Ultra-processed Food Consumption in Youth and Adults: United States, August 2021- August 2023

NCHS Data Brief No. 536, August 2025

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Anne M. Williams, Ph.D., M.P.H., Catharine A. Couch, Ph.D., R.D., Samuel D. Emmerich, D.V.M., and Damon F. Ogburn, Ph.D., M.S.P.H.

Ultra-processed foods tend to be hyperpalatable, energy-dense, low in dietary fiber, and contain little or no whole foods, while having high amounts of salt, sweeteners, and unhealthy fats (1). Ultra-processed food consumption has been associated with higher risk of cardiovascular disease and all-cause mortality (2). This report presents estimates about ultra-processed foods during August 2021-August 2023 by top caloric contributors and mean percentage of total calories from ultra-processed foods by sex, age, family income, and 10-year trends.

Keywords: Nova, caloric intake, National Health and Nutrition Examination Survey (NHANES)

What was the mean percentage of total calories consumed from ultra-processed foods during August 2021-August 2023, and were differences observed by sex and age?

The overall mean percentage of total calories consumed from ultra-processed foods among those age 1 year and older was 55.0% during August 2021-August 2023 (Figure 1, Table 1). Youth ages 1-18 years consumed a higher percentage of calories from ultra-processed foods (61.9%) than adults age 19 and older (53.0%). No significant differences were noted between males and females for either youth or adults.

Did the percentage of calories consumed from ultra-processed foods differ by age among youth and adults?

Among youth, children ages 1-5 years consumed fewer calories from ultra-processed foods (56.1%) than youth ages 6-11 (64.8%) and 12-18 years (63.0%) (Figure 2, Table 2). Among adults, the percentage of calories from ultra-processed foods decreased with increasing age. Adults ages 19-39 consumed 54.4% of calories from ultra-processed foods, while adults 40-59 consumed 52.6% and adults 60 and older consumed 51.7%.

Did the percentage of calories from ultra-processed foods vary by family income and age?

Among youth, the mean percentage of total calories from ultra-processed foods did not differ by income level (Figure 3, Table 3). Among adults, the mean percentage of total calories consumed from ultra-processed foods was lower in those with the highest family income (50.4% in those with incomes 350% or more of the federal poverty level) compared with the lower income levels (54.7% in those with incomes less than 130% and 55.3% in those with incomes 130%-349% of the poverty level).

Which ultra-processed food groups were the top sources of calories among youth and adults?

The top five sources of calories from ultra-processed foods among youth were sandwiches (including burgers), which contributed 7.6% of total calories, followed by sweet bakery products (6.3%), savory snacks (4.9%), pizza (4.7%), and sweetened beverages (3.9%) (Figure 4, Table 4). Similarly, the top five sources of calories from ultra-processed foods among adults were sandwiches (including burgers), which contributed 8.6% of total calories, followed by sweet bakery products (5.2%), sweetened beverages (4.4%), savory snacks (3.4%), and breads, rolls, and tortillas (3.1%).

What were the recent trends in the consumption of ultra-processed foods among youth and adults?

The mean percentage of total calories consumed from ultra-processed foods among youth increased and then decreased between 2013-2014 and August 2021-August 2023 (Figure 5, Table 5). A significant decrease was seen between 2017-2018 (65.6%) and August 2021-August 2023 (61.9%) among youth. Among adults, the mean percentage of total calories consumed from ultra-processed foods decreased from 55.8% in 2013-2014 to 53.0% in August 2021-August 2023. A significant decrease was also noted between 2017-2018 (56.0%) and August 2021-August 2023.

Summary

During August 2021-August 2023, youth consumed 61.9% of their daily calories, on average, from ultra-processed foods, while adults consumed 53.0% of their daily calories from ultra-processed foods. Although youth and adults consumed the majority of their calories from ultra-processed foods in the past decade, a decrease was seen in ultra-processed food consumption among youth and adults between 2017-2018 and August 2021-August 2023, and a decrease was seen among adults from 2013-2014 to August 2021-August 2023. Most dietary guidelines, including the Dietary Guidelines for Americans, 2020-2025, recommend eating a variety of whole foods and limiting intake of foods with added sugars (3).

Definitions

Food categories: The Nova classification system that categorizes foods by processing, from unprocessed to ultra-processed foods, was used in this analysis (4). The four main groups of the Nova classification system are: unprocessed or minimally processed foods; processed culinary ingredients; processed foods that typically have two or three ingredients, such as salt, oil, or sugar; and ultra-processed foods, which consist of industrial formulations of processed foods that typically contain unnatural additives, such as colorings or emulsifiers (1,4). Homemade foods and mixed dishes that may contain ultra-processed foods are disaggregated into their core ingredients to better categorize the sources of their calories (4). The 49 food categories in the U.S. Department of Agriculture's What We Eat in America were used to categorize foods to describe the top caloric contributors of ultra-processed foods (5).

Family income: The poverty income ratio is the annual total family income divided by the dollar amount defined by the U.S. Department of Health and Human Services' poverty guidelines to account for inflation and family size (6) and was used to categorize people into income groups.

Data sources and methods

Data from the August 2021-August 2023 National Health and Nutrition Examination Survey (NHANES) and data obtained from the National Cancer Institute that classifies foods into the Nova categories (4) were used to estimate the mean percentage of calories from ultra-processed foods. NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the U.S. civilian noninstitutionalized population. The NHANES sample is selected through a complex, multistage probability design. NHANES is conducted by the National Center for Health Statistics and consists of home interviews followed by standardized health examinations conducted in mobile examination centers and two 24-hour (midnight-to-midnight) dietary recall interviews with trained interviewers (7). The August 2021-August 2023 survey cycle included a mode change for dietary data collection (8). In other survey cycles included in this report, the first 24-hour dietary recall interview was conducted in-person during the mobile examination center visit, while both 24-hour dietary recall interviews were conducted over the phone on separate days following the mobile examination center visit in the August 2021-August 2023 survey cycle (8).

This analysis included all examined NHANES participants age 1 year and older who had reliable dietary recall data from the Day 1 interview. Day 1 dietary interview sample weights, which accounted for the differential probabilities of selection and nonresponse, were used to calculate nationally representative estimates. All analyses accounted for the survey's complex, multistage probability design. For August 2021-August 2023, differences between estimates overall, among subgroups, and compared with 2017-2018 were evaluated using t tests at the 0.05 level. Polynomial regression was used to test the significance of linear and nonlinear trends, accounting for the unequal spacing of survey cycles.

Data management and statistical analyses were conducted using SAS version 9.4 (SAS Institute, Inc., Cary, N.C.) and SUDAAN version 11.0.4 (RTI International, Research Triangle Park, N.C.).

About the authors

Anne M. Williams, Catharine A. Couch, and Damon F. Ogburn are with the National Center for Health Statistics, Division of Health and Nutrition Examination Surveys. Samuel D. Emmerich is an Epidemic Intelligence Service Officer assigned to the National Center for Health Statistics, Division of Health and Nutrition Examination Surveys.

The authors would like to thank Kirsten Herrick and Jill Reedy at the National Cancer Institute and Euridice Martínez Steele at the University of São Paulo, São Paulo, Brazil, for providing the files that classified foods into Nova categories.

References

1. Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: What they are and how to identify them. Public Health Nutr. 2019 Apr;22(5):936-41.
2. Pagliai G, Dinu M, Madarena MP, Bonaccio M, Iacoviello L, Sofi F. Consumption of ultra-processed foods and health status: A systematic review and meta-analysis. Br J Nutr. 2021 Feb;125(3):308-18.
3. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. 9th ed. Dec 2020. Available from: https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
4. Steele E, O'Connor L, Juul F, Khandpur N, Galastri Baraldi L, Monteiro CA, et al. Identifying and estimating ul-traprocessed food intake in the US NHANES according to the Nova classification system of food processing. J Nutr. 2023 Jan;153(1):225-241
5. Agricultural Research Service. What we eat in America food categories: 2021-2023. Available from: https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/2123/Food_Category_List_2021-2023.pdf
6. Office of the Assistant Secretary for Planning and Evaluation. 2021 poverty guidelines. Available from: https://aspe.hhs.gov/2021-poverty-guidelines
7. Terry AL, Chiappa MM, McAllister J, Woodwell DA, Graber JE. Plan and operations of the National Health and Nutrition Examination Survey, August 2021-August 2023. Vital Health Stat 1. 2024 May;(66):1-21. DOI: https://dx.doi.org/10.15620/cdc/151927
8. Williams AM, Terry A, Akinbami LJ, Ansai N, Ogden CL. What we eat in America dietary data, NHANES: August 2021-August 2023 24-hour dietary recall interview mode change. 2025. Available from: https://wwwn.cdc.gov/nchs/data/Nhanes/Public/2021/Whitepapers/Aug2023-What-We-Eat-In-America-Dietary-Data-Whitepaper.pdf

Suggested citation

Williams AM, Couch CA, Emmerich SE, Ogburn DF. Ultra-processed food consumption among youth and adults: United States, August 2021-August 2023. NCHS Data Brief. 2025 Aug;(536)1-11. DOI: https://dx.doi.org/10.15620/cdc/174612.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Brian C. Moyer, Ph.D., Director
Amy M. Branum, Ph.D., Associate Director for Science

Division of Health and Nutrition Examination Surveys

Alan E. Simon, M.D., Director
Lara J. Akinbami, M.D., Associate Director for Science