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.
BMJ Open. 2019 Aug 28;9(8):e029544. doi: 10.1136/bmjopen-2019-029544.
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).
Cross-sectional study.
National Nutrition and Physical Activity Survey (2011-2012).
12,153 participants aged 2+ years.
Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs.
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.
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.
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.
本研究旨在描述澳大利亚超加工食品的消费情况及其与与非传染性疾病（NCD）相关营养素摄入的关系。
横断面研究。
国家营养与身体活动调查（2011-2012 年）。
12153 名 2 岁及以上的参与者。
与 NCD 相关的营养素的平均饮食含量以及摄入水平不符合 NCD 预防建议的流行率。
根据 NOVA 系统对食物进行分类，该系统基于工业食品加工的性质、程度和目的进行分类。计算了每个 NOVA 食品组及其亚组对总能量摄入的贡献。比较了超加工食品和非超加工食品饮食部分的平均营养素含量。在超加工食品能量贡献的五分位数中，检查了与 NCD 相关的营养素摄入以及不符合 NCD 预防建议的摄入水平的流行率的差异。
超加工食品的膳食贡献最高（占能量摄入的 42.0%），其次是未加工或最低限度加工的食品（35.4%）、加工食品（15.8%）和加工烹饪配料（6.8%）。发现超加工食品消费五分位数与游离糖摄入水平之间存在正相关且具有统计学意义的线性趋势（标准化β0.43，p<0.001）；总（β0.08，p<0.001）、饱和（β0.18，p<0.001）和反式脂肪（β0.10，p<0.001）；钠（β0.21，p<0.001）和饮食能量密度（β0.41，p<0.001），而膳食纤维（β-0.21，p<0.001）和钾（β-0.27，p<0.001）则呈负相关。所有研究营养素的非推荐摄入量的流行率随超加工食品摄入量五分位数的增加而呈线性增加，特别是从游离糖的 22%到 82%，从反式脂肪的 6%到 11%，从饮食能量密度的 2%到 25%，从最低到最高的超加工食品五分位数。
超加工食品的高能量摄入对澳大利亚非超加工食品和所有与 NCD 相关的营养素的摄入产生了负面影响。减少超加工食品的饮食份额将大大改善该国的饮食质量，并帮助人群实现与 NCD 相关的关键营养素的建议摄入量。
