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Front. Nutr. | doi: 10.3389/fnut.2019.00070

Characterizing ultra-processed foods by energy density, nutrient density and cost

Shilpi Gupta1, Terry Hawk1, Anju Aggarwal1 and  Adam Drewnowski2, 3*
  • 1Center for Public Health Nutrition, Department of Epidemiology, University of Washington, United States
  • 2University of Washington, United States
  • 3Department of Epidemiology, Center for Public Health Nutrition, Department of Epidemiology, University of Washington, United States

Background: The NOVA food classification scheme divides foods into ultra-processed, processed, unprocessed, and culinary ingredients. Ultra-processed foods contribute >60% of energy to diets in the US.
Objective: To characterize ultra-processed foods by energy density, nutrient density, and monetary cost.
Methods: The 384 component foods of Fred Hutch (FHCRC) food frequency questionnaire (FFQ), were assigned to 4 NOVA categories and to 7 USDA MyPyramid food groups. Energy density was kcal/g . Nutrient density was measured using the Nutrient Rich Food index NRF9.3. Food prices were collected in local supermarkets from 2004 to2016. Analyses examined time trends in food prices by NOVA category and by USDA food group..
Results: The ultra-processed classification captured mostly grains (91%), fats and sweets (73%), dairy (71%), and beans, nuts and seeds (70%), but only 36% of meat, poultry and fish, 26% of vegetables, and 20% of fruit. Compared to unprocessed foods, ultra-processed foods had lower nutrient density (NRF9.3 per 100kcal: 21.2 vs. 108.5) ,higher energy density (mean (SD): 2.2 vs 1.10 in kcal/g), and lower per calorie cost (0.55 vs. 1.45 in $/100 kcal). Ultra-processed foods did not increase in price as much as unprocessed foods over the 12 year period..
Conclusion: Ultra-processed foods tend to be energy-dense, low-cost, and nutrient-poor. Low energy cost could be one mechanism linking ultra-processed foods with negative health outcomes. Food-based Dietary Guidelines may need to address food processing in relation to economic aspects of food choice.

Keywords: Ultra-processed foods and prices, processed foods by NRF9.3, Dietary guidelines by food processing, Food processing diet indicator, Nutrient density, processed foods and health

Received: 16 Feb 2019; Accepted: 26 Apr 2019.

Edited by:

Jan Steijns, FrieslandCampina (Netherlands), Netherlands

Reviewed by:

Tilakavati Karupaiah, Taylor's University, Malaysia
Anthony Fardet, Institut National de la Recherche Agronomique (INRA), France  

Copyright: © 2019 Gupta, Hawk, Aggarwal and Drewnowski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Adam Drewnowski, University of Washington, Seattle, United States,