Evidence map›Paper›PMID 31462476›Full record

ArticleBMJ open2019

Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study.

Priscila P Machado, Euridice M Steele, Renata B Levy, Zhixian Sui, Anna Rangan, Julie Woods, Tim Gill, Gyorgy Scrinis, Carlos A Monteiro

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 154 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
154citing papers in PubMed, 9 pooled it
28.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

154 citing papers in PubMed, 9 syntheses or guidelines pooled it, 256 citations in OpenAlex.

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  13. Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).The international journal of behavioral nutrition and physical activity · 2022
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  14. Ultra-processed food supply in hospitals: A cross-sectional analysis of Australian hospitals using cook fresh foodservices.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2026
    Article
  15. Generational Influence on Diet Quality: An Analysis Based on Vigitel 2023.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
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94 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Priscila P MachadoGraduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.ORCID 0000-0003-4607-5094
Euridice M SteeleCenter for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil.
Renata B LevyCenter for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil.
Zhixian SuiSchool of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Anna RanganSchool of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Julie WoodsInstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
Tim GillBoden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Gyorgy ScrinisSchool of Agriculture and Food, The University of Melbourne, Melbourne, Victoria, Australia.
Carlos A MonteiroCenter for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil carlosam@usp.br.
Universidade de São Paulo · BRThe University of Sydney · AUDeakin University · AUThe University of Melbourne · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs).

designCross-sectional study.

settingNational Nutrition and Physical Activity Survey (2011-2012).

participants12,153 participants aged 2+ years.

main outcome measuresAverage dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. DATA ANALYSIS: Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined.

resultsUltra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p<0.001); total (β 0.08, p<0.001), saturated (β 0.18, p<0.001) and trans fats (β 0.10, p<0.001); sodium (β 0.21, p<0.001) and diet energy density (β 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (β -0.21, p<0.001) and potassium (β -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile.

conclusionThe high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.

Indexed as

Fast FoodsAdolescentAdultAgedAged, 80 and overAustraliaChildChild, PreschoolCross-Sectional StudiesDietary FatsDietary FiberDietary SugarsEnergy IntakeHumansMiddle AgedNoncommunicable DiseasesDietary FatsDietary FiberDietary SugarsPotassium, DietarySodium, DietaryAustraliadietfood consumptionfood processingquality of diet

Identifiers

PMID31462476
PMCPMC6720475
OpenAlexW2970500414

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.