Neri Daniela, Martinez-Steele Euridice, Monteiro Carlos Augusto, Levy Renata Bertazzi
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil.
Pediatr Obes. 2019 Dec;14(12):e12563. doi: 10.1111/ijpo.12563. Epub 2019 Jul 30.
There is cumulative recognition that increases in the dietary share of ultra-processed foods result in deterioration of the nutritional quality of the overall diet and adverse health outcomes.
The purpose of this study was to assess the consumption of ultra-processed foods and to examine its association with added sugar content in the diet of US children aged 2 to 19 years.
We classified all food items according to the NOVA food classification system and looked at the consumption of ultra-processed foods, measured as percentage of total energy intake. We assessed dietary added sugar content by estimating its contribution to total energy intake and the proportion of individuals with diets exceeding the recommended limit of 10% of total energy intake from added sugars. We also examined the proportion of those who surpassed twice that limit. Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and estimates of added sugar content.
Ultra-processed foods contributed to 65% of total energy intake and to 92% of energy from added sugars in the diet of US children. The mean percent energy provided by added sugars in the observed period was 14.3%. Most individuals (70.9%) had diets exceeding the recommended limit of added sugar (<10% of total energy intake), and 18.4% of the population had diets surpassing twice the recommended level (20% of total energy intake). A 5.5% point increase in the dietary share of ultra-processed foods determined a 1 percentage point increase in the dietary content of added sugars, with stronger adjusted associations among younger children.
Public health efforts to reduce added sugars in the diet of US children must put greater emphasis on decreasing the consumption of ultra-processed foods.
人们逐渐认识到，超加工食品在饮食中所占份额的增加会导致整体饮食营养质量下降以及不良健康后果。
本研究旨在评估美国2至19岁儿童超加工食品的摄入量，并研究其与饮食中添加糖含量的关联。
我们根据NOVA食品分类系统对所有食品进行分类，以总能量摄入量的百分比来衡量超加工食品的摄入量。我们通过估计添加糖对总能量摄入的贡献以及饮食中添加糖摄入量超过推荐上限（总能量摄入的10%）的个体比例，来评估饮食中添加糖的含量。我们还研究了超过该上限两倍的人群比例。高斯回归和泊松回归估计了超加工食品摄入量与添加糖含量估计值之间的关联。
在美国儿童的饮食中，超加工食品占总能量摄入的65%，占添加糖能量的92%。在观察期内，添加糖提供的平均能量百分比为14.3%。大多数个体（70.9%）的饮食中添加糖超过了推荐上限（<总能量摄入的10%），18.4%的人群饮食中添加糖超过推荐水平的两倍（总能量摄入的20%）。超加工食品在饮食中所占份额增加5.5个百分点，会使饮食中添加糖的含量增加1个百分点，且在年幼儿童中经调整后的关联更强。
美国为减少儿童饮食中添加糖而开展的公共卫生工作必须更加重视减少超加工食品的消费。
