Micronutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on micronutrient content, the Nova classification and front of package traffic light labelling

Increased ultra-processed food (UPF) intake is associated with adverse health outcomes. However, with limitations in UPF evidence, and partial overlap between UK front of package labelling (FOPL) and degree of food processing, the value of food processing within dietary guidance is unclear. This study compared food and drink from the UK National Diet and Nutrition Survey (NDNS) database based on micronutrient content, Nova classification and FOPL. The aim was to examine the micronutrient contributions of UK food and drink to UK government dietary micronutrient recommendations for adult females and males, aged 19-64 years, based on the degree of food processing and FOPL. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF, and FOPL traffic lights. MPF, PF and UPF provided similar average contributions per 100g to micronutrient recommendations. Per 100kcal, MPF provided the greatest average contribution to micronutrient recommendations (14.4% [interquartile range (IQR):8.2-28.1]), followed by PF (7.7% [IQR:4.6-10.9], then UPF (5.8% [IQR:3.1-9.7]). After adjusting for healthy/unhealthy items (presence of 1+ red FOPL), MPF had higher odds of an above average micronutrient contribution per 100kcal than UPF (odds ratio (OR): 5.9x (95%CI:4.9, 7.2)), and PF (OR:3.2 (95%CI:2.4, 4.2)). MPFs were more likely to provide greater contributions to dietary micronutrient recommendations than PF or UPF per 100kcal. These findings suggest that UPF or PF diets are less likely to meet micronutrient recommendations than an energy-matched MPF diet. The results are important for understanding how consumers perceive the healthiness of products based on FOPL.