Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study.
Level 4 - case-series / case-control
Nationally representative cross-sectional survey (NHANES)
PubMed 26962035 · doi:10.1136/bmjopen-2015-009892
What was done
Analyzed dietary data from 9,317 participants aged 1 year and older from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) who completed at least one 24-hour dietary recall. Ultra-processed foods were defined as industrial formulations containing substances not used in culinary preparations, especially additives. Survey-weighted Gaussian and Poisson regressions adjusted for age, sex, race/ethnicity, family income, and educational attainment evaluated the relationship between ultra-processed food intake and added sugar consumption.
What was found
Ultra-processed foods contributed 57.9% of total dietary energy and 89.7% of energy intake from added sugars. Added sugars constituted 21.1% of calories in ultra-processed foods, compared with 2.4% in processed foods and 3.7% in unprocessed/minimally processed foods and culinary ingredients combined. Each 5 percentage point increase in energy from ultra-processed foods was associated with a 1 percentage point increase in energy from added sugars. Intake of added sugars increased across ultra-processed food quintiles from 7.5% of total energy in the lowest quintile to 19.5% in the highest quintile. In the highest quintile, 82.1% of participants exceeded the recommended limit of 10% energy from added sugars, compared with 26.4% in the lowest quintile.
Why it matters
This study demonstrates that ultra-processed foods are the primary source of added sugars in the American diet, providing quantitative evidence to inform nutritional guidelines and public health interventions aimed at reducing sugar consumption.
Limits
The study is cross-sectional, precluding causal inference. Dietary data relied on self-reported 24-hour recall, which is vulnerable to recall bias and underreporting. Findings reflect US data from 2009-2010 and may not generalize to other countries or contemporary consumption patterns.
Cited by
- supports In American adults, 60% of daily caloric intake comes from ultra-processed foods.