Abstract
Higher consumption of 'ultra-processed' (UP) foods has been linked to adverse health outcomes. The present paper aims to characterise percentage energy from UP foods by participant socio-economic status (SES), diet quality, self-reported food expenditure and energy-adjusted diet cost. Participants in the population-based Seattle Obesity Study III (n 755) conducted in WA in 2016-2017 completed socio-demographic and food expenditure surveys and the FFQ. Education and residential property values were measures of SES. Retail prices of FFQ component foods (n 378) were used to estimate individual-level diet cost. Healthy Eating Index (HEI-2015) and Nutrient Rich Food Index 9.3 (NRF9.3) were measures of diet quality. UP foods were identified following NOVA classification. Multivariable linear regressions were used to test associations between UP foods energy, socio-demographics, two estimates of food spending and diet quality measures. Higher percentage energy from UP foods was associated with higher energy density, lower HEI-2015 and NRF9.3 scores. The bottom decile of diet cost ($216·4/month) was associated with 67·5 % energy from UP foods; the top decile ($369·9/month) was associated with only 48·7 % energy from UP foods. Percentage energy from UP foods was inversely linked to lower food expenditures and diet cost. In multivariate analysis, percentage energy from UP foods was predicted by lower food expenditures, diet cost and education, adjusting for covariates. Percentage energy from UP foods was linked to lower food spending and lower SES. Efforts to reduce UP foods consumption, an increasingly common policy measure, need to take affordability, food expenditures and diet costs into account.
Highlights
High consumption of ‘ultra-processed’ (UP) foods as defined by the NOVA classification scheme[1] has been associated with a wide range of adverse health outcomes
It is well established that food prices and diet costs contribute to the observed socio-economic disparities in diet quality and may affect health outcomes[16,17,18,19]
Percentage energy from UP foods and other dietary quality indicators were compared across tertiles of diet cost and monthly food expenditure
Summary
The SOS III was a population-based longitudinal study of adult male and female residents of King, Pierce and Yakima Counties in WA State. Participant recruitment was countyspecific, relying on address-based sampling schemes stratified by three bands of residential property values. Participant recruitment and data collection were conducted in-person by local staff at each research site (from July 2016 to May 2017). Eligible adults were aged 21–59 years, household gatekeepers, not pregnant or breast-feeding (at the time of data collection), and without any mobility issues. Participants were invited to complete the first in-person visit at local study site or at home (Yakima only). Written consent was provided during the in-person visit before starting the study procedures. The present analytical sample was based on 755 male and female respondents
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