Ultra-processed food intake and its association with nutrient intake and sociodemographic factors amongst Lebanese school-aged children and adolescents: a national cross-sectional study

Abstract

Abstract The study aimed to evaluate ultra-processed foods (UPFs) consumption among school-aged children and adolescents in Lebanon and examine factors associated with its intake. A cross-sectional national survey was conducted in 2014–2015 on a nationally representative sample of households with children and adolescents aged 5–18 years in Lebanon (n = 1111). Dietary assessment was performed using 24-h recall method and UPF were identified based on the NOVA classification. Information pertinent to sociodemographic characteristics and physical activity levels was also collected. Percent of energy intake (%E) from UPF ranged between 48.3% and 51.4% amongst children in our study sample with pizzas, dough-based dishes, sweets, and fast food as main energy contributors. Overall, UPFs were the largest contributors to carbohydrates, total sugar, total fat, saturated fat, sodium, and iron intakes. Unprocessed or minimally processed foods contributed most to protein, fibre, calcium, zinc, and vitamins A and C intakes, while being the lowest contributors to sodium intakes. Age and sex-based differences in UPF intakes were also noted. Adjusted regression models showed that girls and children of working fathers had significantly lower %E from UPF compared to boys and children of unemployed fathers (β: −0.18, 95% CI: −0.22, −0.14 and β: −0.27, 95% CI: −0.34, −0.20, respectively). In addition, higher household income was associated with increased %E from UPF. Public health action is needed to reduce the high UPF intake observed amongst children and adolescents in Lebanon and promote minimally processed, culturally appropriate diets to improve nutrition and protect the health of this vulnerable population.