Technological advancements in food production, preparation, and processing have yielded improvements in the quality of life, food safety, and health. Yet, the proliferation of highly processed, ready-to-eat or ready-to-heat products, commonly referred to as ultraprocessed foods, has elicited concern because they tend to have poorer nutrient profiles and can replace more nutrient-dense, whole food options in the diet.
In this issue of JAMA, Wang et al1 present trends in the consumption of ultraprocessed foods among US youths using data from 1999-2018 National Health and Nutrition Examination Surveys (NHANES). Foods were categorized based on the NOVA framework, the current gold standard for classifying processed foods.2 NOVA-classified ultraprocessed foods are industrially produced and contain ingredients that will rarely be included in culinary preparations. The industrial production of ultraprocessed foods uses modern technology to create visually appealing and hyperpalatable products comprising materials extracted from food, such as casein and whey; substances derived from food constituents through further processing, such as soy protein isolates and maltodextrin; and nonculinary additives, such as flavor enhancers and emulsifiers.2,3 During the 20-year study period, the estimated percentage of total energy consumed from ultraprocessed foods increased from 61.4% to 67.0% (difference of 5.6%), whereas the estimated percentage of total energy consumed from unprocessed or minimally processed foods decreased from 28.8% to 23.5% (difference of −5.3%). The estimated percentage of energy from consumption of sugar-sweetened beverages decreased (from 10.8% to 5.3%), but the percentage of energy from other subgroups of ultraprocessed foods increased, especially ready-to-heat and -eat meals (from 2.2% to 11.2%).