Consumption of ultra-processed foods and socioeconomic position: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Isabela Judith Martins Benseñor,Bruce Bartholow Duncan,Luana Giatti,Maria Del Carmen Bisi Molina,Renata Bertazzi Levy,Sandhi Maria Barreto,Vivian Cristine Luft,Maria Inês Schmidt,Bárbara Dos Santos Simões,Letícia De Oliveira Cardoso

doi:10.1590/0102-311x00019717

Abstract

The objective of the study was to estimate the contribution of ultra-processed foods to total caloric intake and investigate whether it differs according to socioeconomic position. We analyzed baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil 2008-2010; N = 14.378) and data on dietary intake using a food frequency questionnaire, assigning it into three categories: unprocessed or minimally processed foods and processed culinary ingredients, processed foods, and ultra-processed foods. We measured the associations between socioeconomic position (education, per capita household income, and occupational social class) and the percentage of caloric contribution of ultra-processed foods, using generalized linear regression models adjusted for age and sex. Unprocessed or minimally processed foods and processed culinary ingredients contributed to 65.7% of the total caloric intake, followed by ultra-processed foods (22.7%). After adjustments, the percentage of caloric contribution of ultra-processed foods was 20% lower among participants with incomplete elementary school when compared to postgraduates. Compared to individuals from upper income classes, the caloric contribution of ultra-processed foods was 10%, 15% and 20% lower among the ones from the three lowest income, respectively. The caloric contribution of ultra-processed foods was also 7%, 12%, 12%, and 17% lower among participants in the lowest occupational social class compared to those from high social classes. Results suggest that the caloric contribution of ultra-processed foods is higher among individuals from high socioeconomic positions with a dose-response relationship for the associations.

Highlights

Since the 1970s and the 1980s, human diets have been changing from raw, unprocessed foods and traditional dishes to an increasing intake of ultra-processed food and beverages 1
We investigated the association between socioeconomic position indicators and consumption of ultra-processed foods among participants of the Brazilian Longitudinal Study of Adult Health (ELSABrasil)
ELSA-Brasil was approved by the Research Ethics Committees from the six participating institutions and all participants provided written consents to participate in the study

Summary

Introduction

Since the 1970s and the 1980s, human diets have been changing from raw, unprocessed foods and traditional dishes to an increasing intake of ultra-processed food and beverages 1. Industrial processing creates food products with ingredients and food additives to enhance flavor, increase durability and contribute to the consumer’s convenience. These food products have more calories, higher glycemic indexes, more trans fats, sugars, and sodium, being lower in fiber, micronutrients, and phytochemicals [5,6,7]. Despite the consumption of ultra-processed foods being higher in high income countries, it has been growing both in relative and absolute terms [15,16] in high and middle-income countries, especially in the latter 8. In the last two periods, ultra-processed food purchases were higher among higher income classes, but have increased in all income groups, mainly among those of lower income 17

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Conclusion