The Healthfulness of the US Packaged Food and Beverage Supply: A Cross-Sectional Study.
Level 4 - case-series / case-control
Cross-sectional database study of food products (by design analogy, not clinical CEBM)
PubMed 31344845 · doi:10.3390/nu11081704
What was done
The authors conducted a cross-sectional assessment of the 2018 US packaged food and beverage supply using Label Insight's Open Data database, which represents over 80% of all food and beverage products sold in the US over the preceding three years. Healthfulness was evaluated using the Health Star Rating (HSR) system (scored from 0.5 to 5.0) and processing was assessed using the NOVA classification framework across product categories and leading manufacturers.
What was found
Among 230,156 food and beverage products analyzed, the mean HSR was 2.7 (SD 1.4) out of 5.0, and 71% of products were classified as ultra-processed. Healthfulness and processing varied widely across product categories (HSR range: 1.1-3.9; ultra-processed proportion: 0-100%) and across manufacturers (HSR range: 0.9-4.6; ultra-processed proportion: 26-100%).
Why it matters
This paper provides a comprehensive baseline demonstrating that the majority of US packaged food and beverage options are ultra-processed and of modest nutritional quality. The wide variation between manufacturers indicates opportunities for product reformulation and replacement.
Limits
The study measures product availability rather than actual consumer purchase volume or individual dietary intake. It relies on the accuracy of manufacturer label data, and health outcomes were not evaluated.
Cited by
- supports A typical American supermarket stocks around 40,000 distinct food items, and more than 50% of them are ultra-processed foods.