Consumption of ultra‐processed foods and socioeconomic position: Cross sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)
Authors: dos Santos Simões Bárbara , Barreto Sandhi Maria , del Carmen Bisi Molina Maria , Luft Vivian Cristine , Duncan Bruce Bartholow , Schmidt Maria Inês , Benseñor Isabela M , de Oliveira Cardoso Letícia , Levy Renata Bertazzi , Giatti Luana 
Published: November 2023

Background

Changes that result from globalization are producing changes in the food profile of individuals. Those with low socioeconomic status may have limited access to healthy food choices, resulting in high consumption of ultra‐processed food that consequently increase the risk of obesity and chronic diseases.

Objective

To estimate the contribution of ultra‐processed foods to total caloric intake and investigate whether it differs according to socioeconomic position (SEP).

Methods

We analyzed baseline data from the Brazilian Longitudinal Study of Adult Health (2008–2010; n=14666). Dietary intake was assessed by food frequency questionnaire (FFQ) and assigned to three categories: unprocessed or minimally processed foods and processed culinary ingredients, processed foods, and ultra‐processed foods. Associations between SEP (education, per capita family income, and occupational social class) and the percentage caloric contribution of ultra‐processed foods were investigated using generalized linear regression models, after adjusting for age, gender, and race.

Results

Unprocessed or minimally processed foods and processed culinary ingredients contributed with 66.5% of the total caloric intake, followed by ultra‐processed foods (19%). After adjustments, the percentage caloric contribution from ultra‐processed foods was higher among participants with primary, secondary and tertiary education than among those with postgraduate training. Compared to individuals in the upper income quintile, the caloric contribution of ultra‐processed foods was 3.0, 7.0, and 5.0% greater among those in the lowest three income quintiles, respectively. The caloric contribution from ultra‐processed foods was also 7.0% higher among participants in the lowest occupational social class compared to high social class ones (AMR: 1.07; 95% CI: 1.04–1.1).

Conclusions

In this large cohort, two‐thirds of mean daily caloric intake come from unprocessed or minimally processed foods and processed culinary ingredients. Results suggest that the caloric contribution of ultra‐processed foods is higher among individuals with low SEP, without any indication of dose‐response gradient in the associations.

Support or Funding Information

The ELSA‐Brasil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology and Innovation (Financiadora de Estudos e Projetos‐FINEP and Conselho Nacional de Desenvolvimento científico e tecnológico‐CNPq), grants 0106 0010.00 RS, 01 06 0212.00BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00SP, 01 06 0071.00 RJ. B.S.S received a doctoral scholarship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). S.M.B, L.G, M.D.C.B.M, B.B.D, I.M.B, R.B.L. are research fellows of CNPq.