Ultra-Processed Foods During the Transition to Adulthood in Cebu, Philippines: Sociodemographic Patterns, Drivers of Intake, and Associations with Blood Pressure

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  • Busse, Kyle
    • Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Consumption of ultra-processed foods (UPFs), which are ready-to-eat products containing little or no whole foods, has increased globally over the past half century and continues to rise rapidly in low- and middle-income countries (LMICs). UPF intake has been linked to risk of multiple cardiometabolic diseases, including elevated blood pressure (BP). Previous research indicates that cardiometabolic diseases may originate in adolescence, when UPF intake has been found to be at its highest in many settings. Nonetheless, the drivers of UPF intake during adolescence, when long-term dietary patterns are often established, have received little attention. Furthermore, little is known about the relationship between UPF intake and BP during adolescence and early adulthood among populations in LMICs, where the burden of cardiometabolic diseases continues to grow.Data from fives waves (1994-2009) of the Cebu Longitudinal Health and Nutrition Survey (CLHNS), a birth cohort based in Metropolitan Cebu, Philippines, were used to examine sociodemographic and lifestyle factors associated with UPF intake during adolescence and early adulthood, and to estimate sex- and age-specific associations between BP and UPF intake during the transition to adulthood. Additionally, qualitative data from young people (18-20 years) living in Metro Cebu in 2023 were used to assess awareness, experiences, and beliefs related to UPFs.In this cohort, adolescents’ UPF intake tended to increase with increasing socioeconomic status and was positively associated with maternal UPF intake, but not after adolescents entered adulthood. There was a modest, positive association between BP and UPF intake, which varied by age and sex. Finally, among young people in Cebu, taste, cost, and convenience were key factors influencing UPF intake. Despite rarely or never having encountered the term “ultra-processed food,” young people intuitively grasped its meaning and expressed beliefs about the adverse health effects of UPFs.These results suggest that UPF intake among young people in this metropolitan area of the Philippines varies according to socioeconomic status and is largely influenced by individual and interpersonal factors. The positive association between BP and UPF intake during the transition to adulthood in this setting highlights the need for efforts to limit UPF intake among young people in LMICs.
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  • In Copyright - Educational Use Permitted
Advisor
  • Ammerman, Alice
  • Adair, Linda
  • Mayol, Nanette L
  • Martin, Stephanie
  • Avery, Christy
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2024
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