(LB02-02-25) Trends in Contributions to Total Energy and Food Mass Intake by Nova Categories in the U.S. Population, 2 Years and Older: NHANES 2005-2006 to 2021-2023

Objectives: The metric often used to describe the level of food processing with Nova is kilocalories (kcals). However, using grams to measure exposure estimates may better capture less energy dense products, such as artificially sweetened beverages that do not contribute kcals. Therefore, we compared trends in relative contribution of the four Nova groups—unprocessed/minimally processed foods (MPF), processed culinary ingredients (PCI), processed foods (PF), and ultra-processed foods (UPF)—in terms of total energy and total gram intake in the U.S. population.

Methods: The estimated contribution of Nova groups to total energy intake and total food mass was calculated from satisfactory day 1 24-hour dietary recalls in NHANES, 2005-2006 to 2021-2023 among those aged 2 years and older. Analyses were conducted for overall diet and stratified by foods and beverages. Linear trends by the Nova categories were assessed using orthogonal polynomials using SAS-callable SUDAAN. Dietary sample weights were used to obtain nationally representative estimates.

Results: The contribution of PCI and PF to total energy intake were low (each < 10%) with little variation over time. The contributions of MPF (~30%) and UPF (~55%) to total energy intake were also stable. By contribution to total food mass, PCI and PF were again low (each < 10%) with little variation over time. MPFs accounted for an increasing contribution from 60% of total mass in 2005-2006 to 67% in 2021-2023 (p < 0.01) while UPFs accounted for a decreasing contribution from 34% to 27% (p < 0.01), respectively. The contribution of foods only to total energy intake for MPF (~30%) and UPF (~55%) stayed constant, as did their contribution to total grams of intake (MPF:~50%; UPF:~40%). For beverages alone, the contribution to energy intake of MPF (~40%) and UPF (~50%) stayed constant and contribution by total grams of MPF increased from 65% in 2005-2006 to 75% in 2021-2023 (p < 0.01) and of UPF decreased from 31 to 21% (p < 0.01), respectively.

Conclusions: Overall percent contribution of UPF to energy intake remained constant over time, while overall UPF intakes by weight decreased over time, largely driven by lower UPF beverage intake. The distinction of foods and beverages is essential for accurately quantifying UPF exposure changes in the U.S. population.

Funding Sources: Cancer Prevention Fellowship Program, DCP, NCI, NIH