title: Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada.
abstract: OBJECTIVE
  To investigate consumption of ultra-processed products in Canada and to assess their association with dietary quality.
  
  
  METHODS
  Application of a classification of foodstuffs based on the nature, extent and purpose of food processing to data from a national household food budget survey. Foods are classified as unprocessed/minimally processed foods (Group 1), processed culinary ingredients (Group 2) or ultra-processed products (Group 3).
  
  
  METHODS
  All provinces and territories of Canada, 2001.
  
  
  METHODS
  Households (n 5643).
  
  
  RESULTS
  Food purchases provided a mean per capita energy availability of 8908 (se 81) kJ/d (2129 (se 19) kcal/d). Over 61·7 % of dietary energy came from ultra-processed products (Group 3), 25·6 % from Group 1 and 12·7 % from Group 2. The overall diet exceeded WHO upper limits for fat, saturated fat, free sugars and Na density, with less fibre than recommended. It also exceeded the average energy density target of the World Cancer Research Fund/American Institute for Cancer Research. Group 3 products taken together are more fatty, sugary, salty and energy-dense than a combination of Group 1 and Group 2 items. Only the 20 % lowest consumers of ultra-processed products (who consumed 33·2 % of energy from these products) were anywhere near reaching all nutrient goals for the prevention of obesity and chronic non-communicable diseases.
  
  
  CONCLUSIONS
  The 2001 Canadian diet was dominated by ultra-processed products. As a group, these products are unhealthy. The present analysis indicates that any substantial improvement of the diet would involve much lower consumption of ultra-processed products and much higher consumption of meals and dishes prepared from minimally processed foods and processed culinary ingredients.
authors.affiliation: 1 Núcleo de Pesquisas Epidemiológicas em Nutricão e Saúde, Universidade de São Paulo, Av. Dr Arnaldo 715, 01246-904 São Paulo, SP, Brasil.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Moubarac
authors.forename: Ana Paula Bortoletto
authors.initials: AP
authors.lastname: Martins
authors.forename: Rafael Moreira
authors.initials: RM
authors.lastname: Claro
authors.forename: Renata Bertazzi
authors.initials: RB
authors.lastname: Levy
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Cannon
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Monteiro
mesh_terms: D002170:Canada; D002908:Chronic Disease / Q000517:prevention & control*; D004032:Diet / Q000592:standards*; D002149:Energy Intake; D005191:Family Characteristics; D057140:Fast Foods; D005247:Feeding Behavior; D005511:Food Handling; D006801:Humans; D009753:Nutritive Value; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*