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Trends in consumption of ultra-processed foods and obesity in Sweden between 1960 and 2010

  • Filippa Juul (a1) and Erik Hemmingsson (a1)



To investigate how consumption of ultra-processed foods has changed in Sweden in relation to obesity.


Nationwide ecological analysis of changes in processed foods along with corresponding changes in obesity. Trends in per capita food consumption during 1960–2010 were investigated using data from the Swedish Board of Agriculture. Food items were classified as group 1 (unprocessed/minimally processed), group 2 (processed culinary ingredients) or group 3 (3·1, processed food products; and 3·2, ultra-processed products). Obesity prevalence data were pooled from the peer-reviewed literature, Statistics Sweden and the WHO Global Health Observatory.


Nationwide analysis in Sweden, 1960–2010.


Swedish nationals aged 18 years and older.


During the study period consumption of group 1 foods (minimal processing) decreased by 2 %, while consumption of group 2 foods (processed ingredients) decreased by 34 %. Consumption of group 3·1 foods (processed food products) increased by 116 % and group 3·2 foods (ultra-processed products) increased by 142 %. Among ultra-processed products, there were particularly large increases in soda (315 %; 22 v. 92 litres/capita per annum) and snack foods such as crisps and candies (367 %; 7 v. 34 kg/capita per annum). In parallel to these changes in ultra-processed products, rates of adult obesity increased from 5 % in 1980 to over 11 % in 2010.


The consumption of ultra-processed products (i.e. foods with low nutritional value but high energy density) has increased dramatically in Sweden since 1960, which mirrors the increased prevalence of obesity. Future research should clarify the potential causal role of ultra-processed products in weight gain and obesity.

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1. Slimani, N, Deharveng, G, Southgate, DA et al. (2009) Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 63, Suppl. 4, S206S225.
2. Stuckler, D & Nestle, M (2012) Big food, food systems, and global health. PLoS Med 9, e1001242.
3. Moubarac, JC, Claro, RM, Baraldi, LG et al. (2013) International differences in cost and consumption of ready-to-consume food and drink products: United Kingdom and Brazil, 2008–2009. Glob Public Health 8, 845856.
4. Monteiro, CA, Levy, RB, Claro, RM et al. (2010) A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica 26, 20392049.
5. Moubarac, J-C, Parra, D, Cannon, G et al. (2014) Food classification systems based on food processing: significance and implications for policies and actions. A systematic literature review and assessment. Curr Obes Rep 3, 256272.
6. Moodie, R, Stuckler, D, Monteiro, C et al. (2013) Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 381, 670679.
7. Monteiro, CA, Moubarac, JC, Cannon, G et al. (2013) Ultra-processed products are becoming dominant in the global food system. Obes Rev 14, Suppl. 2, 2128.
8. Monteiro, CA & Cannon, G (2012) The impact of transnational ‘big food’ companies on the South: a view from Brazil. PLoS Med 9, e1001252.
9. Smith, LP, Ng, SW & Popkin, BM (2013) Trends in US home food preparation and consumption: analysis of national nutrition surveys and time use studies from 1965–1966 to 2007–2008. Nutr J 12, 45.
10. Hu, FB (2013) Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 14, 606619.
11. Malik, VS, Schulze, MB & Hu, FB (2006) Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 84, 274288.
12. Malik, VS, Popkin, BM, Bray, GA et al. (2010) Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 121, 13561364.
13. Hu, FB & Malik, VS (2010) Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav 100, 4754.
14. Moreno, LA & Rodriguez, G (2007) Dietary risk factors for development of childhood obesity. Curr Opin Clin Nutr Metab Care 10, 336341.
15. Bachman, CM, Baranowski, T & Nicklas, TA (2006) Is there an association between sweetened beverages and adiposity? Nutr Rev 64, 153174.
16. Vartanian, LR, Schwartz, MB & Brownell, KD (2007) Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health 97, 667675.
17. Faramawi, MF, Johnson, E, Fry, MW et al. (2007) Consumption of different types of meat and the risk of renal cancer: meta-analysis of case–control studies. Cancer Causes Control 18, 125133.
18. Hu, J, La Vecchia, C, Morrison, H et al. (2011) Salt, processed meat and the risk of cancer. Eur J Cancer Prev 20, 132139.
19. Kris-Etherton, PM, Lefevre, M, Mensink, RP et al. (2012) Trans fatty acid intakes and food sources in the US population: NHANES 1999–2002. Lipids 47, 931940.
20. Rohrmann, S, Overvad, K, Bueno-de-Mesquita, HB et al. (2013) Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition. BMC Med 11, 63.
21. Sinha, R, Cross, AJ, Graubard, BI et al. (2009) Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 169, 562571.
22. Mozaffarian, D, Aro, A & Willett, WC (2009) Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr 63, Suppl. 2, S5S21.
23. Ganguly, R & Pierce, GN (2012) Trans fat involvement in cardiovascular disease. Mol Nutr Food Res 56, 10901096.
24. Bendsen, NT, Christensen, R, Bartels, EM et al. (2011) Consumption of industrial and ruminant trans fatty acids and risk of coronary heart disease: a systematic review and meta-analysis of cohort studies. Eur J Clin Nutr 65, 773783.
25. Pereira, MA, Kartashov, AI, Ebbeling, CB et al. (2005) Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet 365, 3642.
26. Schroder, H, Fito, M & Covas, MI (2007) Association of fast food consumption with energy intake, diet quality, body mass index and the risk of obesity in a representative Mediterranean population. Br J Nutr 98, 12741280.
27. Bowman, SA & Vinyard, BT (2004) Fast food consumption of US adults: impact on energy and nutrient intakes and overweight status. J Am Coll Nutr 23, 163168.
28. Eidstedt, MW & Christina, (2012) Consumption of Food and Nutritive Values, Data up to 2010. Statistical Report no. 2012:01. Jönköping: Swedish Board of Agriculture.
30. Statistics Sweden (2010) Household Budget Survey (HBS) 20072009, Expenditure and Income Report . Stockholm: Statistics Sweden.
31. Berg, C, Rosengren, A, Aires, N et al. (2005) Trends in overweight and obesity from 1985 to 2002 in Goteborg, West Sweden. Int J Obes (Lond) 29, 916924.
32. Lilja, M, Eliasson, M, Stegmayr, B et al. (2008) Trends in obesity and its distribution: data from the Northern Sweden MONICA Survey, 1986–2004. Obesity (Silver Spring) 16, 11201128.
33. Neovius, K, Johansson, K, Kark, M et al. (2013) Trends in self-reported BMI and prevalence of obesity 2002–10 in Stockholm County, Sweden. Eur J Public Health 23, 312315.
34. Neovius, M, Teixeira-Pinto, A & Rasmussen, F (2008) Shift in the composition of obesity in young adult men in Sweden over a third of a century. Int J Obes (Lond) 32, 832836.
36. WHO Global Health Observatory Data Repository (n.d.) Overweight/Obesity: Mean body mass index trends (crude estimate) by country. (accessed June 2013).
37. Kark, M & Rasmussen, F (2005) Growing social inequalities in the occurrence of overweight and obesity among young men in Sweden. Scand J Public Health 33, 472477.
38. Moubarac, JC, Martins, AP, Claro, RM et al. (2013) Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada. Public Health Nutr 16, 22402248.
39. Tavares, LF, Fonseca, SC, Garcia Rosa, ML et al. (2012) Relationship between ultra-processed foods and metabolic syndrome in adolescents from a Brazilian Family Doctor Program. Public Health Nutr 15, 8287.
40. Moubarac, J-C, Batal, M, Martins, AP et al. (2014) Processed and ultra-processed food products: consumption trends in Canada from 1938 to 2011. Can J Diet Pract Res 75, 1521.
41. Martins, AP, Levy, RB, Claro, RC et al. (2013) Increased contribution of ultra-processed food products in the Brazilian diet (1987–2009). Rev Saude Publica 47, 110.
42. Monteiro, CA (2009) Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutr 12, 729731.
43. Drewnowski, A (2004) Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med 27, 3 Suppl., 154162.
44. Monsivais, P & Drewnowski, A (2007) The rising cost of low-energy-density foods. J Am Diet Assoc 107, 20712076.
45. Astrup, A, Dyerberg, J, Selleck, M et al. (2008) Nutrition transition and its relationship to the development of obesity and related chronic diseases. Obes Rev 9, Suppl. 1, 4852.
46. Ludwig, DS (2011) Technology, diet, and the burden of chronic disease. JAMA 305, 13521353.
47. Nielsen, SJ, Siega-Riz, AM & Popkin, BM (2002) Trends in energy intake in US between 1977 and 1996: similar shifts seen across age groups. Obes Res 10, 370378.
48. Guthrie, JF, Lin, BH & Frazao, E (2002) Role of food prepared away from home in the American diet, 1977–78 versus 1994–96: changes and consequences. J Nutr Educ Behav 34, 140150.
49. Prentice, AM & Jebb, SA (2003) Fast foods, energy density and obesity: a possible mechanistic link. Obes Rev 4, 187194.
50. Duffey, KJ, Gordon-Larsen, P, Jacobs, DR Jr et al. (2007) Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study. Am J Clin Nutr 85, 201208.
51. Thompson, OM, Ballew, C, Resnicow, K et al. (2004) Food purchased away from home as a predictor of change in BMI z-score among girls. Int J Obes Relat Metab Disord 28, 282289.
52. Asfaw, A (2011) Does consumption of processed foods explain disparities in the body weight of individuals? The case of Guatemala. Health Econ 20, 184195.
53. Canella, DS, Levy, RB, Martins, AP et al. (2014) Ultra-processed food products and obesity in Brazilian households (2008–2009). PLoS One 25, e92752.
54. Mozaffarian, D, Hao, T, Rimm, EB et al. (2011) Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 364, 23922404.
55. Ruano, C, Henriquez, P, Martinez-Gonzalez, MA et al. (2013) Empirically derived dietary patterns and health-related quality of life in the SUN project. PLoS One 8, e61490.
56. Jacka, FN, Mykletun, A, Berk, M et al. (2011) The association between habitual diet quality and the common mental disorders in community-dwelling adults: the Hordaland Health study. Psychosom Med 73, 483490.
57. Bakhtiyari, M, Ehrampoush, E, Enayati, N et al. (2013) Anxiety as a consequence of modern dietary pattern in adults in Tehran – Iran. Eat Behav 14, 107112.
58. Jacka, FN, Rothon, C, Taylor, S et al. (2013) Diet quality and mental health problems in adolescents from East London: a prospective study. Soc Psychiatry Psychiatr Epidemiol 48, 12971306.
59. Jacka, FN, Kremer, PJ, Berk, M et al. (2011) A prospective study of diet quality and mental health in adolescents. PLoS One 6, e24805.
60. Ifland, JR, Preuss, HG, Marcus, MT et al. (2009) Refined food addiction: a classic substance use disorder. Med Hypotheses 72, 518526.
61. Larson, NI, Perry, CL, Story, M et al. (2006) Food preparation by young adults is associated with better diet quality. J Am Diet Assoc 106, 20012007.
62. McLaughlin, C, Tarasuk, V & Kreiger, N (2003) An examination of at-home food preparation activity among low-income, food-insecure women. J Am Diet Assoc 103, 15061512.
63. Laska, MN, Larson, NI, Neumark-Sztainer, D et al. (2012) Does involvement in food preparation track from adolescence to young adulthood and is it associated with better dietary quality? Findings from a 10-year longitudinal study. Public Health Nutr 15, 11501158.
64. Zick, CD, Stevens, RB & Bryant, WK (2011) Time use choices and healthy body weight: a multivariate analysis of data from the American Time Use Survey. Int J Behav Nutr Phys Act 8, 84.
65. Kolodinsky, JM & Goldstein, AB (2011) Time use and food pattern influences on obesity. Obesity (Silver Spring) 19, 23272335.
66. Chen, RC, Lee, MS, Chang, YH et al. (2012) Cooking frequency may enhance survival in Taiwanese elderly. Public Health Nutr 15, 11421149.
67. de Graaf, C (2006) Effects of snacks on energy intake: an evolutionary perspective. Appetite 47, 1823.
68. Robinson, TN (1999) Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA 282, 15611567.
69. Mattes, R (2006) Fluid calories and energy balance: the good, the bad, and the uncertain. Physiol Behav 89, 6670.
70. Monteiro, CA, Levy, RB, Claro, RM et al. (2011) Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr 14, 513.
71. Barr, SB & Wright, JC (2010) Postprandial energy expenditure in whole-food and processed-food meals: implications for daily energy expenditure. Food Nutr Res 2010, 54.
72. Bernstein, AM, de Koning, L, Flint, AJ et al. (2012) Soda consumption and the risk of stroke in men and women. Am J Clin Nutr 95, 11901199.
73. Lin, J & Curhan, GC (2011) Associations of sugar and artificially sweetened soda with albuminuria and kidney function decline in women. Clin J Am Soc Nephrol 6, 160166.
74. Nettleton, JA, Lutsey, PL, Wang, Y et al. (2009) Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 32, 688694.
75. Payne, AN, Chassard, C & Lacroix, C (2012) Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host-microbe interactions contributing to obesity. Obes Rev 13, 799809.
76. Corkey, BE (2012) Diabetes: have we got it all wrong? Insulin hypersecretion and food additives: cause of obesity and diabetes? Diabetes Care 35, 24322437.
77. Ciardi, C, Jenny, M, Tschoner, A et al. (2012) Food additives such as sodium sulphite, sodium benzoate and curcumin inhibit leptin release in lipopolysaccharide-treated murine adipocytes in vitro . Br J Nutr 107, 826833.


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