Consumption of ultra-processed food products and diet quality among children, adolescents and adults in Belgium.

Purpose: To assess the dietary share of ultra-processed foods (UPF) among Belgian children, adolescents and adults and associations with diet quality.

Methods: Data from the national Food Consumption Surveys 2004 (N = 3083; ≥ 15 years) and 2014-2015 (N = 3146; 3-64 years) were used. Two 24-h recalls (dietary records for children) were used for data collection. Foods consumed were classified by the level of processing using the NOVA classification. The usual proportion of daily energy intake from UPF was determined using SPADE (Statistical Program to assess dietary exposure).

Results: In 2014/2015, 36.4% of foods consumed were ultra-processed, while 42.4% were unprocessed/minimally processed. The usual proportion of daily energy intake from UPF was 33.3% (95% CI 32.1-35.0%) for children, 29.2% (95% CI 27.7-30.3%) for adolescents and 29.6% (95% CI 28.5-30.7%) for adults. There were no differences in UPF consumption between 2004 and 2014/2015. The products contributing most to UPF consumption were processed meat (14.3%), cakes, pies, pastries (8.9%), sweet biscuits (7.7%) and soft drinks (6.7%). The UPF dietary share was significantly lower during consumption days when participants met the WHO salt intake recommendation (≤ 5 g/day) and when saturated fat was ≤ 10% of their total energy intake. The dietary share of unprocessed/minimally processed foods was significantly higher during consumption days when participants met the WHO salt and fruit/vegetable intake (≥ 400 g/day) recommendations and when saturated fat was ≤ 10% of their total energy intake.

Conclusions: The UPF dietary share is substantial and associated with lower diet quality. Internationally recommended policies to limit UPF accessibility and marketing need to be implemented to reduce UPF consumption.