Intake of ultra-processed foods in Sweden and its association with diet quality and weight status: cross-sectional analyses from three national dietary surveys.
Torsten Sällström, Anna Turesson Wadell, Julia Wanselius, Ola Wallengren, Agneta Åkesson, Rikard Landberg, Anna Karin Lindroos, Emma Patterson, Lotta Moraeus, Therese Karlsson, Linnea Bärebring
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引用次数: 0
Abstract
Background: Ultra-processed foods (UPF) contribute substantially to energy intake in many countries and have been linked to poorer nutrient profiles and increased risk for excess body weight. Swedish data on UPF intake and its relation to diet quality and weight status are lacking.
Methods: Data were derived from the three most recent Swedish national dietary surveys: Riksmaten (RM)-Adults (2010-2011; n = 1797), RM-Adolescents (2016-2017; n = 3099), and RM-Young Children (2021-2024; n = 1820). Classification of UPFs was based on the Nova system using a transparent protocol incorporating recipe disaggregation, independent classification, and alternative classification scenarios to address uncertainty. Associations between energy percent (E%) from UPF and diet quality indicators and micronutrient intakes were examined using quantile regression. Associations between E% UPF and body mass index (BMI or BMI z-score) were assessed using linear regression, and prevalence ratios (PR) of overweight or obesity were estimated using Poisson regression with robust variance. Models were adjusted for sociodemographic factors, with additional adjustment for total energy intake and diet quality.
Results: According to the primary classification scenario, the mean dietary share of UPF was 45 E% among adults, 52 E% among adolescents, and 46 E% among young children. With stricter classification of ambiguous food items, estimates ranged between 23 and 29 E%. A higher dietary share of UPF was associated with less favourable diet quality across most indicators, except for salt and saturated fat in all age groups and iron and vitamin E in young children. Among adults, each 10 E% increment in UPF corresponded to 0.61% higher BMI (95% CI: 0.04-1.18; p = 0.036). The prevalence of overweight or obesity was higher in the top versus bottom tertiles of UPF intake after energy adjustment (PR = 1.16; 95% CI: 1.03-1.30; p = 0.018). No associations were observed among adolescents or young children.
Conclusions: UPF contributed substantially to energy intake in all age groups, though estimates differed markedly depending on the classification scenario. UPF intake was inversely associated with diet quality across most, but not all, indicators. No robust relationships with BMI were observed.
期刊介绍：
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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