Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, USA.
Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA.
Br J Nutr. 2021 Dec 28;126(12):1861-1871. doi: 10.1017/S000711452100060X. Epub 2021 Feb 19.
Ultraprocessed foods provide the majority of energy content in the American diet, yet little is known regarding consumption trends over time. We determined trends in diet processing level and diet quality from 1991 to 2008 within the prospective Framingham Offspring Cohort. Dietary intakes were collected by FFQ quadrennially 1991-2008 (total of four examinations). The analytical sample included 2893 adults with valid dietary data for ≥3 examinations (baseline mean age = 54 years). Based on the NOVA framework, we classified foods as: unprocessed/minimally processed foods; processed culinary ingredients (salt/sugar/fats/oils); and processed foods and ultraprocessed foods. We evaluated diet quality using the Dietary Guidelines for Americans Adherence Index (DGAI) 2010. Trends in consumption of foods within each processing level (servings/d) and diet quality over the four examinations were evaluated using mixed effects models with subject-specific random intercepts. Analyses were stratified by sex, BMI (<25 kg/m2, 25-29·9 kg/m2, ≥30 kg/m2) and smoking status. Over 17 years of follow-up, ultraprocessed food consumption decreased from 7·5 to 6·0 servings/d and minimally processed food consumption decreased from 11·9 to 11·3 servings/d (Ptrend < 0·001). Changes in intakes of processed foods, culinary ingredients and culinary preparations were minimal. Trends were similar by sex, BMI and smoking status. DGAI-2010 score increased from 60·1 to 61·5, P < 0·001. The current study uniquely describes trends in diet processing level in an ageing US population, highlighting the longstanding presence of ultraprocessed foods in the American diet. Given the poor nutritional quality of ultraprocessed foods, public health efforts should be designed to limit their consumption.
超加工食品在美国饮食中提供了大部分的能量,但关于其随时间的消费趋势却知之甚少。我们在弗雷明汉后代队列的前瞻性研究中,确定了 1991 年至 2008 年期间饮食加工水平和饮食质量的变化趋势。饮食摄入量通过 FFQ 每四年(1991-2008 年,共四次检查)收集。分析样本包括 2893 名具有至少 3 次检查有效饮食数据的成年人(基线平均年龄为 54 岁)。根据 NOVA 框架,我们将食物分为:未加工/最低限度加工食品;加工烹饪原料(盐/糖/脂肪/油);以及加工食品和超加工食品。我们使用 2010 年《美国人膳食指南遵守指数》(DGAI)评估饮食质量。使用具有个体随机截距的混合效应模型评估每个加工水平(份/天)和四次检查期间饮食质量的变化趋势。分析按性别、BMI(<25 kg/m2、25-29·9 kg/m2、≥30 kg/m2)和吸烟状况分层。在 17 年的随访期间,超加工食品的消耗量从 7.5 份/天减少到 6.0 份/天,最低限度加工食品的消耗量从 11.9 份/天减少到 11.3 份/天(Ptrend <0.001)。加工食品、烹饪原料和烹饪准备的摄入量变化很小。性别、BMI 和吸烟状况相似。DGAI-2010 评分从 60.1 增加到 61.5,P <0.001。本研究在一个老龄化的美国人群中独特地描述了饮食加工水平的变化趋势,强调了超加工食品在美饮食中的长期存在。鉴于超加工食品的营养质量较差,应设计公共卫生措施来限制其消费。
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