School of Global Public Health, New York University, New York, NY, USA.
NYU Grossman School of Medicine, New York University, New York, NY, USA.
Am J Clin Nutr. 2022 Jan 11;115(1):211-221. doi: 10.1093/ajcn/nqab305.
BACKGROUND: Accumulating evidence links ultra-processed foods to poor diet quality and chronic diseases. Understanding dietary trends is essential to inform priorities and policies to improve diet quality and prevent diet-related chronic diseases. Data are lacking, however, for trends in ultra-processed food intake. OBJECTIVES: We examined US secular trends in food consumption according to processing level from 2001 to 2018. METHODS: We analyzed dietary data collected by 24-h recalls from adult participants (aged >19 y; N = 40,937) in 9 cross-sectional waves of the NHANES (2001-2002 to 2017-2018). We calculated participants' intake of minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods as the relative contribution to daily energy intake (%kcal) using the NOVA framework. Trends analyses were performed using linear regression, testing for linear trends by modeling the 9 surveys as an ordinal independent variable. Models were adjusted for age, sex, race/ethnicity, education level, and income. Consumption trends were reported for the full sample and stratified by sex, age groups, race/ethnicity, education level, and income level. RESULTS: Adjusting for changes in population characteristics, the consumption of ultra-processed foods increased among all US adults from 2001-2002 to 2017-2018 (from 53.5 to 57.0 %kcal; P-trend < 0.001). The trend was consistent among all sociodemographic subgroups, except Hispanics, in stratified analyses. In contrast, the consumption of minimally processed foods decreased significantly over the study period (from 32.7 to 27.4 %kcal; P-trend < 0.001) and across all sociodemographic strata. The consumption of processed culinary ingredients increased from 3.9 to 5.4 %kcal (P-trend < 0.001), whereas the intake of processed foods remained stable at ∼10 %kcal throughout the study period (P-trend = 0.052). CONCLUSIONS: The current findings highlight the high consumption of ultra-processed foods in all parts of the US population and demonstrate that intake has continuously increased in the majority of the population in the past 2 decades.
背景：越来越多的证据表明，超加工食品与不良饮食质量和慢性病有关。了解饮食趋势对于确定优先事项和制定政策以改善饮食质量和预防与饮食相关的慢性病至关重要。然而，超加工食品摄入量的趋势数据却很缺乏。
目的：我们研究了从 2001 年到 2018 年美国按加工水平划分的食物消费的季节性趋势。
方法：我们分析了来自 NHANES（2001-2002 年至 2017-2018 年）9 个横断面波次中 24 小时回忆调查的成年参与者（年龄>19 岁；N=40937）的膳食数据。我们使用 NOVA 框架，将最低限度加工食品、加工烹饪原料、加工食品和超加工食品的摄入量计算为每日能量摄入的相对贡献（%千卡）。采用线性回归进行趋势分析，将 9 项调查建模为有序自变量，以检验线性趋势。模型调整了年龄、性别、种族/民族、教育水平和收入。报告了全样本和按性别、年龄组、种族/民族、教育水平和收入水平分层的消费趋势。
结果：在调整人口特征变化的情况下，所有美国成年人的超加工食品消费从 2001-2002 年到 2017-2018 年期间有所增加（从 53.5%千卡增加到 57.0%千卡；P 趋势<0.001）。在分层分析中，除了西班牙裔以外，所有社会人口统计学亚组都呈现出一致的趋势。相比之下，在整个研究期间，最低限度加工食品的消费显著下降（从 32.7%千卡下降到 27.4%千卡；P 趋势<0.001），并且在所有社会人口统计学阶层中都是如此。加工烹饪原料的摄入量从 3.9%千卡增加到 5.4%千卡（P 趋势<0.001），而加工食品的摄入量在整个研究期间保持稳定在 10%千卡左右（P 趋势=0.052）。
结论：目前的研究结果强调了美国人口中高度消费超加工食品的情况，并表明在过去 20 年中，大多数人群的摄入量持续增加。
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