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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.
BMJ Open. 2019 08 28; 9(8):e029544.BO

Abstract

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.

Authors+Show Affiliations

Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil.Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil.Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil. Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.School of Agriculture and Food, The University of Melbourne, Melbourne, Victoria, Australia.Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil carlosam@usp.br. Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31462476

Citation

Machado, Priscila P., et al. "Ultra-processed Foods and Recommended Intake Levels of Nutrients Linked to Non-communicable Diseases in Australia: Evidence From a Nationally Representative Cross-sectional Study." BMJ Open, vol. 9, no. 8, 2019, pp. e029544.
Machado PP, Steele EM, Levy RB, et al. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. BMJ Open. 2019;9(8):e029544.
Machado, P. P., Steele, E. M., Levy, R. B., Sui, Z., Rangan, A., Woods, J., Gill, T., Scrinis, G., & Monteiro, C. A. (2019). Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. BMJ Open, 9(8), e029544. https://doi.org/10.1136/bmjopen-2019-029544
Machado PP, et al. Ultra-processed Foods and Recommended Intake Levels of Nutrients Linked to Non-communicable Diseases in Australia: Evidence From a Nationally Representative Cross-sectional Study. BMJ Open. 2019 08 28;9(8):e029544. PubMed PMID: 31462476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. AU - Machado,Priscila P, AU - Steele,Euridice M, AU - Levy,Renata B, AU - Sui,Zhixian, AU - Rangan,Anna, AU - Woods,Julie, AU - Gill,Tim, AU - Scrinis,Gyorgy, AU - Monteiro,Carlos A, Y1 - 2019/08/28/ PY - 2019/8/30/entrez PY - 2019/8/30/pubmed PY - 2020/9/1/medline KW - Australia KW - diet KW - food consumption KW - food processing KW - quality of diet SP - e029544 EP - e029544 JF - BMJ open JO - BMJ Open VL - 9 IS - 8 N2 - 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. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/31462476/Ultra_processed_foods_and_recommended_intake_levels_of_nutrients_linked_to_non_communicable_diseases_in_Australia:_evidence_from_a_nationally_representative_cross_sectional_study_ DB - PRIME DP - Unbound Medicine ER -