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Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study
  1. Larissa Galastri Baraldi1,2,
  2. Euridice Martinez Steele1,2,
  3. Daniela Silva Canella2,3,
  4. Carlos Augusto Monteiro1,2
  1. 1 Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
  2. 2 Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
  3. 3 Department of Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
  1. Correspondence to Dr Carlos Augusto Monteiro; carlosam{at}


Objectives To compare ultra-processed food consumption across sociodemographic groups and over time (2007–2008, 2009–2010, 2011–2012) in the USA.

Design Cross-sectional study.

Setting National Health and Nutrition Examination Survey (NHANES) 2007–2012.

Participants All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847).

Main outcome measures Average dietary contribution of ultra-processed foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification.

Data analysis Linear regression was used to evaluate the association between sociodemographic characteristics or NHANES cycles and dietary contribution of ultra-processed foods.

Results Almost 60% of calories consumed in the period 2007–2012 came from ultra-processed foods. Consumption of ultra-processed foods decreased with age and income level, was higher for non-Hispanic whites or non-Hispanic blacks than for other race/ethnicity groups and lower for people with college than for lower levels of education, all differences being statistically significant. Overall contribution of ultra-processed foods increased significantly between NHANES cycles (nearly 1% point per cycle), the same being observed among males, adolescents and high school education-level individuals.

Conclusions Ultra-processed food consumption in the USA in the period 2007–2012 was overall high, greater among non-Hispanic whites or non-Hispanic blacks, less educated, younger, lower-income strata and increased across time.

  • diet
  • nutrition surveys
  • United States

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  • Contributors CAM and LGB designed the research. LGB and EMS took care of data management. LGB, EMS and DSC analysed the data. LGB, EMS and CAM wrote the paper. CAM and LGB had primary responsibility for the final content. All authors revised critically the final version to be published, had full access to all of the data (including statistical reports and tables), read and officially approved the final version. All authors absolutely agreed to be accountable for all aspects of the study.

  • Funding This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Edital MCTI/CNPq/Universal (Processo CNPq number 443477/2014-0) and from Fundação de Amparo à Pesquisa do Estado de São Paulo (Processo FAPESP number 2015/14900-9).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Secondary publicly available data from NHAES were used in this study. NHANES obtained Ethics Committee/Institutional Review Board approval by NCHS Research Ethics Review Board under Continuation of Protocol #2005-06 and Protocol #2011-17 for 2007–2008/2009–2010 cycles and for 2011–2012 cycle, respectively.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This study is based on open data of the American population that is available by Centers for Disease Control and Prevention in their website: