title: Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil.
abstract: OBJECTIVE
  To assess time trends in the contribution of processed foods to food purchases made by Brazilian households and to explore the potential impact on the overall quality of the diet.
  
  
  METHODS
  Application of a new classification of foodstuffs based on extent and purpose of food processing to data collected by comparable probabilistic household budget surveys. The classification assigns foodstuffs to the following groups: unprocessed/minimally processed foods (Group 1); processed culinary ingredients (Group 2); or ultra-processed ready-to-eat or ready-to-heat food products (Group 3).
  
  
  METHODS
  Eleven metropolitan areas of Brazil.
  
  
  METHODS
  Households; n 13,611 in 1987-8, n 16,014 in 1995-5 and n 13,848 in 2002-3.
  
  
  RESULTS
  Over the last three decades, the household consumption of Group 1 and Group 2 foods has been steadily replaced by consumption of Group 3 ultra-processed food products, both overall and in lower- and upper-income groups. In the 2002-3 survey, Group 3 items represented more than one-quarter of total energy (more than one-third for higher-income households). The overall nutrient profile of Group 3 items, compared with that of Group 1 and Group 2 items, revealed more added sugar, more saturated fat, more sodium, less fibre and much higher energy density.
  
  
  CONCLUSIONS
  The high energy density and the unfavourable nutrition profiling of Group 3 food products, and also their potential harmful effects on eating and drinking behaviours, indicate that governments and health authorities should use all possible methods, including legislation and statutory regulation, to halt and reverse the replacement of minimally processed foods and processed culinary ingredients by ultra-processed food products.
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil. carlosam@usp.br
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Monteiro
authors.forename: Renata Bertazzi
authors.initials: RB
authors.lastname: Levy
authors.forename: Rafael Moreira
authors.initials: RM
authors.lastname: Claro
authors.forename: Inês Rugani Ribeiro
authors.initials: IR
authors.lastname: de Castro
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Cannon
mesh_terms: D001938:Brazil; D004032:Diet / Q000592:standards* / Q000639:trends; D002149:Energy Intake; D057140:Fast Foods; D005502:Food / Q000009:adverse effects / Q000145:classification* / Q000592:standards*; D005511:Food Handling / Q000379:methods*; D006801:Humans; D011634:Public Health