Abstract

Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012-13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25-64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25-44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45-64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25-44 years) compared with the older (45-64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1-3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.

Highlights

  • Dietary patterns are undergoing change with traditional diets based on minimally processed foods[1,2] being displaced by convenient, mass-produced, highly marketed, ultra-processed foods (UPFs)(3)

  • We evaluated the prevalence of inadequate intake across two diet fractions, namely UPF (NOVA group 4) and non-UPF fractions (NOVA groups 1–3), using the international dietary nutrient recommendations specified by the World Health Organization (WHO)(28)

  • 441 Barbadian adults were selected from the participants in the Health of the Nation (HotN), of which 364 (83 % response rate) consented to take part

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Summary

Introduction

Dietary patterns are undergoing change with traditional diets based on minimally processed foods[1,2] being displaced by convenient, mass-produced, highly marketed, ultra-processed foods (UPFs)(3). The Pan American Health Organization[5] and the United Nations Food and Agricultural Organization[9] propose the use of the percentage of energy intake derived from UPF as an index of the overall nutritional quality of contemporaneous diets. In developed countries such as Canada, an estimated 45 % of total daily energy intake comes from UPF; being higher among men, younger adults and those with fewer years of formal education[10]. While for Mexico, a developing nation, 30 % of total daily energy is attributed to UPF consumption; being highest in younger age groups and persons of higher educational levels[11]

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