Contribution of Ultra-Processed Foods to Complimentary Foods and Beverage Intake Among U.S. Infants and Toddlers According to NOVA

OBJECTIVES: To describe processing degree of complimentary foods and beverages (CFBs) according to NOVA for infants and toddlers in the US and describe how each NOVA group contributes to nutrients and food groups of concern identified by the 2020–2025 US Dietary Guideline for Americans. METHODS: Using day 1 dietary recall data from 2013–18 NHANES, we classified reported CFBs for infants and toddlers aged 6–23 months (n = 1140) into NOVA groups [unprocessed, culinary ingredients, processed, and ultra-processed foods (UPFs)]. We calculated % contribution of each NOVA group to energy from CFB (not including energy from human milk and formula). We also estimated the % contribution of NOVA groups to intakes of iron, vit D, zinc, sodium, vit B12, choline, potassium, vit A, vit C, and calcium from USDA's Food and Nutrient Database for Dietary Studies and total fruit, whole fruit, total vegetable, total grains, refined grains, whole grains, total dairy, milk, yogurt, total protein foods, added sugars, and solid fats from USDA's Food Patterns Equivalents Database. Complex survey design features were applied with SAS survey procedures. RESULTS: For infants and toddlers aged 6–23 months, 42 ± 0.9% of energy intake from CFBs was classified as unprocessed, 3 ± 0.2% as culinary ingredients, 9 ± 0.6% as processed, and 45 ± 0.8% as UPFs. At least 35% of all selected nutrients were from UPFs. Iron (81 ± 0.01%), zinc (58 ± 0.01%), and sodium (57 ± 0.01%) had the highest contributions from UPFs. UPFs were the largest contributor to intake of total grains (83 ± 0.01%), refined grains (83 ± 0.01%), whole grains (81 ± 0.02%), yogurt (82 ± 0.04%), and added sugars (87 ± 0.01%). Total fruit (78 ± 0.01%), whole fruit (69 ± 0.02%), total vegetable (56 ± 0.02%), total dairy (74 ± 0.02%), and milk (94 ± 0.01%) were largely from unprocessed foods. Unprocessed foods and UPFs contributed similarly to intakes of total protein foods and solid fats. CONCLUSIONS: UPFs contributed the majority of added sugar intake to the diets of infants and toddlers in the US, but also contributed meaningfully to foods and nutrients that are under consumed, such as iron and whole grains. Degree of food processing as a dimension of dietary quality among infants and toddlers requires further consideration. FUNDING SOURCES: None.