Ultra-processed food consumption in Scotland: A nationally representative analysis of sociodemographic patterns and dietary contributions

OBJECTIVE: To quantify ultra-processed food (UPF) intake in Scotland, identify key contributing food groups, and examine sociodemographic associations using nationally representative data. DESIGN: Cross-sectional analysis of 2021 Scottish Health Survey data using two-day dietary recalls via Intake24 classified by NOVA. UPF intake was calculated as percentage of total energy intake (%TEI) and grams per day (g/day). Multivariable linear regression assessed associations with sex, age, ethnicity, income, socioeconomic classification, highest educational qualification, urban/rural location, region, and Scottish Index of Multiple Deprivation (SIMD) quintiles. SETTING: Nationally representative sample of Scottish households. PARTICIPANTS: Individuals aged 16 or over with complete dietary and sociodemographic data (n = 2,645). RESULTS: Mean energy intake was 1,637.8 kcal/day (95% CI 1615.8, 1659.8). Mean UPF consumption was 666.9 g/day (95% CI: 647.9, 685.9), amounting to 919.9 kcal/day (95% CI 901.1, 938.6), representing 55.4% of TEI (95% CI: 54.7, 56.2) and 28.2% of total food weight. The main contributors to UPF intake were cereal products (244.8 kcal/day, 27.0% of UPF kcal), confectionery (170.3 kcal/day, 17.9%), and meats (153.6 kcal/day, 16.2%). Sandwiches (99.9% UPF), salty snacks (94.1%), and dietary supplements (90.5%) showed highest UPF proportions by food groups. Adjusted analyses revealed greater UPF consumption (%TEI) among: males (β = -3.3, p < 0.001), younger adults (β = -2.8 per decade, p < 0.001), White participants (β = +12.9 vs Non-White, p < 0.001), and lower SIMD quintile (β = -1.8 per quintile, p < 0.001). Similar patterns emerged for absolute intake (g/day). CONCLUSIONS: UPF dominates Scotland's diet, with inequitable distribution across sociodemographic groups. Policy actions - such as adopting NOVA in dietary guidelines and restricting UPF marketing - are urgently needed to address this public health crisis.