(OR13-02-26) Estimating Trends in Energy Intake From Nova Groups in U.S. Youth and Adults Using the NCI Method

Objectives: Ultra-processed food (UPF) consumption may increase the risk of diet-related chronic diseases; thus, monitoring UPF intake over time remains essential. Adjusting for error in self-report estimates of dietary intake is needed to evaluate UPF exposure. We aimed to quantify the relative contribution (% of total kilocalories) of Nova groups—minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF), and UPF—to U.S. dietary intake and to assess trends over time.

Methods: We estimated average contributions of each Nova group relative to total energy consumed in the U.S. population ages ≥2 years from ten cycles of the National Health and Nutrition Examination Survey (NHANES) 2001–2002 to August 2021–August 2023 using the National Cancer Institute method (NCI) applied to reliable 24-hour dietary recalls. Mean contributions were calculated for each cycle, adjusted for age, sex, poverty-to-income ratio, race/ethnicity, and mode of interview for dietary recall. Polynomial (up to cubic) smoothing curves were fit to the cycle means (y) to characterize curvature in the trends over time on a by-year scale (x), using the Akaike Information Criterion (AIC) to choose the best fitting curves.

Results: UPF energy contribution in the overall population exceeded that of other Nova groups, showing a quadratic trend (y = -0.03(x-μ)² - 0.06x + 56.7; AIC -2.7; centering value µ = 12.2 = mean(x)) over time. MPF energy contribution showed a cubic trend (y = 0.001(x-µ)³ + 0.01(x-µ)² - 0.27x + 33.0; AIC -8.1). Relative to UPF and MPF, PCI and PF contributed less to total energy intake, showing cubic (y = -0.001(x-µ)³ + 0.02(x-µ)² + 0.25x + 2.4; AIC -15.8) and quadratic (y = 0.01(x-µ)² + 0.07x + 8.0; AIC -23.5) trends, respectively. Among youth, UPF contribution showed a quadratic trend for males (y = -0.03(x-µ)² - 0.08x + 61.9; AIC 6.1) and a cubic trend for females (y = 0.002(x-µ)³ - 0.03(x-µ)² - 0.27x + 64.0; AIC 6.5). In adults, UPF contribution showed quadratic trends (male: y = -0.03(x-µ)² - 0.05x + 54.6; AIC -2.8; female: y = -0.03(x-µ)² - 0.06x + 55.5; AIC 1.2).

Conclusions: Ten cycles of NHANES dietary intake data reveal UPFs contribute the most to total energy intake compared to other Nova groups. Curvature in smoothed trends typically suggests UPF consumption in kilocalories has declined in more recent cycles.

Funding Sources: Cancer Prevention Fellowship Program, NCI