Chang Zhiyao, Talsma Elise F, Cai Hongyi, Fan Shenggen, Ni Yuanying, Wen Xin, van 't Veer Pieter, Biesbroek Sander
College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China.
Division of Human Nutrition and Health, Wageningen University & Research, 6700 AB Wageningen, The Netherlands.
Nutrients. 2025 Jan 17;17(2):334. doi: 10.3390/nu17020334.
Rapid socio-economic developments confront China with a rising consumption of ultra-processed foods (UPFs) and ultra-processed drinks (UPDs). This study aims to evaluate their potential impact on diet transformation towards sustainability including nutrition, environmental sustainability, and diet-related cost.
Dietary intake was assessed by 24 h recalls in 27,311 participants (age: 40.5 ± 19.7; female, 51.1%) in the China Health and Nutrition Survey 1997-2011. The nutrient quality, environmental sustainability (greenhouse gas emission (GHGE), total water use (TWU), land use (LU), and diet cost were assessed as diet-related sustainability indicators. Foods and drinks were classified according to the degree of processing based on NOVA. Two-level mixed effects models were applied to explore the secular trends of the sustainability indicators being nested within random effect (individual level).
UPFs and UPDs are less nutrient-dense, containing more energy, sodium, and added sugar compared to unprocessed or minimally processed foods and drinks (MPFs and MPDs). UPFs and UPDs were higher for GHGE and TWU but lower for LU. Costs of UPDs tripled those of MPDs. In the period of 1997-2011, the percentage of UPFs and UPDs per 2000 kcal increased for both sexes. The increase in UPFs and UPDs was associated with a lower nutrient quality but a higher environmental impact and diet cost.
From 1997 to 2011, there was a significant increase in the consumption of UPFs and UPDs in China. This trend had negative impacts on both the nutrient quality and environmental impact; meanwhile, it led to increased diet costs. Policies to reduce the production and consumption of UPFs and UPDs should be reinforced by making alternatives for ultra-processed breakfast cereals, snacks, and alcoholic beverages available and acceptable. Additionally, instead of only focusing on high-UPFD consumers, attention is needed on the currently low-UPFD consumers as their consumption has been growing rapidly in the last decades.
快速的社会经济发展使中国面临超加工食品（UPF）和超加工饮料（UPD）消费不断上升的情况。本研究旨在评估它们对饮食向可持续性转变的潜在影响，包括营养、环境可持续性和饮食相关成本。
通过对1997 - 2011年中国健康与营养调查中27311名参与者（年龄：40.5±19.7岁；女性占51.1%）进行24小时膳食回顾来评估膳食摄入量。将营养质量、环境可持续性（温室气体排放（GHGE）、总用水量（TWU）、土地利用（LU））和饮食成本作为与饮食相关的可持续性指标进行评估。根据NOVA对食品和饮料按加工程度进行分类。应用两级混合效应模型来探索嵌套在随机效应（个体水平）内的可持续性指标的长期趋势。
与未加工或最低限度加工的食品和饮料（MPF和MPD）相比，UPF和UPD的营养密度较低，含有更多能量、钠和添加糖。UPF和UPD的GHGE和TWU较高，但LU较低。UPD的成本是MPD的三倍。在1997 - 2011年期间，男女每2000千卡中UPF和UPD的百分比均有所增加。UPF和UPD的增加与较低的营养质量相关，但对环境的影响较大且饮食成本较高。
1997年至2011年期间，中国UPF和UPD的消费量显著增加。这一趋势对营养质量和环境影响均产生了负面影响；同时，导致饮食成本增加。应加强政策以减少UPF和UPD的生产和消费，提供并推广超加工早餐谷物、零食和酒精饮料的替代品。此外，不应只关注高UPFD消费者，还需要关注目前低UPFD消费者，因为他们的消费量在过去几十年中增长迅速。
