Ultra-Processed Food Intake and Associations With Demographic Factors in Young New Zealand Children

J Acad Nutr Diet. 2021 Feb;121(2):305-313. doi: 10.1016/j.jand.2020.08.088. Epub 2020 Oct 21.


Background: Children consume ultra-processed food (UPF) from a young age, but the proportional contribution of UPF to young children's total energy intakes has not been evaluated in developed countries.

Objectives: To describe UPF intake and associations with demographic factors in young children from 12 to 60 months of age.

Design: Cohort study comprising a secondary analysis of data from a randomized controlled trial. Demographic data were collected by questionnaire. At 12, 24, and 60 months of age validated food frequency questionnaires estimated percentage of energy intake from UPF (%kcal UPF).

Participants/setting: The 669 children were born in Dunedin, New Zealand, between May 2009 and December 2010.

Main outcome measures: Mean percentage of energy intake from UPF at 12, 24, and 60 months of age, mean differences in %kcal UPF by demographic variables.

Statistical analyses performed: Mixed effects regression models were used to estimate relationships between demographics and %kcal UPF. Multiple imputation methods were used to impute missing UPF data.

Results: UPF contributed mean (95% confidence interval) 45% (44%, 47%), 42% (41%, 44%), and 51% (50%, 52%) of energy intake to the diets of children at 12, 24, and 60 months of age, respectively. Energy intake from UPF was moderately correlated between 24 and 60 months (r = 0.36). No demographic factors were associated with mean %kcal UPF across time points, except for maternal obesity predicting higher UPF intake at 12 months. Bread, yoghurt, crackers, whole-wheat breakfast cereal, sausages, and muesli bars were among the 10 foods making the greatest contribution to mean %kcal UPF intakes at all time points.

Conclusions: UPF contribute a substantial proportion of energy to the diets of young children. A range of foods with varying nutritional profiles contribute to these high intakes.

Trial registration: ClinicalTrials.gov NCT00892983.

Keywords: Children; Early life feeding practices; NOVA; Percentage of energy from ultra-processed foods; Ultra-processed foods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Behavior*
  • Child, Preschool
  • Demography / statistics & numerical data*
  • Diet / statistics & numerical data*
  • Diet Surveys
  • Energy Intake*
  • Fast Foods / statistics & numerical data*
  • Feeding Behavior*
  • Female
  • Humans
  • Infant
  • Male
  • New Zealand
  • Randomized Controlled Trials as Topic
  • Regression Analysis
  • Surveys and Questionnaires

Associated data

  • ClinicalTrials.gov/NCT00892983