Consumption of ultra-processed foods and non-communicable disease-related nutrient profile in Portuguese adults and elderly (2015–2016): the UPPER project

Abstract

This study aims to investigate the dietary share of ultra-processed foods and its association with non-communicable diseases (NCDs)-related nutrient profile of adult and elderly population in Portugal. Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015–2016) of the Portuguese population has been analyzed. Dietary intake was assessed by two non-consecutive 24-h recalls and food items were classified according to the NOVA system. We estimated the percentage of dietary energy provided by each of the NOVA food groups and assessed the NCD-related nutrient profile of the overall diet across quintiles of ultra-processed foods consumption. Weighted t-test, besides crude and adjusted linear and Poisson regressions have been performed. Ultra-processed foods contributed with around 24% and 16% of daily energy intake for adults and elderly, respectively. In both groups, as the consumption of ultra-processed foods increased, the dietary content of free sugars, total fats and saturated fats increased, while the dietary content of protein decreased. In adults, the total energy intake, the dietary energy density, and content of carbohydrates also increased as the consumption of ultra-processed foods increased, while the dietary content of fibre, sodium and potassium decreased. The prevalence of those exceeding the upper limits recommended for free sugars and saturated fats increased by 544% and 153% in adults, and 619% and 60% in elderly, when comparing the lowest to the highest quintile of ultra-processed consumption. Such a scenario demands for effective strategies addressing food processing in Portuguese population to improve their diet quality and prevention against diet-related NCDs.

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

“…Other reasons are related to socio-economic inequalities, including lower education status of the mother or unemployed parents, which may lead to a preference for cheaper and less nutritious foods [ 105 ]. A different trend was observed for older subjects who showed a lower intake of UPF compared to younger subjects; the main UPF products included cookies and pastries, but also processed breads, breakfast cereals, and yogurts [ 16 , 128 ]. Compared to age, a minor variability was found for sex and/or BMI, which might differ for the net amount of UPF consumption but not for the percent of TEI from UPF.…”

“…On average, the age of participants was 38.9 years, although half of the studies did not report this information. Fifteen studies focused only on children [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], seven on adolescents [31][32][33][34][35][36][37], five on pregnant women [38][39][40][41][42], and three on older subjects [43][44][45], whereas others focused on an adult population or on ≥2 target groups. Overall, 58.8% of participants were women.…”

Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples

“…A total of 29 additional studies were excluded for the following reasons: (i) did not report sufficient data (n = 14); (ii) did not include nationally representative samples (n = 6); (iii) did not use the NOVA classification system (n = 2); and (iv) were duplicates of previously selected more complete reports from the same survey (n = 7). Therefore, a total of 14 studies providing data for 13 unambiguously nationally representative samples were included in the present meta-analysis [22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Consumption of packaged foods by the Portuguese population: type of materials and its associated factors

“…Taking into consideration the consumption of ultra-processed food (UPF) by the adult Portuguese population, and using the NOVA classification, one-quarter of the total daily energy intake is coming from the UPF (De Miranda et al, 2020). Also a higher consumption of UPF was also associated with higher intake of free sugars and saturated fats (De Miranda et al, 2020).…”

“…Taking into consideration the consumption of ultra-processed food (UPF) by the adult Portuguese population, and using the NOVA classification, one-quarter of the total daily energy intake is coming from the UPF (De Miranda et al, 2020). Also a higher consumption of UPF was also associated with higher intake of free sugars and saturated fats (De Miranda et al, 2020). However, despite these results and the existence of dietary guidelines with recommendations for the consumption of fresh, in natura and unprocessed foods versus processed and ultra-processed products, it is not possible to directly relate this information with the consumption of PFs (A nova Roda dos Alimentos, 2003;Melo et al, 2014; U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015;WHO, 2003).…”