Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia

Khandpur, Neha; Cediel, Gustavo; Obando, Daniel Ayala; Jaime, Patrícia Constante; Parra, Diana C.

doi:10.11606/s1518-8787.2020054001176

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Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054001176 copy

Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To analyze the consumption of ultra-processed foods in the Colombian population across sociodemographic factors.

METHODS

We used data from the 2005 National Survey of the Nutritional Status in Colombia. Food consumption was assessed using a 24-hour food recall in 38,643 individuals. The food items were classified according to the degree and extent of industrial processing using the NOVA classification.

RESULTS

The mean calorie contribution of ultra-processed foods ranged from 0.2% in the lowest quintile of consumers to 41.1% in the highest quintile of consumers. The greatest increases were due to the consumption of industrialized breads, sweet and savory snacks, sugary drinks, processed meats, and confectionery. No major differences were found in the consumption of ultra-processed foods between men and women. We observed significant differences by age, socioeconomic status, area of residence, and geographic region. Children and adolescents showed a higher intake of ultra-processed foods, almost double that of participants over 50 years of age. Children consumed significantly more snacks, confectionery products, processed cereals, milk-based drinks and desserts. Participants over 50 years consumed fewer products from these sub-groups of ultra-processed foods but had the highest consumption of industrialized bread. Individuals from urban areas, those with high socioeconomic status, participants residing in the Bogotá region had 1.5 to 1.7 times higher calorie intake from ultra-processed foods compared with those from a lower socioeconomic status and those residing in rural regions.

CONCLUSION

In Colombia, industrialized bread is the ultra-processed product that is most easily assimilated into the traditional diet, along with snacks and sugary drinks. Children and adolescents residing in urban areas and households with greater purchasing power have some of the highest intakes of ultra-processed foods in the country.

Food Consumption; Ultra-processed Foods; Socioeconomic Factors; Colombia; Diet Surveys

Indicator	Distribution

	Mean	Standard error
Age (years)	26.5	0.2
	n	%^*
Sex
Female	19,991	51.9
Male	18,527	48.1
Age groups (years)
2–9	7,126	18.5
10–19	8,859	23.0
20–34	10,130	26.3
35–49	7,703	20.0
≥ 50	4,699	12.2
Socioeconomic status
Level 1 (low)	10,169	29.4
Level 2	14,213	36.9
Level 3	10,977	28.5
Level 4 (high)	1,964	5.1
Area of residence
Urban	28,272	73.4
Central	5,854	15.2
Rural	4,391	11.4
Region
Atlantic	9,745	25.3
Eastern	6,471	16.8
Central	9,167	23.8
Pacific	6,509	16.9
Bogotá	6,124	15.9
Orinoquía and Amazon	423	1.1

Food Groups	Total 1,835 kcal	Q1 1,511 kcal	Q2 1,879 kcal	Q3 1,873 kcal	Q4 1,889 kcal	Q5 2,039 kcal
UPF calorie percentage		0–1.5%	1.6–9.3%	9.4–17.2%	17.3–28.7%	28.8–100%

Natural or minimally processed foods	63.3	76.1	70.7	64.9	58.4	44.1
Bananas, roots and tubers (includes flours)	9.0	22.4	18.4	15.8	13.4	9.3
Cereals, grains (includes flours)	14.2	19.4	15.8	14.3	12.0	9.0
Culinary preparations (ready to eat)^a	7.1	7.6	8.9	7.4	6.6	4.8
Milk, yogurt (natural)	5.5	3.9	5.2	6.1	6.7	5.8
Red meat	5.1	5.3	5.4	5.4	4.9	4.0
Fruits^b	3.6	4.4	4.1	3.7	3.2	2.4
Beans, pulse, legumes (includes flours)	3.5	4.2	4.0	3.7	3.3	2.0
Eggs	2.5	2.3	2.7	2.6	2.7	2.2
Poultry meat	2.2	1.9	2.2	2.4	2.5	2.0
Vegetables	1.6	1.5	1.7	1.7	1.7	1.4
Seafood	0.8	1.7	0.8	0.7	0.4	0.3
Natural fruit juice	0.3	0.2	0.2	0.3	0.3	0.3
Other minimally processed foods^c	0.9	1.4	1.1	0.9	0.7	0.5
Processed culinary ingredients	15.8	19.3	18.3	16.3	14.1	10.4
Sugar	8.9	11.2	10.6	9.3	7.7	5.3
Vegetable oils	6.1	6.9	6.7	6.2	5.8	4.6
Animal fat	0.8	1.2	1.0	0.8	0.6	0.4
Other culinary ingredients^c	0.0	0.0	0.0	0.0	0.0	0.01
Groups 1 + 2	79.1	95.4	89.0	81.2	72.5	54.6
Processed foods	4.9	4.4	5.4	5.6	5.0	4.4
Cheeses	1.9	2.2	2.0	2.1	1.9	1.7
Bakery (fresh unpackaged)	1.7	1.0	1.9	2.1	2.0	1.4
Meats (canned, smoked)	0.2	0.2	0.3	0.3	0.2	0.2
Canned fruits and vegetables	0.1	0.0	0.1	0.1	0.1	0.1
Wine and beer	0.1	0.0	0.1	0.1	0.1	0.1
Other processed foods^c	0.0	0.0	0.0	0.0	0.0	0.01
Ultra-processed foods	15.9	0.2	5.6	13.2	22.5	41.1
Industrialized breads	5.0	0.0	2.1	5.3	8.2	10.3
Snacks (sweet and savory)^d	2.5	0.0	0.7	1.8	3.2	7.5
Sugary drinks^e	2.5	0.0	0.1	2.2	3.7	6.0
Confectionery (chocolate, candies, sweets)	1.5	0.0	0.8	1.3	2.2	3.6
Processed meats	1.3	0.0	0.3	0.9	1.9	3.9
Ready-to-eat preparations “junk food”^f	0.6	0.0	0.0	0.1	0.4	2.8
Commercial desserts	0.5	0.0	0.1	0.3	0.7	1.5
Industrial breakfast cereals	0.3	0.0	0.1	0.1	0.4	0.9
Industrial dairy drinks^g	0.2	0.0	0.1	0.2	0.3	0.5
Other ultra-processed foods^c	1.4	0.0	0.0	1.1	1.5	4.2

Sociodemographic factors	UPF energy % (SE)	Beta (not adjusted)	p	Adjusted UPF energy % (SE)	Beta (adjusted)	p
Sex
Female	16.2 (0.3)	Reference	-	16.2 (0.2)	Reference	-
Male	15.5 (0.4)	-0.7	0.012	15.5 (0.2)	-0.6	0.007
Age (years)
2–9	18.5 (0.4)	Reference	-	19.3 (0.3)	Reference	-
10–19	18.6 (0.4)	0.1	0.678	19.3 (0.2)	-0.1	0.718
20–34	16.0 (0.4)	-2.5	< 0.001	15.4 (0.3)	-3.9	< 0.001
35–49	12.6 (0.4)	-5.9	< 0.001	12.2 (0.3)	-7.1	< 0.001
≥ 50	11.8 (05)	-6.8	< 0.001	11.4 (0.4)	-7.9	< 0.001
Socioeconomic status
Level 1 (low)	10.4 (0.4)	Reference		12.7 (0.3)	Reference	-
Level 2	16.5 (0.4)	6.1	< 0.001	15.8 (0.3)	3.1	< 0.001
Level 3	19.4 (0.4)	9.0	< 0.001	17.9 (0.3)	5.2	< 0.001
Level 4 (high)	23.6 (1.1)	13.2	< 0.001	22.8 (1.0)	10.1	< 0.001
Area of residence
Urban	18.2 (0.3)	Reference		17.3 (0.2)	Reference	-
Central	9.2 (0.7)	-8.9	< 0.001	12.6 (0.5)	-4.6	< 0.001
Rural	10.4 (0.7)	-7.8	< 0.001	11.2 (0.6)	-6.1	< 0.001
Region
Atlantic	11.4 (0.6)	Reference	-	12.7 (0.3)	Reference	-
Eastern	17.6 (0.8)	6.2	< 0.001	18.1 (0.4)	5.4	< 0.001
Central	14.8 (0.7)	3.5	< 0.001	14.4 (0.4)	1.7	0.001
Pacific	14.4 (0.6)	3.1	< 0.001	14.9 (0.4)	2.2	< 0.001
Bogotá	24.4 (0.6)	13.0	< 0.001	21.6 (0.5)	8.9	< 0.001
Orinoquía and Amazon	17.1 (0.6)	5.7	< 0.001	15.7 (0.6)	3.0	< 0.001

Indicators	All UPF	Industrialized breads	Snacks (sweet and savory)^b	Sugary drinks^c	Confectionery	meats	Junk food^d	Commercial desserts	Cereals	Dairy Drinks^e	Others UPF^f
Sex
Female	16.2 (0.2)	5.2 (0.1)	2.8 (0.1)	2.2 (0.1)	1.7 (0.1)	1.4 (0.1)	0.6 (0.0)	0.6 (0.0)	0.4 (0.0)	0.2 (0.0)	1.2 (0.1)
Male	15.5 (0.2)	4.8 (0.1)	2.2 (0.1)	2.8 (0.1)	1.3 (0.0)	1.3 (0.1)^a	0.7 (0.1)	0.4 (0.0)	0.2 (0.0)	0.2 (0.0) ^a	1.6 (0.1)
Age (years)
2 – 9	19.3 (0.3)	5.2 (0.1)	4.5 (0.1)	2.1 (0.1)	2.3 (0.1)	1.6 (0.1)	0.5 (0.1)	0.9 (0.1)	0.6 (0.0)	0.5 (0.0)	0.9 (0.1)
10 – 19	19.3 (0.2)	5.4 (0.1) ^a	3.8 (0.1)	2.8 (0.1)	2.1 (0.1)	1.7 (0.1) ^a	0.9 (0.1)	0.7 (0.0)	0.3 (0.0)	0.2 (0.0)	1.2 (0.1)
20 – 34	15.4 (0.3)	4.6 (0.2)	1.8 (0.1)	3.3 (0.1)	1.1 (0.1)	1.4 (0.1) ^a	0.6 (0.1) ^a	0.3 (0.0)	0.2 (0.0)	0.1 (0.0)	1.9 (0.2)
35 – 49	12.2 (0.3)	4.7 (0.2)	1.1 (0.1)	2.1 (0.1) ^a	1.0 (0.1)	1.0 (0.1)	0.3 (0.1)	0.3 (0.1)	0.1 (0.0)	0.1 (0.0)	1.4 (0.1)
≥ 50	11.4 (0.4)	5.5 (0.3) ^a	0.9 (0.1)	1.3 (0.1)	1.0 (0.1)	0.8 (0.1)	0.4 (0.1) ^a	0.2 (0.1)	0.1 (0.0)	0.1 (0.0)	1.3 (0.2) ^a
Socioeconomic status
Level 1 (low)	12.7 (0.3)	4.4 (0.2)	1.9 (0.1)	1.8 (0.1)	1.4 (0.1)	1.0 (0.1)	0.3 (0.0)	0.3 (0.0)	0.1 (0.0)	0.1 (0.0)	1.3 (0.1)
Level 2	15.8 (0.3)	5.4 (0.1)	2.3 (0.1)	2.5 (0.1)	1.6 (0.1)	1.3 (0.1) ^a	0.6 (0.0)	0.5 (0.0)	0.3 (0.0)	0.2 (0.0)	1.3 (0.1) ^a
Level 3	17.9 (0.3)	5.2 (0.1)	3.1 (0.1)	2.9 (0.1)	1.5 (0.1) ^a	1.6 (0.1)	0.8 (0.1)	0.6 (0.1)	0.4 (0.1)	0.3 (0.0)	1.5 (0.1) ^a
Level 4 (high)	22.8 (1.0)	5.2 (0.4) ^a	3.8 (0.4)	3.7 (0.3)	1.4 (0.2) ^a	2.3 (0.4)	1.8 (0.3)	1.0 (0.1)	0.7 (0.1)	0.6 (0.1)	2.2 (0.4)
Area of residence
Urban	17.3 (0.2)	5.4 (0.1)	2.6 (0.1)	2.8 (0.1)	1.5 (0.1)	1.5 (0.1)	0.7 (0.0)	0.6 (0.0)	0.3 (0.0)	0.2 (0.0)	1.4 (0.1)
Central	12.6 (0.5)	4.2 (0.2)	2.3 (0.2)	1.8 (0.1)	1.5 (0.1) ^a	0.9 (0.1)	0.4 (0.0)	0.4 (0.1) ^a	0.2 (0.0)	0.1 (0.0)	0.8 (0.1)
Rural	11.2 (0.6)	3.5 (0.3)	1.5 (0.1)	1.4 (0.2)	1.3 (0.2) ^a	0.7 (0.2)	0.2 (0.1)	0.3 (0.1) ^a	0.1 (0.0)	0.1 (0.0)	2.1 (0.4) ^a
Region
Atlantic	12.7 (0.3)	3.5 (0.1)	2.2 (0.1)	2.4 (0.1)	0.5 (0.0)	1.3 (0.1)	0.5 (0.0)	0.3 (0.0)	0.2 (0.0)	0.2 (0.0)	1.4 (0.1)
Eastern	18.1 (0.4)	6.3 (0.3)	2.4 (0.1) ^a	3.0 (0.1)	2.1 (0.1)	1.1 (0.1) ^a	0.6 (0.1) ^a	0.6 (0.1)	0.4 (0.1)	0.1 (0.0) ^a	1.4 (0.1) ^a
Central	14.4 (0.4)	3.1 (0.2) ^a	2.6 (0.1)	2.3 (0.1) ^a	1.3 (0.1)	1.7 (0.1)	0.7 (0.1)	0.6 (0.1)	0.3 (0.0)	0.3 (0.0)	1.5 (0.2) ^a
Pacific	14.9 (0.4)	5.5 (0.2)	2.6 (0.1)	2.1 (0.1)	0.9 (0.1)	1.4 (0.1) ^a	0.4 (0.1) ^a	0.4 (0.0)	0.2 (0.0) ^a	0.2 (0.0) ^a	1.1 (0.1) ^a
Bogotá	21.6 (0.5)	8.2 (0.3)	2.8 (0.2)	2.6 (0.2) ^a	3.3 (0.2)	1.0 (0.1) ^a	0.9 (0.1)	0.7 (0.1)	0.4 (0.1)	0.2 (0.0) ^a	1.4 (0.2) ^a
Orinoquía and Amazon	15.7 (0.6)	4.9 (0.3)	2.5 (0.2) ^a	3.4 (0.2)	1.7 (0.2)	1.1 (0.1) ^a	0.6 (0.1) ^a	0.4 (0.1) ^a	0.3 (0.0)	0.1 (0.0) ^a	0,7 (0,1)

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[1] Correspondence: Neha Khandpur Av. Dr. Arnaldo, 715 01246-904 São Paulo, SP, Brasil E-mail: neha.khandpur@usp.br