Current Intake of Ultra-Processed Foods in the U.S. Adult Population According to Education-Level and Income

Abstract

Objectives: Ultra-processed food have been associated with multiple chronic diseases, yet recent data regarding its consumption in the U.S. and potential differences in intake across population groups is lacking. We determined the intake of ultra-processed food across diverse socioeconomic strata in the U.S. adult population. Methods: We performed cross-sectional analysis of dietary intake among adults (>20y, N = 9759) in the National Health and Nutrition Examination Survey (NHANES) 2015-2018. Data on dietary intake was collected by 24h dietary recall. Foods were classified as ultra-processed/non ultra-processed according to the NOVA classification. We determined intake of ultra-processed food (%kcal) in the overall sample, and stratified by education ( <130%, 130-349% and ≥ 350% of the federal poverty threshold). Multivariable linear regression was used to assess if education and income were independent predictors of ultra-processed food intake, controlling for age, sex and race/ethnicity. Results: Ultra-processed foods provided 54% of energy among U.S. adults in 2015-2018. Compared to adults without a high school degree (52%kcal), high school graduates and adults with some college education consumed significantly more ultra-processed foods (57% kcal, P = 0.022 and 57.0% kcal, P = 0.009, resp.), while college graduates consumed significantly less ultra-processed foods (49% kcal, P < 0.001). Adults with a family income of 130-349% of the federal poverty threshold consumed significantly more ultra-processed foods than adults with the lowest family income (56 vs. 54% kcal, P = 0.009). However, intake did not differ significantly between adults with low and high income (52% kcal, P = 0.817). Conclusions: This study uniquely describes ultra-processed food consumption across socioeconomic groups in the U.S. population and may inform policies and intervention to reduce intakes of ultra-processed foods and prevent chronic disease outcomes. Although consumption differed across education-and income levels, ultra-processed food intake is high in all socioeconomic strata. Our results highlight the need for public health efforts to reduce ultra-processed food consumption in the U.S.