Advertisement

Consumption of ultra-processed food products and diet quality among children, adolescents and adults in Belgium

  • Stefanie Vandevijvere
  • Karin De Ridder
  • Thibault Fiolet
  • Sarah Bel
  • Jean Tafforeau
Original Contribution

Abstract

Purpose

To assess the dietary share of ultra-processed foods (UPF) among Belgian children, adolescents and adults and associations with diet quality.

Methods

Data from the national Food Consumption Surveys 2004 (N = 3083; ≥ 15 years) and 2014–2015 (N = 3146; 3–64 years) were used. Two 24-h recalls (dietary records for children) were used for data collection. Foods consumed were classified by the level of processing using the NOVA classification. The usual proportion of daily energy intake from UPF was determined using SPADE (Statistical Program to assess dietary exposure).

Results

In 2014/2015, 36.4% of foods consumed were ultra-processed, while 42.4% were unprocessed/minimally processed. The usual proportion of daily energy intake from UPF was 33.3% (95% CI 32.1–35.0%) for children, 29.2% (95% CI 27.7–30.3%) for adolescents and 29.6% (95% CI 28.5–30.7%) for adults. There were no differences in UPF consumption between 2004 and 2014/2015. The products contributing most to UPF consumption were processed meat (14.3%), cakes, pies, pastries (8.9%), sweet biscuits (7.7%) and soft drinks (6.7%). The UPF dietary share was significantly lower during consumption days when participants met the WHO salt intake recommendation (≤ 5 g/day) and when saturated fat was ≤ 10% of their total energy intake. The dietary share of unprocessed/minimally processed foods was significantly higher during consumption days when participants met the WHO salt and fruit/vegetable intake (≥ 400 g/day) recommendations and when saturated fat was ≤ 10% of their total energy intake.

Conclusions

The UPF dietary share is substantial and associated with lower diet quality. Internationally recommended policies to limit UPF accessibility and marketing need to be implemented to reduce UPF consumption.

Keywords

Ultra-processed foods Diet quality Food consumption surveys Belgium 

Notes

Acknowledgements

The authors want to thank the Ministry of Health to provide funding for the national food consumption surveys of 2004 and 2014/2015.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

394_2018_1870_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 31 KB)

References

  1. 1.
    GBD 2016 Causes of Death Collaborators (2017) Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390:1423–1459CrossRefGoogle Scholar
  2. 2.
    Vandevijvere S, Chow CC, Hall K, Umali E, Swinburn B (2015) Increased food energy supply as a major driver of the obesity epidemic: a global analysis. Bull World Health Organ 93:446–456CrossRefGoogle Scholar
  3. 3.
    Imamura F, Micha R, Khatibzadeh S et al (2015) Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment. Lancet Glob Health 3:e132–e142CrossRefGoogle Scholar
  4. 4.
    Institute for Health Metrics and Evaluation (2018) Country Profile Belgium. http://www.healthdata.org/belgium. Accessed 10 Aug 2018
  5. 5.
    Vandevijvere S, De VS, Huybrechts I et al (2009) The gap between food-based dietary guidelines and usual food consumption in Belgium, 2004. Public Health Nutr 12:423–431Google Scholar
  6. 6.
    De Ridder K, Bel S, Brocatus L et al (2016) De consumptie van voedingsmiddelen en de inname van voedingsstoffen. In: Bel S, Tafforeau J (eds) Voedselconsumptiepeiling 2014–2015. Rapport 4. Wetenschappenlijk Instituut voor Volksgezondheid, BrusselsGoogle Scholar
  7. 7.
    Monteiro CA (2009) Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutr 12:729–731CrossRefGoogle Scholar
  8. 8.
    Monteiro CA, Cannon G, Moubarac JC et al (2018) The UN decade of nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr 21:5–17CrossRefGoogle Scholar
  9. 9.
    Monteiro C, Cannon G, Levy RB et al (2016) NOVA. The star shines bright. World Nutr 7(1–3):28–38Google Scholar
  10. 10.
    Fardet A (2016) Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food Funct 7:2338–2346CrossRefGoogle Scholar
  11. 11.
    Zinöcker MK, Lindseth IA (2018) The Western diet–microbiome–host interaction and its role in metabolic disease. Nutrients 10:365CrossRefGoogle Scholar
  12. 12.
    Martinez SE, Baraldi LG, Louzada ML et al (2016) Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open 6:e009892CrossRefGoogle Scholar
  13. 13.
    Poti JM, Mendez MA, Ng SW, Popkin BM (2015) Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households? Am J Clin Nutr 101:1251–1262CrossRefGoogle Scholar
  14. 14.
    Moubarac JC, Martins AP, Claro RM et al (2013) Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada. Public Health Nutr 16:2240–2248CrossRefGoogle Scholar
  15. 15.
    Adams J, White M (2015) Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12). Int J Behav Nutr Phys Act 12:160CrossRefGoogle Scholar
  16. 16.
    Batal M, Johnson-Down L, Moubarac JC et al (2018) Quantifying associations of the dietary share of ultra-processed foods with overall diet quality in First Nations peoples in the Canadian provinces of British Columbia, Alberta, Manitoba and Ontario. Public Health Nutr 21:103–113CrossRefGoogle Scholar
  17. 17.
    Bielemann RM, Motta JV, Minten GC, Horta BL, Gigante DP (2015) Consumption of ultra-processed foods and their impact on the diet of young adults. Revista de Saude Publica 49:28Google Scholar
  18. 18.
    Cediel G, Reyes M, da Costa Louzada ML et al (2018) Ultra-processed foods and added sugars in the Chilean diet (2010). Public Health Nutr 21:125–133CrossRefGoogle Scholar
  19. 19.
    Cornwell B, Villamor E, Mora-Plazas M et al (2018) Processed and ultra-processed foods are associated with lower-quality nutrient profiles in children from Colombia. Public Health Nutr 21:142–147CrossRefGoogle Scholar
  20. 20.
    Martinez SE, Popkin BM, Swinburn B, Monteiro CA (2017) The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metr 15:6CrossRefGoogle Scholar
  21. 21.
    Moubarac JC, Batal M, Louzada ML, Martinez SE, Monteiro CA (2017) Consumption of ultra-processed foods predicts diet quality in Canada. Appetite 108:512–520CrossRefGoogle Scholar
  22. 22.
    Louzada MLDC, Ricardo CZ, Steele EM et al (2018) The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr 21:94–102CrossRefGoogle Scholar
  23. 23.
    Juul F, Martinez-Steele E, Parekh N, Monteiro CA, Chang VW (2018) Ultra-processed food consumption and excess weight among US adults. Br J Nutr 120:90–100CrossRefGoogle Scholar
  24. 24.
    Nardocci M, Leclerc BS, Louzada ML et al (2018) Consumption of ultra-processed foods and obesity in Canada. Can J Public Health.  https://doi.org/10.17269/s41997-018-0130-x CrossRefGoogle Scholar
  25. 25.
    Julia C, Martinez L, Alles B et al (2018) Contribution of ultra-processed foods in the diet of adults from the French NutriNet-Sante study. Public Health Nutr 21:27–37CrossRefGoogle Scholar
  26. 26.
    Canella DS, Levy RB, Martins AP et al (2014) Ultra-processed food products and obesity in Brazilian households (2008–2009). PLoS One 9:e92752CrossRefGoogle Scholar
  27. 27.
    Louzada ML, Baraldi LG, Steele EM et al (2015) Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med 81:9–15CrossRefGoogle Scholar
  28. 28.
    Pan American Health Organization (2015) Ultra-processed food and drink products in Latin America: trends, impact on obesity, policy implications. Pan American Health Organization, Washington, D.C.Google Scholar
  29. 29.
    Monteiro CA, Moubarac JC, Levy RB et al (2018) Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr 21:18–26CrossRefGoogle Scholar
  30. 30.
    Mendonca RD, Pimenta AM, Gea A et al (2016) Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study. Am J Clin Nutr 104:1433–1440CrossRefGoogle Scholar
  31. 31.
    Mendonca RD, Lopes AC, Pimenta AM et al (2017) Ultra-processed food consumption and the incidence of hypertension in a mediterranean cohort: the Seguimiento Universidad de Navarra Project. Am J Hypertens 30:358–366Google Scholar
  32. 32.
    Fiolet T, Srour B, Sellem L et al (2018) Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 360:k322CrossRefGoogle Scholar
  33. 33.
    European Food Safety Authority (2009) General principles for the collection of national food consumption data in the view of a pan-European dietary survey. EFSA J 17:1435CrossRefGoogle Scholar
  34. 34.
    Bel S, Van den Abeele S, Lebacq T et al (2016) Protocol of the Belgian food consumption survey 2014: objectives, design and methods. Arch Public Health 74:20CrossRefGoogle Scholar
  35. 35.
    Park MK, Freisling H, Huseinovic E et al (2018) Comparison of meal patterns across five European countries using standardized 24-h recall (GloboDiet) data from the EFCOVAL project. Eur J Nutr 57:1045–1057CrossRefGoogle Scholar
  36. 36.
    Black AE (2000) The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity. Eur J Clin Nutr 54:395–404CrossRefGoogle Scholar
  37. 37.
    Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G (2010) A new classification of foods based on the extent and purpose of their processing. Cadernos de Saude Publica 26:2039–2049CrossRefGoogle Scholar
  38. 38.
    FAO (2015) Guidelines on the collection of information on food processing through food consumption surveys. FAO, RomeGoogle Scholar
  39. 39.
    Pan American Health Organization (2016) PAHO nutrient profile model. Pan American Health Organization, Washington, D.C.Google Scholar
  40. 40.
    Souverein OW, Dekkers AL, Geelen A et al (2011) Comparing four methods to estimate usual intake distributions. Eur J Clin Nutr 65(Suppl 1):S92–S101CrossRefGoogle Scholar
  41. 41.
    Dodd KW, Guenther PM, Freedman LS et al (2006) Statistical methods for estimating usual intake of nutrients and foods: a review of the theory. J Am Diet Assoc 106:1640–1650CrossRefGoogle Scholar
  42. 42.
    Dekkers AL, Verkaik-Kloosterman J, van Rossum CT, Ocke MC (2014) SPADE, a new statistical program to estimate habitual dietary intake from multiple food sources and dietary supplements. J Nutr 144:2083–2091CrossRefGoogle Scholar
  43. 43.
    Baraldi LG, Martinez SE, Canella DS, Monteiro CA (2018) Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open 8:e020574CrossRefGoogle Scholar
  44. 44.
    Wetenschappenlijk Instituut voor Volksgezondheid (2016) Voedselconsumptiepeiling 2014–2015. Rapport 1: Voedingsgewoonten, antropometrie en voedingsbeleid. Wetenschappenlijk Instituut voor Volksgezondheid, BrusselsGoogle Scholar
  45. 45.
    Monteiro CA, Cannon G, Moubarac JC et al (2015) Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil. Public Health Nutr 18:2311–2322CrossRefGoogle Scholar
  46. 46.
    Ministerio de Salud (2016) Guia alimentaria para la poblacion uruguaya. Para una alimentacion saludable, compartida y placentera. http://msp.gub.uy/sites/default/files/archivos_adjuntos/MS_guia_web.pdf. Accessed 10 Oct 2018
  47. 47.
    Fiolet T (2018) Quoi dans mon assiette: Objectifs du PNNS 2018–2022. https://quoidansmonassiette.fr/objectifs-pnns-2018-2022-pour-politique-nutritionnelle-et-sante-en-france/. Accessed 10 Oct 2018
  48. 48.
    New York Times (2018) In sweeping war on obesity, Chile slays tony the tiger. https://www.nytimes.com/2018/02/07/health/obesity-chile-sugar-regulations.html. Accessed 10 Oct 2018
  49. 49.
    Batis C, Rivera JA, Popkin BM, Taillie LS (2016) First-year evaluation of Mexico’s tax on nonessential energy-dense foods: an observational study. PLoS Med 13:e1002057CrossRefGoogle Scholar
  50. 50.
    Hernandez F, Batis C, Rivera JA, Colchero MA (2018) Reduction in purchases of energy-dense nutrient-poor foods in Mexico associated with the introduction of a tax in 2014. Prev Med 118:16–22CrossRefGoogle Scholar
  51. 51.
    Biro A (2015) Did the junk food tax make the Hungarians eat healthier? Food Policy 54:107–115CrossRefGoogle Scholar
  52. 52.
    Colchero MA, Popkin BM, Rivera JA, Ng SW (2016) Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ 352:h6704CrossRefGoogle Scholar
  53. 53.
    Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B (2013) Ultra-processed products are becoming dominant in the global food system. Obes Rev 14(Suppl 2):21–28CrossRefGoogle Scholar
  54. 54.
    Lam MCL, Adams J (2017) Association between home food preparation skills and behaviour, and consumption of ultra-processed foods: cross-sectional analysis of the UK National diet and nutrition survey (2008–2009). Int J Behav Nutr Phys Act 14:68CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Stefanie Vandevijvere
    • 1
  • Karin De Ridder
    • 1
  • Thibault Fiolet
    • 2
  • Sarah Bel
    • 1
  • Jean Tafforeau
    • 1
  1. 1.Scientific Institute of Public Health (Sciensano)BrusselsBelgium
  2. 2.Federal Public Service of Health, Food Chain Safety and EnvironmentBrusselsBelgium

Personalised recommendations