Abstract
OBJECTIVES: Ultraprocessed foods (UPF) have recently been examined as a risk factor for diet-related disease in adults. Studies have demonstrated changes in trends in consumption patterns of UPF over the past several decades, but few studies have evaluated the association between UPF and perception of diet along with measured dietary intake. The objective of this study was to examine the association between UPF consumption, dietary intake patterns, and self-perceived diet quality in a nationally representative sample of US children and adults. METHODS: Data from the 2017–2018 NHANES was used for this study. Dietary intake information was collected using 24-hour recall; recalled foods were classified using the NOVA classification system and NOVA Category 4 (ultraprocessed) were identified. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the. RESULTS: Consumption of ultraprocessed foods is associated with poor diet in US children and adults. In adults, higher consumption of ultraprocessed foods was is associated with higher dietary energy density (p = 0.0001), lower vegetable consumption (p = 0.002), greater intake of added sugars (p < 0.0001), and lower intake of plant-based protein foods (p < 0.0001). In children, consumption of ultraprocessed foods was associated with higher dietary energy density (p < 0.0001), lower consumption of vegetables (p < 0.0001) even when including fewer servings of white potatoes (p = 0.04). Interestingly, perception of diet quality was also strongly associated with ultraprocessed food consumption. Individuals who self-reported a ‘poor’ diet consumed 84% of daily calories from ultraprocessed foods, compared to individuals who self-reported an ‘excellent’ diet reporting 52% of daily calories from ultraprocessed foods, p < 0.0001. Adults who perceived themselves to be overweight also reported higher consumption of processed foods than adults who perceived themselves to be about the right weight (60% vs. 56%, p = 0.004). There was no association with processed food consumption and parent perception of child weight. CONCLUSIONS: Ultraprocessed food consumption is associated with lower diet quality in US children and adults. Additionally, UPF consumption is associated with perception of diet quality and body weight. FUNDING SOURCES: None.