US adolescents get two-thirds of caloric intake from ultra-processed foods, flags dietary analysis

11 Aug 2021 --- Foods like ready meals and packaged desserts now make up over two-thirds (67 percent) of US children and teenagers’ caloric intake, according to a new analysis. 

However, calories from sugar-sweetened beverages (SSBs) have been falling, with the researchers calling for the “same energy and level of commitment” to be mobilized for other unhealthy food categories. 

“Food processing is an often-overlooked dimension in nutrition research,” argues senior and corresponding author Fang Fang Zhang, nutrition epidemiologist at the Friedman School, Tufts University, US.

“We may need to consider that ultra-processing of some foods may be associated with health risks, independent of the poor nutrient profile of ultra-processed foods generally.” 

While many consumers have trouble distinguishing between processed and ultra-processed foods, the researchers define ultra-processed foods as ready-to-eat or ready-to-heat items often high in added sugar, sodium and carbohydrates and low in fiber, protein, vitamins and minerals. 

They also typically contain added sugars, hydrogenated oils and flavor enhancers. Examples include packaged sweet snacks and desserts, sugary breakfast cereals, French fries, fast food burgers and some lunch meats such as bologna and salami.When consumed in excess, ultra-processed foods are linked with diabetes, obesity and certain cancers. 

Nuances within ultra-processed foods
The analysis, now published in JAMA, analyzed dietary intake from 33,795 US consumers aged 2-19 years between 1999 and 2018. 

Overall, the calories that children and adolescents consumed from ultra-processed foods jumped from 61 percent to 67 percent of total caloric intake from 1999 to 2018.

Over the study period, calories from often healthier unprocessed or minimally processed foods decreased from 28.8 percent to 23.5 percent. 

The remaining percentage of calories came from moderately processed foods such as cheese and canned fruits and vegetables, and consumer-added flavor enhancers such as sugar, honey, maple syrup and butter.

Zhang explains that some ultra-processed foods like whole-grain breads and dairy can still be healthier than other ultra-processed foods. Processing can keep food fresher longer, allows for food fortification and enrichment and enhances consumer convenience.

“However, many ultra-processed foods are less healthy, with more sugar and salt, and less fiber than unprocessed and minimally processed foods. The increase in their consumption by children and teenagers is concerning,” she details. 

Pervasive trends
The largest spike in calories came from such ready-to-eat or ready-to-heat dishes as takeout and frozen pizza and burgers, which rose from 2.2 percent to 11.2 percent of calories. 

The second largest spike in calories came from packaged sweet snacks and desserts, the consumption of which grew from 10.6 percent to 12.9 percent.

There was also a larger increase in the consumption of ultra-processed foods among non-Hispanic Black children (10.3 percent) and Mexican Americans (7.6 percent) than non-Hispanic white children (5.2 percent). Trends in other ethnic groups were not assessed due to a lack of sufficient data that allows for nationally representative estimates across survey cycles.

Additionally, parental education and family income seemed not to have a significant impact. Zhang says that this indicates that ultra-processed foods are pervasive in children’s diets.

“This finding supports the need for researchers to track trends in food consumption more fully, taking into account consumption of ultra-processed foods.”The average age of participants was 10.7 years and was roughly equally divided between boys and girls.

Drawing inspiration from SSBs
One positive finding was that calories from SSBs dropped from 10.8 percent to 5.3 percent of overall calories – a 51 percent decline.

“This finding shows the benefits of the concerted campaign over the past few years to reduce overall consumption of sugary drinks,” notes Zhang. 

An example of this global movement is the UK, where a sugar tax on soft drinks helped slash sugar intake from soft drinks by 10 percent. Meanwhile, The Union of European Soft Drinks Associations recently pledged to reduce sugar by a further 10 percent by 2025. 

“We need to mobilize the same energy and level of commitment when it comes to other unhealthy ultra-processed foods such as cakes, cookies, doughnuts and brownies,” Zhang emphasizes. 

In June, UK researchers also called for “more radical and effective” public health actions to reduce children’s exposure and consumption of ultra-processed foods. 

Previous research linked higher consumption of ultra-processed food with increased risk of developing Type 2 diabetes. 

Edited by Katherine Durrell