ArticleThe American journal of clinical nutrition2026
Ultraprocessed food consumption by urbanization level among United States youth and adults: cross-sectional analysis of NHANES 2013-March 2020.
Article in The American journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- Clustering of Unhealthy Diets, Inflammation Levels, and Depressive Symptoms in Chinese Adolescents: A Longitudinal Study.Nutrients · 2026Article
- Article
- Ultra-processed food consumption across early life: implications for pediatric health and disease risk.Frontiers in nutrition · 2026Review
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Authors and funding
7 authors.
Funding
Abstract
backgroundIn the United States, ultraprocessed foods (UPFs) may contribute to poorer diet quality that has been observed in rural areas compared with urban areas, as increased UPF consumption is linked with decreased nutritional quality.
objectivesTo describe the mean contribution to total energy and total gram intakes from UPFs, unprocessed or minimally processed foods (MPFs), and other Nova categories and subcategories by urbanization level among United States youth and adults.
methodsCross-sectional data from the National Health and Nutrition Examination Survey from 2013 to March 2020 were analyzed. The mean percent of total energy and total gram intakes from Nova categories (MPFs, processed culinary ingredients, processed foods, and UPFs) were estimated by urbanization level (nonmetropolitan statistical areas [non-MSAs, n = 3976], small-to-medium MSAs [n = 9170], and large MSAs [n = 14,637]) for youth 2-19 y and adults 20 y and older. Trends by urbanization level were assessed using orthogonal contrasts in linear regression models adjusted for sex, age, race and Hispanic origin, and income. Day 1 dietary sample weights accounted for differential probabilities of selection, nonresponse, noncoverage, and day of the week.
resultsAmong youth, there was no trend in MPF or UPF as a percent of energy by the urbanization level. As a percent of grams, MPF increased and UPF decreased with a higher urbanization level. After adjustment for sex, age, race and Hispanic origin, and income, only the trend in the percent of grams from MPF remained. Among adults, as both a percent of energy and a percent of grams, MPF increased and UPF decreased with higher urbanization levels. These trends remained significant after adjustment for covariates.
conclusionsAdults in rural areas consumed more UPF and less MPF than those in urban areas in terms of both energy and grams. There were a few significant differences by urbanization among youth.
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