Ultra-processed food consumption among the paediatric population: an overview and call to action from the European Childhood Obesity Group

N Khandpur, DA Neri, C Monteiro, A Mazur… - Annals of Nutrition and …, 2020 - karger.com
N Khandpur, DA Neri, C Monteiro, A Mazur, ML Frelut, E Boyland, D Weghuber, D Thivel
Annals of Nutrition and Metabolism, 2020karger.com
Just for a moment, think of food or beverage products that are extensively marketed,
commonly consumed and widely liked by children. It is quite likely that the examples you are
thinking of fall within the category of ultra-processed foods (UPF). UPF are ready-to-eat
formulations of processed substances that have been extracted or refined from whole foods
and that typically contain added flavours, colours, and other cosmetic additives, with little, if
any, whole food remaining [1]. Soda, flavoured dairy drinks, packaged snacks, many …
Just for a moment, think of food or beverage products that are extensively marketed, commonly consumed and widely liked by children. It is quite likely that the examples you are thinking of fall within the category of ultra-processed foods (UPF). UPF are ready-to-eat formulations of processed substances that have been extracted or refined from whole foods and that typically contain added flavours, colours, and other cosmetic additives, with little, if any, whole food remaining [1]. Soda, flavoured dairy drinks, packaged snacks, many breakfast cereals, flavoured ice creams, instant noodles and soups, nuggets and similar reconstituted meat products are all examples of UPF. These products are generally high in free sugars, saturated fat, and sodium, and low in protein, dietary fibre, micronutrients and phytochemicals, relative to their unprocessed/minimally processed counterparts [2, 3]. They are also highly palatable, energy dense, with a high glycaemic load [4]. As the sale and consumption of these products increases worldwide [5, 6], children and adolescents have the concerning distinction of being their leading consumers [7, 8]. In the United Kingdom, 65% of calories eaten by primary and secondary school children come from UPF [9, 10]. A majority of 7-year-old British children eat a diet of predominantly UPF including white bread, biscuits, fizzy drinks, crisps and chips [11]. A similarly high intake of UPF (> 55%) is seen in paediatric populations of the United States and Canada [12, 13]. Between the years 2009–2014, US pre-schoolers were getting close to 60% of their daily calories from mass produced breads, cookies, savoury snacks, reconstituted meat products, milk-based drinks, breakfast cereals, juices and sodas, and frozen and ready-to-eat meals [12]. Among US school-aged children and adolescents UPF provided 66.2 and 66.4% of total daily energy respectively. Pizzas, sodas and juices were among the most consumed products among these age groups [12]. In low-and middle-income countries, the consumption of UPF is lower (18–35%), but young children are still their earliest adopters and their largest consumers [3, 14, 15]. There are also worrying inequalities in UPF consumption, with multi-dimensional socio-economic disadvantage being positively associated with UPF-based dietary patterns. European children whose mothers have relatively low education attainment, are younger, or have difficulty affording food are more likely to eat cheaper, less nutri-
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