Ultra-processed food intake in toddlerhood and mid-childhood in the UK: cross sectional and longitudinal perspectives

Eur J Nutr. 2024 Dec;63(8):3149-3160. doi: 10.1007/s00394-024-03496-7. Epub 2024 Oct 4.

Abstract

Purpose: (i) Characterize ultra-processed food (UPF) intakes in toddlerhood and mid-childhood, including identifying principal UPF sub-groups and associations with nutrient profile; (ii) explore stability and change in UPF intake between toddlerhood and mid-childhood.

Methods: Data were from children in the UK Gemini twin cohort at 21 months (n = 2,591) and 7 years (n = 592) of age. UPF intakes were estimated using diet diaries and Nova classification. Complex samples general linear or logistic regression models were used to explore associations between UPF intake, UPF sub-groups and nutrients, and changes in intake over time.

Results: The contribution of UPF to total energy was 46.9% (± 14.7) at 21 months and 59.4% (± 12.5) at 7 years. Principal UPF sub-groups were yogurts, higher-fiber breakfast cereals, and wholegrain breads in toddlerhood, and puddings and sweet cereal products and white breads in mid-childhood. At both ages, mean free sugar and sodium intakes exceeded recommended maximums and higher UPF consumption was associated with consuming more of each nutrient (P < 0.001). UPF intake was negatively associated with fat, saturated fat and protein intake in toddlerhood, and fiber intake in mid-childhood (P < 0.001). Being in the highest UPF intake quintile in toddlerhood was predictive of being in the highest quintile in mid-childhood (OR 9.40, 95%CI 3.94-22.46).

Conclusions: UPF accounted for nearly half of toddlers' energy, increasing to 59% in mid-childhood. Higher UPF consumers had higher intakes of free sugar and sodium. UPF intake in toddlerhood was predictive of mid-childhood intake. Effective policies are needed to reduce UPF intakes in the early years.

Keywords: Children; Diet quality; Toddlers; UK; Ultra-processed foods.

Publication types

  • Twin Study

MeSH terms

  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Diet Records
  • Diet* / methods
  • Diet* / statistics & numerical data
  • Dietary Fats / administration & dosage
  • Dietary Fiber / administration & dosage
  • Energy Intake*
  • Fast Foods* / statistics & numerical data
  • Female
  • Food Handling / methods
  • Food, Processed
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • United Kingdom

Substances

  • Dietary Fiber
  • Dietary Fats