From Egypt to Italy, children who regularly consume ultra-processed foods are straying from traditional Mediterranean eating patterns and falling short of dietary guidelines, researchers warn. A recent study published in the journal Foods highlights the growing concern over the impact of ultra-processed food (UPF) consumption on diet quality among youth in five Mediterranean countries.
The study’s analysis revealed a troubling link between higher UPF consumption and poorer overall diet quality, reduced compliance with dietary guidelines, and lower adherence to the Mediterranean diet. This shift is particularly alarming given the historical reputation of Mediterranean diets for their health benefits.
The Rise of Ultra-Processed Foods
Daily consumers of UPFs face significant dietary challenges. The study found that children consuming UPFs daily had a 37-60% lower likelihood of achieving high diet quality scores, with the most pronounced negative effects observed in Egypt, Italy, and Portugal. This trend reflects a broader shift over recent decades from seasonal, fresh, and local foods to industrially processed alternatives.
Technological advances and globalization have reshaped food production, increasing the shelf life and convenience of foods at the expense of nutritional quality. This shift is particularly concerning for children, who are vulnerable due to their developmental needs, susceptibility to marketing, and dependence on caregivers and schools for their diet.
Early exposure to poor eating habits can disrupt healthy growth, impair cognitive and immune function, and increase the long-term risk of cardiovascular disease, obesity, and diabetes.
Mediterranean countries, once celebrated for their balanced and nutrient-rich diets, are experiencing a gradual transition toward Western-style eating habits characterized by nutrient-poor, calorie-dense foods. Although the overall consumption of such foods remains lower than in countries like the United States or the United Kingdom, the trend is worrying.
Understanding Ultra-Processed Foods
According to the Nova classification, UPFs are industrial products high in sugars, fats, and additives but low in essential nutrients. Growing evidence links frequent UPF consumption with poor diet quality, chronic diseases, and even cognitive problems.
Study Insights
The study examined dietary habits among children and adolescents aged 6 to 17 years in Lebanon, Egypt, Portugal, Spain, and Italy. Researchers collected data from 2011 parents via an online survey, which included demographic information, weight status, and physical activity levels.
Dietary intake was assessed through 24-hour recalls and weekly food frequency questions. Special attention was given to 13 categories of UPFs, including fast food, soft drinks, pastries, and candies. UPF consumption was categorized as “high” (above the median) or “daily” (consumption of at least one type of UPF daily).
Legumes got sidelined: Across all five countries, children eating more UPFs consistently fell short of dietary recommendations for legumes – a cornerstone of the traditional Mediterranean diet.
Diet quality was assessed using two indices: the Youth Healthy Eating Index and the Mediterranean Diet Quality Index. Statistical analyses included Chi-square, analysis of variance (ANOVA), and multivariate logistic regression, adjusting for physical activity, weight, age, and sex.
Key Findings and Implications
The study found that diets high in UPFs were not only linked to increased meat consumption but specifically to diets richer in processed meats like sausages and pre-packaged cold cuts. Among the 2011 participants, no significant differences by sex were found across UPF consumption groups. However, obesity and overweight were more common among children with higher daily UPF intake.
Interestingly, a higher proportion of physically active adolescents also reported high UPF consumption. The authors suggested this might reflect increased hunger from higher activity levels rather than inherently unhealthy behaviors, though this finding contrasts with most literature and requires further investigation.
In terms of food groups, high and daily UPF consumers ate more sweets, nuts, dairy, meat, and cereals but showed a lower proportion consuming high fruit intake. Notably, vegetable and whole grain intake remained consistent regardless of UPF consumption levels. Country-specific patterns largely mirrored these results.
Diet quality was consistently lower in children with higher UPF intake. Those consuming UPFs daily or frequently scored significantly lower on both diet quality indices.
Subgroup analyses showed particularly strong negative associations in Egypt, Portugal, and Italy. In contrast, Lebanon showed paradoxical increases in Mediterranean diet adherence among high UPF consumers, and findings were less consistent in Spain.
Conclusions and Future Directions
The study underscores the urgent need to address the rising consumption of unhealthy UPFs among children and adolescents in Mediterranean countries. Frequent UPF intake is associated with unbalanced diets rich in fats, sweets, and processed meats, potentially displacing minimally processed foods.
The research provides a comprehensive multi-country assessment of UPF consumption in Mediterranean youth using standardized metrics. While the study’s strengths include its standardized, multi-country design and focus on both diet quality indices and adherence to national guidelines, limitations exist. These include its cross-sectional design, reliance on parental reports, and restricted focus on certain UPF categories.
Reducing unhealthy UPF intake is essential to preserve the health benefits associated with the Mediterranean diet. This requires multi-sectoral strategies, including education, stricter marketing regulations, school nutrition policies, and industry accountability through reformulation and labeling.
