Global trends in ultraprocessed food and drink product sales and their association with adult body mass index trajectories

Abstract

Summary This study evaluated global trends in ultraprocessed food and drink (UPFD) volume sales/capita and associations with adult body mass index (BMI) trajectories. Total food/drink volume sales/capita from Euromonitor for 80 countries (2002‐2016) were matched to mean adult BMI from the NCD Risk Factor Collaboration (2002‐2014). Products were classified as UPFD/non‐UPFD according to the NOVA classification system. Mixed models for repeated measures were used to analyse associations between UPFD volume sales/capita and adult BMI trajectories, controlling for confounding factors. The increase in UPF volume sales was highest for South and Southeast Asia (67.3%) and North Africa and the Middle East (57.6%), while for UPD, the increase was highest for South and Southeast Asia (120.0%) and Africa (70.7%). In 2016, baked goods were the biggest contributor to UPF volume sales (13.1%‐44.5%), while carbonated drinks were the biggest contributor to UPD volume sales (40.2%‐86.0%). For every standard deviation increase (51 kg/capita, 2002) in UPD volume sales, mean BMI increased by 0.195 kg/m2 for men (P < .001) and 0.072 kg/m2 for women (P = .003). For every standard deviation (40 kg/capita, 2002) increase in UPF volume sales, mean BMI increased by 0.316 kg/m2 for men (P < .001), while the association was not significant for women. Increases in UPFD volume sales/capita were positively associated with population‐level BMI trajectories.

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“…These products are high in salt, fat and/or sugar, and people who frequently consume ultra-processed products in their diets often have low intakes of fresh fruits and vegetables [57]. Sales of ultra-processed products have been shown to be increasing globally, including in LMICs, with corresponding increases in body mass index [58]. While we have investigated components of diet quality, we were not able to investigate the level of consumption of ultra-processed products, which may be a reason for the overall minimal associations observed between the diet behaviours and cardiovascular risk factors.…”

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“…The effect of food labelling has not been extensively studied in low-and middle-income countries where consumers may have different profiles than their peers in high-income countries, where evidence about the positive effect of food labelling interventions is still inconclusive [41]. Because there is a positive association between ultra-processed foods and drinks sales and BMI at the population level [46], policies should look for the strongest interventions to reduce their purchasing and consumption.…”

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“…The increase in food energy supply over several decades has been suggested as a major driver of the obesity epidemic . Vandevijvere et al showed that the sales of ultra‐processed foods and drinks (UPFD) increased substantially over 15 years in all regions worldwide, except in Western Europe, North America, and Australasia, where UPFD product sales were already very high during the early 2000s. This study found that an increase in UPFD volume sales/capita was positively associated with population‐level body mass index (BMI) trajectories.…”