Ultra Processed Food Consumption in Children and Adolescents: Main Food Group Contributors and Associations With Weight Status

Consumption of ultra-processed foods (UPFs) is thought to play an important role in the development of childhood obesity worldwide. The aim of this study was to assess the main food groups contributing to UPF consumption and their association with weight status. Following exclusion of children with implausible intakes and misreporters, the final sample included 443 of 484 eligible (children and adolescents aged 2-18 years old) (91.5%), from the Hellenic National Nutrition and Health Survey (HNNHS). UPF items reported in 24-h recalls were identified according to the NOVA4 system and the proportion of their contribution to the daily energy intake was calculated. Main UPF food contributors were derived for the total population and by weight status. The association between weight status and UPF intake for the main contributors was examined using generalised linear models. The average percentage of total daily energy provided by UPFs was 39.8%. Four major food groups were found to contribute > 10% of total UPF intake: ready-to-eat/heat dishes (36.2%), sweet grain products (21.4%), savoury snacks (15.4%) and sweets (12.9%). These provided 86% of the total UPF intake, with no significant differences between children's weight status. There was also no significant association between the total percentage of energy as UPF and obesity. The relatively high contribution of UPFs, however, to children's daily energy intake in Greece emphasises the need for public food awareness campaigns for health promotion. Evaluation of the contribution of different food groups and not only of total UPF intake is also important.