Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York; Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
Am J Prev Med. 2022 Feb;62(2):252-264. doi: 10.1016/j.amepre.2021.08.014. Epub 2021 Nov 6.
Consumption of ultraprocessed foods has been linked with higher intake of added sugars, sodium, and unhealthful fats, but the associations of ultraprocessed foods with overall diet quality and major food groups are not well known.
Data were derived from the National Health and Nutrition Examination Survey (2015-2018), including 9,758 adults (aged ≥20 years) and 5,280 children (aged 2-19 years) with 24-hour dietary recalls (≥1), with analysis performed in 2020. Ultraprocessed foods were identified using the NOVA classification, with intake (% energy) assessed in quintiles. Diet quality was assessed using the validated American Heart Association 2020 continuous primary and secondary diet scores and Healthy Eating Index 2015. Poor diet was defined as <40% adherence to the American Heart Association secondary score. Generalized linear regressions estimated relationships between ultraprocessed food intake and diet quality.
Compared with the lowest quintile of ultraprocessed food consumption (<39.1% energy), the American Heart Association primary score in adults was progressively lower in Quintile 2 (-1.99, 95% CI= -2.73, -1.25), Quintile 3 (-3.60, 95% CI= -4.47, -2.72), Quintile 4 (-5.29, 95% CI= -6.28, -4.30), and Quintile 5 (-7.24, 95% CI= -8.13, -6.36; >70.7% energy). Corresponding values in children were -2.05 (95% CI= -3.01, -1.09), -2.97 (95% CI= -4.16, -1.79), -3.82 (95% CI= -5.20, -2.44), and -6.22 (95% CI= -7.20, -5.25; >79.0% energy). The estimated proportion of children having poor diet progressively increased from 31.3% (95% CI=26.2%, 36.5%) in Quintile 1 up to 71.6% (95% CI=68.1%, 75.1%) in Quintile 5. Corresponding proportions of adults having poor diet increased from 18.1% (95% CI=14.3%, 22.0%) in Quintile 1 up to 59.7% (95% CI=55.3%, 64.1%) in Quintile 5. Findings were similar using the American Heart Association secondary score and Healthy Eating Index 2015 score.
Higher ultraprocessed food consumption is associated with substantially lower diet quality among children and adults.
食用超加工食品与添加糖、钠和不健康脂肪的摄入量增加有关，但超加工食品与整体饮食质量和主要食物组的关系尚不清楚。
数据来自国家健康和营养检查调查（2015-2018 年），包括 9758 名成年人（年龄≥20 岁）和 5280 名儿童（年龄 2-19 岁），他们进行了 24 小时膳食回忆（≥1 次），分析于 2020 年进行。使用 NOVA 分类法识别超加工食品，摄入量（%能量）按五分位数评估。使用经过验证的美国心脏协会 2020 年连续主要和次要饮食评分和健康饮食指数 2015 评估饮食质量。不良饮食定义为美国心脏协会次要评分的依从性<40%。广义线性回归估计了超加工食品摄入量与饮食质量之间的关系。
与超加工食品消费最低五分位数（<39.1%能量）相比，成年人的美国心脏协会主要评分在 Quintile 2（-1.99，95%CI=-2.73，-1.25）、Quintile 3（-3.60，95%CI=-4.47，-2.72）、Quintile 4（-5.29，95%CI=-6.28，-4.30）和 Quintile 5（-7.24，95%CI=-8.13，-6.36；>70.7%能量）逐渐降低。儿童相应的值分别为-2.05（95%CI=-3.01，-1.09）、-2.97（95%CI=-4.16，-1.79）、-3.82（95%CI=-5.20，-2.44）和-6.22（95%CI=-7.20，-5.25；>79.0%能量）。从 Quintile 1 中 31.3%（95%CI=26.2%，36.5%）到 Quintile 5 中 71.6%（95%CI=68.1%，75.1%），儿童不良饮食的估计比例逐渐增加。成年人不良饮食的比例从 Quintile 1 中的 18.1%（95%CI=14.3%，22.0%）上升到 Quintile 5 中的 59.7%（95%CI=55.3%，64.1%）。使用美国心脏协会次要评分和健康饮食指数 2015 评分也得到了类似的结果。
超加工食品摄入量较高与儿童和成年人的饮食质量明显下降有关。
