P2B342: Food Processing, as Classified by Nova, and Dietary Patterns of US Infants and Toddlers

Background: High intake of ultra-processed foods (UPFs) is associated with increased risk of chronic disease, thus is it important to understand how UPFs influence diet quality early in life. We describe complementary foods and beverages (CFBs) according to the Nova food processing classification system for infants and toddlers in the US and estimate how Nova groups and subgroups contribute to energy and select nutrients and food groups.

Methods: We used one 24-hr recall from infants and toddlers aged 6-23 months from the cross sectional, nationally representative 2013-18 National Health and Nutrition Examination Survey (n=1140). We estimated contributions of Nova groups and subgroups to energy and select nutrients and food groups consumed as CFBs (excluding human milk and formula) using the population ratio with weighted survey commands.

Results: For US infants and toddlers, 42 ± 0.9% (mean ± SEM) of energy intake from CFBs was classified as unprocessed/minimally processed (U/MP) and 45 ± 0.8% as UPFs. Unprocessed/minimally processed foods contributed most to nutrient intakes (except iron, zinc, and sodium); at least 20% of all selected nutrients were from UPFs. Ultra-processed foods contributed most to iron (75 ± 1.0%) and zinc (48 ± 1.3%); ultra-processed breakfast cereals were the top source for both. Most fruit, vegetables, and dairy were from U/MP foods. More than 80% of total grains, whole grains, refined grains, and added sugars were UPFs.

Conclusion: Unprocessed/minimally processed foods support healthy dietary patterns of infants and toddlers in the US while UPFs contribute meaningfully to nutrients and foods groups to be encouraged (iron, zinc, whole grains) as well as some that should be limited (added sugars and sodium). More research is needed to better understand the utility and sensitivities of using Nova for providing dietary guidance for US infants and toddlers.