(P26-19-26) Sociodemographic Correlates of Ultra-Processed Food Intake and Diet Quality Among Young Children in the US-Affiliated Pacific

Objectives: To examine associations between ultra-processed food (UPF) intake, sociodemographic characteristics, and diet quality among young children in the US-affiliated Pacific region (USAP).

Methods: Baseline data (2013-2014) from children aged 2-8 years from the Children’s Healthy Living (CHL) Program across 11 USAP jurisdictions were analyzed (n=3529). Two days of dietary records completed by a parent/caregiver were collected. Child- and household-level sociodemographic characteristics were assessed via questionnaire. The Nova classification system was applied at the food code level to estimate UPF intake (% total energy). Diet quality was evaluated using Healthy Eating Index-2020 (HEI-2020) total and component scores. Descriptive statistics and chi-squared tests compared sociodemographic characteristics across quartiles of UPF intake. Survey-weighted crude and multivariable linear regression models estimated mean HEI-2020 scores by quartile of UPF intake, adjusting for child age, sex, race or ethnicity, total energy intake, caregiver education, and household income.

Results: Sociodemographic characteristics and diet quality differed across quartiles of UPF intake. Notably, children in Q4 (highest UPF intake) were more likely to live in food-secure households, have integrated or assimilated acculturation status, higher household income, and caregivers with higher education compared to Q1 (lowest UPF; χ² tests; p < 0.0001). UPF intake was inversely associated with HEI-2020 total scores in crude models (Q1: 50.6 [95% CI 49.6 - 51.6] vs. Q4: 45.1 [95% CI 43.3 - 47.0]; p < 0.0001) and fully adjusted models (Q1: 58.4 [95% CI 57.0 - 59.9] vs. Q4: 50.3 [95% CI 48.6 - 51.9]; p < 0.0001).

Conclusions: Higher UPF intake was associated with lower diet quality among young children in the USAP. Sociocultural and economic characteristics varied across UPF quartiles, warranting further investigation into the contextual drivers of UPF consumption to inform appropriate and equitable policies and interventions in the region.

Funding Sources: USDA NIFA AFRI, NIH/NIDDK T32