Eating ultra-processed ‘gateway’ foods drives unhealthy consumption patterns in teens
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Adolescents who ate more candy, pastries and frozen desserts during the COVID-19 pandemic were more likely to increase consumption of other ultra-processed foods compared with teens reporting eating fewer ultra-processed foods, data show.
Previous data showed a diet rich in ultra-processed food is associated with increased hazards of all-cause and CVD mortality, particularly among people with preexisting CVD.
“The study found that specific ultra-processed foods act as ‘gateway’ foods and teens who change their consumption of them are likely to change consumption of all other ultra-processed foods as well,” Maria Balhara, a dual-enrolled student at Broward College and Cooper City High School in Davie, Florida, who presented the findings at the American Heart Association Hypertension Scientific Sessions, told Healio. “Teens in the study who increased intake of candy, pastries and frozen desserts during the pandemic also reported increased levels of all other ultra-processed foods.”
Balhara, who led the study, analyzed data from 315 adolescents from Florida aged 13 to 19 years (mean age, 16 years). She calculated participants’ Processed Intake Evaluation (PIE) scores (scale of 0 to 100), based on an averaged consumption of 12 ultra-processed food products, and assessed score changes before and after the COVID-19 pandemic. Participants were grouped as having increased (n = 135) or decreased (n = 180) ultra-processed food intake during the pandemic.
During the pandemic, 43% of participants increased their consumption of ultra-processed foods, whereas 57% of teens decreased consumption.
Among teens who increased intake of ultra-processed foods, an increased intake of candy, store pastries or frozen desserts was associated with a 31%, 12% and 11% increase in ultra-processed food intake across all other ultra-processed food categories, respectively (P for change in score < .01).
Among teens who decreased intake of ultra-processed foods during the pandemic, reduced intake of biscuits, white bread or processed meat was associated with a 10%, 9% and 8% decrease in overall ultra-processed food intake across all other ultra-processed food categories, respectively (P for change in score < .01).
“For teens, gateway ultra-processed foods such as candy, store pastries and frozen desserts should thus be prioritized for preventive dietary interventions, as they increase intake across all other ultra-processed foods,” Balhara told Healio. “A growing body of evidence has proven that a diet loaded with ultra-processed foods, which are high in sugar, salt and unhealthy trans fats, leads to hypertension, weight gain and increased burden of heart disease.”
Balhara said ultra-processed foods are designed to be hyper-palatable, cheap and convenient, making such choices difficult to resist for adolescents.
“In fact, ultra-processed foods now make up nearly two-thirds of the American adolescent diet,” Balhara told Healio. “Because of this, it is important to conduct more research on adolescent eating habits to propose better interventions. With such a large percentage of our diet coming from these foods, new strategies such as the one outlined by this ‘gateway food model’ are urgently needed to improve public health. The confirmation of ‘gateway foods’ is significant; however, more research is needed on the gateway foods in other subgroups, defined by age and other factors. Studying these will give scientists more insight into how outreach programs should be targeted and personalized to each patient.”
In an interim analysis of the PIE study reported by Healio, Balhara reported that adolescents and young adults are eating less ultra-processed food since the start of the COVID-19 pandemic compared with before the pandemic, reversing a 30-year trend of increased ultra-processed food consumption.
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Balhara M. Abstract 778. Presented at: American Heart Association Hypertension Scientific Sessions; Sept. 7-10, 2022; San Diego (hybrid meeting).
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