,937) in 9 cross-sectional waves of the NHANES (2001–2002 to 2017–2018). We calculated participants’ intake of minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods as the relative contribution to daily energy intake (%kcal) using the NOVA framework. Trends analyses were performed using linear regression, testing for linear trends by modeling the 9 surveys as an ordinal independent variable. Models were adjusted for age, sex, race/ethnicity, education level, and income. Consumption trends were reported for the full sample and stratified by sex, age groups, race/ethnicity, education level, and income level.
Adjusting for changes in population characteristics, the consumption of ultra-processed foods increased among all US adults from 2001–2002 to 2017–2018 (from 53.5 to 57.0 %kcal; P-trend < 0.001). The trend was consistent among all sociodemographic subgroups, except Hispanics, in stratified analyses. In contrast, the consumption of minimally processed foods decreased significantly over the study period (from 32.7 to 27.4 %kcal; P-trend < 0.001) and across all sociodemographic strata. The consumption of processed culinary ingredients increased from 3.9 to 5.4 %kcal (P-trend < 0.001), whereas the intake of processed foods remained stable at ∼10 %kcal throughout the study period (P-trend = 0.052).
The current findings highlight the high consumption of ultra-processed foods in all parts of the US population and demonstrate that intake has continuously increased in the majority of the population in the past 2 decades.
Juul, F., Parekh, N., Martinez-Steele, E., Monteiro, C.A. and Chang, V.W., 2021. Ultra-processed food consumption among US adults from 2001 to 2018. The American Journal of Clinical Nutrition, nqab305.
Read the full paper here. See also the TABLE explainer What is ultra-processed food? And why do people disagree about its utility as a concept?