Ultra-Processed Food Consumption among the Paediatric Population: An Overview and Call to Action from the European Childhood Obesity Group

Khandpur, Neha; Neri, Daniela; Monteiro, Carlos Augusto; Mazur, Artur; Frelut, Marie-Laure; Boyland, Emma; Weghuber, Daniel; Torgerson, David

doi:10.1159/000507840

Cited by 83 publications

(74 citation statements)

References 52 publications

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“…Regarding age, studies generally reported large variations amongst the age groups. However, UPF intake generally decreased with increasing age, with the highest levels of UPF intake observed in children and adolescents, and the lowest in older subjects [ 51 , 54 , 87 , 104 , 108 , 110 , 112 , 118 ] ( Table 3 ). Only five studies also stratified results based on body mass index (BMI) of the participants, generally finding a slight, but higher, UPF intake in subjects with the highest BMI (e.g., greater than 30 kg/m 2 ) [ 58 , 87 , 89 , 95 ] ( Table 4 ) [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…In addition to country, the level of UPF intake was found to be inversely associated with the increase in age. In this regard, children generally showed the highest intake of UPF, which led the European Childhood Obesity Group to “a call to action” aimed to inform people about the potential harmful effects of UPF [ 118 ]. For example, it was found that in the United Kingdom, 65% of calories eaten by primary and secondary school children derived from white bread, biscuits, carbonated drinks, crisps, and chips.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the pediatric populations of the United States and Canada reported an intake of UPF above 55% by including breads, cookies, savory snacks, reconstituted meat products, milk-based drinks, breakfast cereals, juices and sodas, and frozen and ready-to-eat meals in the diet [ 18 , 96 ]. Among U.S. school-aged children and adolescents, UPF provided 66.2% and 66.4% of TEI, respectively, with pizzas, sodas, and juices being the most-consumed products [ 118 ]. In this scenario, it was proposed that the levels of UPF intake in the young may reflect, at least in part, their lifestyle.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

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A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

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“…Categories include standard infant formula (0-6 months), follow-up formula (7-12 months), growing-up (or toddler) milks (13-36 months) and specialised formulas. By definition, milk formulas are ultraprocessed foods [19,20], typically formulations of powdered milk proteins, vegetable oils, lactose and other sugars, micronutrients and cosmetic additives [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry

et al. 2021

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Background The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets. In this paper, our aim is to understand the strategies used by the baby food industry to shape ‘first-foods systems’ across its diverse markets, and in doing so, drive milk formula consumption on a global scale. We used a theoretically guided synthesis review method, which integrated diverse qualitative and quantitative data sources. Results Global milk formula sales grew from ~US$1.5 billion in 1978 to US$55.6 billion in 2019. This remarkable expansion has occurred along two main historical axes. First, the widening geographical reach of the baby food industry and its marketing practices, both globally and within countries, as corporations have pursued new growth opportunities, especially in the Global South. Second, the broadening of product ranges beyond infant formula, to include an array of follow-up, toddler and specialized formulas for a wider range of age groups and conditions, thereby widening the scope of mother-child populations subject to commodification. Sophisticated marketing techniques have been used to grow and sustain milk formula consumption, including marketing through health systems, mass-media and digital advertising, and novel product innovations backed by corporate science. To enable and sustain this marketing, the industry has engaged in diverse political practices to foster favourable policy, regulatory and knowledge environments. This has included lobbying international and national policy-makers, generating and deploying favourable science, leveraging global trade rules and adopting corporate policies to counter regulatory action by governments. Conclusion The baby food industry uses integrated market and political strategies to shape first-foods systems in ways that drive and sustain milk formula market expansion, on a global scale. Such practices are a major impediment to global implementation of the International Code of Marketing of Breastmilk Substitutes, and other policy actions to protect, promote and support breastfeeding. New modalities of public health action are needed to negate the political practices of the industry in particular, and ultimately to constrain corporate power over the mother-child breastfeeding dyad.

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“…In no small part this is due to the availability of cheap ultra-processed, energy-dense, but nutrient poor, high-fat and high-sugar foods. 38,39 Indeed, in a a cross-sectional analysis of a nationally representative sample of adults from the United States, food-insecure adults were more likely to have NAFLD and advanced fibrosis. 40 Food insecurity is associated with obesity, diabetes, and hypertension and drives a cardiometabolic risk profile, which are all risk factors for fatty liver development .…”

Section: Discussionmentioning

confidence: 99%

European ‘NAFLD Preparedness Index’ — Is Europe ready to meet the challenge of fatty liver disease?

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Ultra-Processed Food Consumption among the Paediatric Population: An Overview and Call to Action from the European Childhood Obesity Group

Cited by 83 publications

References 52 publications

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry

European ‘NAFLD Preparedness Index’ — Is Europe ready to meet the challenge of fatty liver disease?

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