Ultraprocessed Food Consumption by Urbanization Level Among United States Youth and Adults: Cross-sectional Analysis of NHANES 2013-March 2020.

Details

• Alternative Title:
  The American Journal of Clinical Nutrition, 2026, v. 123, no. 1: Ultraprocessed Food Consumption by Urbanization Level Among United States Youth and Adults: Cross-sectional Analysis of NHANES 2013-March 2020.
• Journal Article:
  The American Journal of Clinical Nutrition
• Personal Author:
  Ansai, Nicholas ; Williams, Anne ; Emmerich, Samuel D. ; Herrick, Kirsten A. ; Wambogo, Edwina A. ; Steele, Euridice Martínez ; Ogden, Cynthia L.
• Description:
  In the United States, ultraprocessed foods (UPFs) may contribute to poorer diet quality that has been observed in rural areas compared with urban areas, as increased UPF consumption is linked with decreased nutritional quality.
  
  To describe the mean contribution to total energy and total gram intakes from UPFs, unprocessed or minimally processed foods (MPFs), and other Nova categories and subcategories by urbanization level among United States youth and adults.
  
  Cross-sectional data from the National Health and Nutrition Examination Survey from 2013 to March 2020 were analyzed. The mean percent of total energy and total gram intakes from Nova categories (MPFs, processed culinary ingredients, processed foods, and UPFs) were estimated by urbanization level (nonmetropolitan statistical areas non-MSAs, n = 3976, small-to-medium MSAs n = 9170, and large MSAs n = 14,637) for youth 2-19 y and adults 20 y and older. Trends by urbanization level were assessed using orthogonal contrasts in linear regression models adjusted for sex, age, race and Hispanic origin, and income. Day 1 dietary sample weights accounted for differential probabilities of selection, nonresponse, noncoverage, and day of the week.
  
  Among youth, there was no trend in MPF or UPF as a percent of energy by the urbanization level. As a percent of grams, MPF increased and UPF decreased with a higher urbanization level. After adjustment for sex, age, race and Hispanic origin, and income, only the trend in the percent of grams from MPF remained. Among adults, as both a percent of energy and a percent of grams, MPF increased and UPF decreased with higher urbanization levels. These trends remained significant after adjustment for covariates.
  
  Adults in rural areas consumed more UPF and less MPF than those in urban areas in terms of both energy and grams. There were a few significant differences by urbanization among youth.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Cross-Sectional Studies
  • Adult
  • Adolescent
  • Nutrition Surveys
  • Urbanization
  • United States
  • Male
  • Young Adult
  • Female
  More +
• Keywords:
  • Urban
  • Rural
  • Nova
  • Food processing
  • NHANES
  • urban
  • rural
  • food processing
• Source:
  The American Journal of Clinical Nutrition, 2026, v. 123, no. 1
• DOI:
  https://doi.org/10.1016/j.ajcnut.2025.10.010
• ISSN:
  0002-9165 ; 1938-3207
• Pubmed ID:
  41110829
• Pubmed Central ID:
  PMC12851886
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  101093 (19 pdf pages)
• Volume:
  123
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c92941c20cbfbedf82e9b85c4a416e45f2cd907223e594a8e2be3ecad45d29c5fcf0ed1086f761f8294d999b8dc0b00c8cc311d5dcafa0d7da67e98ca2892452