Advertisement

Associations between Consumption of Ultra-Processed Foods and Intake of Nutrients Related to Chronic Non-Communicable Diseases in Mexico

      Abstract

      Background

      Ultra-processed foods are highly palatable and can be consumed anywhere at any time, but typically have a poor nutritional profile. Therefore, their contribution to total energy intake has been proposed as an indicator for studying overall dietary quality.

      Objective

      The aim of this study was to investigate the associations between the energy contribution from ultra-processed foods and the intake of nutrients related to chronic non-communicable diseases in Mexico.

      Design

      This study used a secondary analysis of cross-sectional data from the 2012 Mexican National Health and Nutrition Survey.

      Participants/setting

      This study included participants aged 1 year and older (n=10,087) who had completed a 1-day 24-hour recall.

      Main outcome measures

      Intake from added sugar (% kcal), total fat (% kcal), saturated fat (% kcal), protein (% kcal), dietary fiber (g/1,000 kcal), and dietary energy density (kcal/g) were measured.

      Statistical analysis

      Multiple linear regression models adjusted for sociodemographic variables were fitted to assess the association between quintiles of energy contribution from ultra-processed foods and nutrient intake.

      Results

      Mean reported energy contribution from ultra-processed foods to the Mexican population’s diet ranged from 4.5% kcal in quintile 1 (Q1) to 64.2% kcal in quintile 5 (Q5). An increased energy contribution from ultra-processed foods was positively associated with intake from added sugar (Q1: 7.4% kcal; Q5: 17.5% kcal), total fat (Q1: 30.6% kcal; Q5: 33.5% kcal) and saturated fat (Q1: 9.3% kcal; Q5: 13.2% kcal), as well as dietary energy density (Q1: 1.4 kcal/g; Q5: 2.0 kcal/g) (P≤0.001); and inversely associated with intake from protein (Q1: 15.1% kcal; Q5: 11.9% kcal) and dietary fiber (Q1: 16.0 g/1,000 kcal; Q5: 8.4 g/1,000 kcal) (P≤0.001).

      Conclusions

      In the Mexican population, an increased energy contribution from ultra-processed foods was associated with a lower dietary quality with regard to intake of nutrients related to chronic non-communicable diseases. Future research is needed to identify barriers to eating a variety of unprocessed and minimally processed foods for the Mexican population, as well as effective public health strategies and policies to overcome these barriers.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Monteiro C.A.
        • Cannon G.
        • Moubarac J.C.
        • et al.
        The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing.
        Public Health Nutr. 2018; 21: 5-17
        • Crovetto M.
        • Uauy R.
        [Changes in processed food expenditure in the population of Metropolitan Santiago in the last twenty years].
        Rev Med Chil. 2012; 140 (in Spanish): 305-312
        • Stuckler D.
        • McKee M.
        • Ebrahim S.
        • Basu S.
        Manufacturing epidemics: The role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco.
        PLoS Med. 2012; 9: e1001235
        • Moodie R.
        • Stuckler D.
        • Monteiro C.
        • et al.
        Profits and pandemics: Prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries.
        Lancet. 2013; 381: 670-679
        • Solberg S.L.
        • Terragni L.
        • Granheim S.I.
        Ultra-processed food purchases in Norway: A quantitative study on a representative sample of food retailers.
        Public Health Nutr. 2016; 19: 1990-2001
        • Luiten C.M.
        • Steenhuis I.H.
        • Eyles H.
        • Ni Mhurchu C.
        • Waterlander W.E.
        Ultra-processed foods have the worst nutrient profile, yet they are the most available packaged products in a sample of New Zealand supermarkets.
        Public Health Nutr. 2016; 19: 530-538
        • Baker P.
        • Friel S.
        Food systems transformations, ultra-processed food markets and the nutrition transition in Asia.
        Global Health. 2016; 12: 80
        • Monteiro C.A.
        • Moubarac J.C.
        • Cannon G.
        • Ng S.W.
        • Popkin B.
        Ultra-processed products are becoming dominant in the global food system.
        Obes Rev. 2013; 14: S21-S28
        • Popkin B.
        Contemporary nutritional transition: Determinants of diet and its impact on body composition.
        Proc Nutr Soc. 2010; 70: 82-91
        • Batis C.
        • Rodríguez-Ramírez S.
        • Ariza A.
        • Rivera J.A.
        Intakes of energy and discretionary food in Mexico are associated with the context of eating: Mealtime, activity, and place.
        J Nutr. 2016; 146: 1907S-1915S
        • Parra D.C.
        • da Costa-Louzada M.L.
        • Moubarac J.C.
        • et al.
        Association between ultra-processed food consumption and the nutrient profile of the Colombian diet in 2005.
        Salud Publica Mex. 2019; 61: 147-154
        • Louzada M.L.
        • Ricardo C.Z.
        • Steele E.M.
        • Levy R.B.
        • Cannon G.
        • Monteiro C.A.
        The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil.
        Public Health Nutr. 2017; 21: 94-102
        • Cediel G.
        • Reyes M.
        • Louzada M.L.
        • et al.
        Ultra-processed foods and added sugars in Chilean diet (2010).
        Public Health Nutr. 2017; 21: 125-133
        • Moubarac J.C.
        • Batal M.
        • Louzada M.L.
        • Steele E.M.
        • Monteiro C.A.
        Consumption of ultra-processed foods predicts diet quality in Canada.
        Appetite. 2017; 108: 512-520
        • Rauber F.
        • Louzada M.L.
        • Martinez Steele E.
        • Millett C.
        • Monteiro C.A.
        • Levy R.B.
        Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UK (2008-2014).
        Nutrients. 2018; 10: 587
        • Baraldi L.G.
        • Martinez Steele E.
        • Canella D.S.
        • Monteiro C.A.
        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. 2018; 8: e020574
        • Vandevijvere S.
        • Monteiro C.A.
        • Krebs-Smith S.M.
        • et al.
        Monitoring and benchmarking population diet quality globally: A step-wise approach.
        Obes Rev. 2013; 14: 135-149
        • World Health Organization
        Diet, nutrition and the prevention of chronic diseases.
        World Health Organ Tech Rep Ser. 2003; 916: 55-58
        • Pan American Health Organization
        Pan American Health Organization Nutrient Profile Model.
        Pan American Health Organization, Washington, DC2016
        • Marrón-Ponce J.A.
        • Sánchez-Pimienta T.
        • Louzada M.L.
        • Batis C.
        Energy contribution of NOVA food groups and sociodemographic determinants of ultra-processed foods consumption in Mexican population.
        Public Health Nutr. 2017; 21: 87-93
        • López-Olmedo N.
        • Carriquiry A.L.
        • Rodríguez-Ramírez S.
        • et al.
        Usual intake of added sugars and saturated fats is high while dietary fiber is low in the Mexican population.
        J Nutr. 2016; 146: 1856S-1865S
        • Aburto T.C.
        • Cantoral A.
        • Hernández-Barrera L.
        • Carriquiry A.L.
        • Rivera J.A.
        Usual dietary energy density distribution is positively associated with excess body weight in Mexican children.
        J Nutr. 2015; 145: 1524-1530
        • Romero-Martínez M.
        • Shamah-Levy T.
        • Franco-Núñez A.
        • et al.
        [National Health and Nutrition Survey 2012: Design and coverage].
        Salud Publica Mex. 2013; 55 (in Spanish): S332-S340
        • Goldberg G.R.
        • Black A.E.
        • Jebb S.A.
        • et al.
        Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording.
        Eur J Clin Nutr. 1991; 45: 569-581
        • Barquera S.
        • Hotz C.
        • Rivera J.
        • et al.
        Food Consumption, Food Expenditure, Anthropometric Status and Nutrition-Related Diseases in Mexico.
        Nutrition and the Double-Burden of Disease in Developing Countries. FAO, Rome, Italy2006
        • Barquera S.
        • Campos-Nonato I.
        • Hernández-Barrera L.
        • Pedroza-Tobías A.
        • Rivera-Dommarco J.A.
        Prevalence of obesity in Mexican adults, ENSANUT 2012.
        Salud Publica Mex. 2013; 55: S151-S160
        • Moshfegh A.J.
        • Rhodes D.G.
        • Baer D.J.
        • et al.
        The US Department of Agriculture automated multiple-pass method reduces bias in the collection of energy intakes.
        Am J Clin Nutr. 2008; 88: 324-332
        • World Cancer Research Fund, American Institute for Cancer Research
        Public health goals and personal recommendations.
        Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. American Institute for Cancer Research, Washington, DC2007: 366-393
      1. Food Composition Table. Version 2014. National Institute of Public Health, Cuernavaca, Mexico2012
        • Sánchez-Pimienta T.G.
        • Batis C.
        • Lutter C.K.
        • Rivera J.A.
        Sugar-sweetened beverages are the main source of added sugar intake in the Mexican population.
        J Nutr. 2016; 146: 1888S-1896S
      2. Stata Statistical Software [computer program]. Version 12. StataCorp LP, College Station, TX2011
        • Djupegot I.L.
        • Nenseth C.B.
        • Bere E.
        • et al.
        The association between time scarcity, sociodemographic correlates and consumption of ultra-processed foods among parents in Norway: A cross-sectional study.
        BMC Public Health. 2017; 17: 447
        • Monteiro C.A.
        • Levy R.B.
        • Claro R.M.
        • Castro I.R.
        • Cannon G.
        Increasing consumption of ultra-processed foods and likely impact on human health: Evidence from Brazil.
        Public Health Nutr. 2011; 14: 5-13
        • Moubarac J.C.
        • Borletto A.P.
        • Moreira R.
        • Bertazzi R.
        • Cannon G.
        • Monterio C.A.
        Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada.
        Public Health Nutr. 2012; 16: 2240-2248
        • Crovetto M.
        • Uauy R.
        • Martins A.P.
        • Moubarac J.C.
        • Monteiro C.
        [Household availability of ready-to-consume food and drink products in Chile: Impact on nutritional quality of the diet].
        Rev Med Chil. 2014; 142 (in Spanish): 850-858
        • Monteiro C.A.
        • Martins A.P.
        • Martins C.A.
        • et al.
        Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil.
        Public Health Nutr. 2015; 18: 2311-2322
        • Ministerio de Salud
        Guía alimentaria para la población uruguaya.
        (Published December 2016. Revised December 7, 2016. Accessed April 17, 2018)
        • Martínez Steele E.
        • Popkin B.M.
        • Swinburn B.
        • Monteiro C.A.
        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. 2017; 15: 6
        • Bonvecchio-Arenas A.
        • Fernández-Gaxiola A.C.
        • Plazas-Belausteguigoitia M.
        • et al.
        [Dietary and Physical Activity Guidelines in the Context of Overweight and Obesity in the Mexican Population: Position Paper.].
        Intersistemas, Mexico City, Mexico2015 (in Spanish)
        • O'Connor L.
        • Walton J.
        • Flynn A.
        Dietary energy density: Estimates, trends and dietary determinants for a nationally representative sample of the Irish population (aged 5–90 years).
        Br J Nutr. 2015; 113: 172-180
        • O'Connor L.
        • Walton J.
        • Flynn A.
        Dietary energy density and its association with the nutritional quality of the diet of children and teenagers.
        J Nutr Sci. 2013; 2: e10
        • Batis C.
        • Pedraza L.S.
        • Sánchez-Pimienta T.G.
        • Aburto T.C.
        • Rivera-Dommarco J.A.
        Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico.
        Salud Publica Mex. 2017; 59: 512-517
        • Barquera S.
        • White M.
        Treating obesity seriously in Mexico: Realizing, much too late, action must be immediate.
        Obesity. 2018; 26: 1530-1531
      3. Comité de expertos académicos nacionales del etiquetado frontal de alimentos y bebidas no alcohólicas para una mejor salud. A front-of-pack labelling system for food and beverages for Mexico: A strategy of healthy decision-making.
        Salud Publica Mex. 2018; 60: 479-486
        • Barquera S.
        • Campos I.
        • Rivera J.A.
        Mexico attempts to tackle obesity: The process, results, push backs and future challenges.
        Obes Rev. 2013; 14: 69-78
        • Bahena L.
        • Torres F.
        • Calvillo A.
        Explorando el Ambiente Escolar Alimentario: Barreras y Facilitadores en la Implementación de la Regulación de la Venta de Alimentos y Bebidas en Escuelas Primarias del Centro de México.
        El Poder del Consumidor, Ciudad de México, México2018
      4. Dietary Assessment Primer, 24-hour dietary recall (24HR) at a glance. National Institutes of Health, National Cancer Institute. National Cancer Institute’s Dietary Assessment Primer website.
        (Published June 2015. Revised June 29, 2015. Accessed April 24, 2019)

      Biography

      J. A. Marrón-Ponce is a researcher, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.

      Biography

      M. Flores is a professor, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.

      Biography

      G. Cediel is a professor, Escuela de Nutrición y Dietética, Universidad de Antioquia, Medellín, Colombia.

      Biography

      C. A. Monteiro is a professor, Department of Nutrition, School of Public Health, Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.

      Biography

      C. Batis is a professor, CONACYT - Center for Nutrition and Health Research, National Institute of Public Health, Mexico City, Mexico.

      Linked Article

      • Dietary Assessment Methodology in Response to November 2019 Issue
        Journal of the Academy of Nutrition and DieteticsVol. 120Issue 6
        • Preview
          The November 2019 issue of JAND neatly frames the issues surrounding the methods by which researchers measure food intake and dietary patterns. Kirkpatrick and colleagues’ article, “Best Practices for Conducting and Interpreting Studies to Validate Self-Report Dietary Assessment Methods,”1 sets a framework for the remainder of the issue, which includes assessment and associations of specific nutrient and diet patterns in the United States,2 Korea,3 Mexico,4 Brazil,5 and China,6 as well as knowledge translation in Switzerland.
        • Full-Text
        • PDF