Ultra-processed food consumption, nutrition quality, and obesity prevalence in Israel

Obesity is associated with chronic disease and burdens individuals and health systems heavily. Obesity prevalence has increased globally in recent decades. Concurrently, consumption of natural and home-prepared foods has decreased while that of industrial and ultra-processed foods (UPFs) that may play a role in obesity etiology, has increased. Our aim was to assess the extent of UPF consumption, nutrition quality and obesity prevalence in Israel, using data from a cross-sectional National Health and Nutrition survey conducted in 2014-16 on a representative sample of 25-64Y individuals who were face-to-face interviewed and anthropometrically measured. Participants reported 24h dietary intake. Consumed foods were coded into 4 groups based on the NOVA method which classifies foods by their level of processing, from unprocessed foods to UPFs. Obesity prevalence was determined by body mass index (≥30Kg/m2), relative fat mass and waist circumference. Univariable and multivariable logistic regression models adjusted for potential confounders were used to assess associations between UPFs consumption and obesity prevalence. In 2,563 participants (mean age=42.2±11.1Y, 46.8% males), average UPFs consumption was 34.5% of total energy intake. Highest quartile of UPFs consumption was associated with younger age (p = 0.0015), lower physical activity (p < 0.001) and current smoking (p = 0.0162). High consumption of UPFs was significantly associated with higher intake of energy, carbohydrates, saturated fat, and thiamin, and lower intake of protein, monounsaturated fatty acids, dietary fiber, folic acid, vitamin B12, Vitamin C, zinc and total fats. No association was found between UPFs consumption and obesity prevalence. In conclusion, high consumption of UPFs is associated with higher likeliness of unhealthy behaviors and lower nutrition quality in 25-64Y Israeli individuals. No association was found between UPFs consumption and obesity prevalence. KEY MESSAGES: • Consumption of ultra-processed foods is associated with lower nutrition quality. • Consumption of ultra-processed foods was not associated with obesity prevalence.