CONSUMPTION OF ULTRA-PROCESSED FOODS, DIETARY PATTERNS AND ANTHROPOMETRIC STATUS OF ADULTS AGED (20-49 YEARS) IN IKWUANO LOCAL GOVERNMENT AREA, ABIA STATE.

The dietary patterns of the world population have been on transition due to the high consumption of ready-to-eat foods which have increased levels of fat and sugar, and lower intake of unprocessed foods, such as fruits, vegetables, tubers, and cereals (oat meals) (Monteiro et al., 2011). The potential cause of the pandemic of overweight, obesity and  rapid rise of related chronic diseases especially in under developed countries is the corresponding  increase in the production, processing and consumption of readily available ‘fast’ or ‘convenience’ ready-to-eat or ready-to-heat processed food and beverage products (WHO, 2003). Recent research shows that consumption of various products such as cookies (biscuits), baked products, sweets and desserts, sugar-sweetened drinks or products, processed meats, and French fries and chips (chips and crisps) is associated with weight gain in adults (Mozaffarian et al., 2011).

Ultra-processed foods are defined within the NOVA classification system, which groups foods according to the extent and purpose of industrial processing. NOVA is a food classification system developed by researchers at the university of Sao Paulo Brazil (Monteiro et al., 2010). Processes enabling the manufacture of ultra-processed foods include the fractioning of whole foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-processed foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unprocessed or minimally processed food products  (Canno et al., 2016). A practical way to identify an ultra-processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and antifoaming, bulking, carbonating, foaming, preservatives, gelling and glazing agents) (Monteiro et al., 2016). Ultra-processed foods already make up more than half of the total dietary energy consumed in high-income countries and between one-fifth and one-third of total dietary energy in middle-income countries. Population-based studies conducted in several countries, most of them using national dietary intake surveys, have shown that ultra-processed foods are typically high energy- dense products, high in sugar, unhealthy fats and salt, and low in dietary fibre, protein, vitamins and minerals (Chediel et al., 2010). Cross-sectional and longitudinal studies have shown that increases in the dietary share of ultra-processed foods result in deterioration of the nutritional quality of the overall diet and increased obesity, hypertension, coronary and cerebrovascular diseases, dyslipidaemia, metabolic syndrome, gastrointestinal disorders, and total and breast cancer. Avoidance of ultra-processed foods is the ‘golden rule’ of national dietary guidelines issued recently in Latin American countries (Collins et al., 2019).

Ultra-processed fast foods and soft drinks are the main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television. Over-consumption is also pushed by lightly regulated or often practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being (Allemandi, 2018) . General, animal foods are good sources of various amino acids, vitamins and minerals, but contain little or no dietary fibre. Quite often they are energy-dense and high in unhealthy types of fat. Plant foods are usually low in energy density and good sources of dietary fibre. Many are high in various micronutrients and bioactive compounds, and some are good sources of amino acids. This is why the human species has evolved as omnivorous. This explains why a great variety of traditional and long established food systems have been developed that have in common, the combination of plant foods with complementary nutrient profiles, such as grains (cereals) with legumes (pulses), or roots with tubers and legumes, or grains with vegetables, and usually with modest amounts of animal foods. 

Due to the sudden increase of obesity and overweight and other non communicable diseases (NCDs), the consumption of ultra-processed foods and drinks, and dietary pattern of adults  was found out to be one of the causes of overweight and obesity in adults  which in turn affects the BMI  giving rise to the development of non-communicable diseases like hypertension, diabetes, dyslipidaemia and cancer  among higher consumers of ultra-processed foods. The consumption of ultra-processed foods (UPFs) and sugar-sweetened beverages is increasing rapidly, replacing use of traditional or indigenous, culturally acceptable freshly cooked food (Moodie et al., 2013). These Ultra-processed products are characteristically formulated from ‘refined’ and ‘purified’ ingredients freed from the fibrous watery matrix of their original raw materials. They are formulated to be sensually appealing, hyper-palatable, and habit-forming, by the use of sophisticated mixtures of cosmetic and other additives, and state of the craft packaging and marketing. The leading branded ultra-processed foods and drinks are manufactured by transnational companies creating substrates for their products at rock-bottom or even subsidised process (Baker and Friel, 2016). They penetrate new markets in lower-income countries, with massive marketing and advertising budgets, and may undercut local industries, drive them out of business, or take them over. Rauber (2018) reported that high consumption of Ultra-processed foods correlated with lower intake of protein, fibre, and potassium and a higher intake of carbohydrates, free sugars, total fats, saturated fats, and sodium, thereby increasing the risk of diet-related non communicable diseases, cardiovascular diseases and some cancers. The world health organization (WHO) and the World Cancer Research Fund state that sugary drinks, energy dense snacks and 'fast food', all of which are ultra-processed, are key drivers of obesity, diabetes, cardiovascular diseases and certain cancers. In the last decades, ultra-processed products have usually become relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy. They are often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer (Mallarino et al., 2013). The packaging may cost more than the contents. Ultra-processed snacks and soft drinks are available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations. Ultra-processed fast foods and soft drinks are the main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television. Over-consumption is also pushed by lightly regulated or often practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being (Allemandi, 2018). A feature of the promotion of ultra-processed products in low-income countries, is incitement to over-consumption much more blatant than any now commonly found in other high-income countries where obesity is understood by all to be a crisis. Another feature is the direct marketing of branded products to impoverished communities (Monteiro et al., 2010). These products are made in such a way that the consumers cannot easily resist them with the saying “ Take one, taste and you will surrender!. It would be strange if, in the volume now manufactured and consumed, they were not a leading cause of the current pandemic of overweight and obesity. Importantly, there was a significant positive association between the availability and consumption of ultra-processed foods and the prevalence of adult obesity at national level (Monteiro et al., 2018). Most people crave and consume more of these ready to eat or convenient foods not necessarily because they want them but because they see these ultra-processed foods are the fastest and easiest food to prepare or consume. Others also consume them just to save time while few other take them as meal to meet up their daily dietary requirement. Additionally, due to the increase of fast. food centres, convenience food store, shops  in  Ikwuano L.G.A of Abia State, Nigeria. There is a major concern as this is a major contributor to the consumption of ultra-processed products among adults. Although the consequencies of such decisions is unknown to them. Hence, the purpose of this study. These has predominantly giving rise to non-communucable diseases like hypertension, high blood pressure, diabetes and stroke amongst adults.

General Objective of the study

The general objective of the study was to investigate the consumption of ultra-processed foods and dietary pattern of adults aged (20-49 years) in Ikwuano Local Government Area, Abia State. 

Specific Objectives of the study

The specific Objectives of this study were;

1. To determine the socio-economic and demographic characteristics of the respondents.

2. To ascertain the consumption of ultra-processed food and dietary pattern of the respondents.

3. To assess the anthropometric status of the respondents.

4. To determine the relationship between ultra-processed food consumption and the body mass index of the respondents.

1.3  SIGNIFICANCE OF THE STUDY     

The findings of this study will enlighten the public on the importance of attaining good nutritional standard within the household and also the health consequences associated with increased consumption of ultra-processed foods and beverages thereby limiting the prevalence of some ailments such as non communicable diseases, cardiovascular diseases and some cancers (De Vogli et al., 2014). This study will help policy makers and regulatory bodies in implementing laws that will guide the production, distribution and consumption of some of the products listed as ultra-processed products. Also consumers will be empowered to always make the right choices in food selection thereby improving the well being of households as well as the community. With the recognition of role of Ultra-processed foods in causing Non-communicable diseases, this study will enlighten the individual on the need to create a selective efforts to regulate the marketing of Ultra-processed and as well reducing their consumption (Foodie et al.,2013). However, more needs to be done to effectively reduce their consumption. A comprehensive documentation of national efforts and evaluation of their impact may be a first step. More importantly, a global marketing code should be adopted, based on which national legal instruments may be enacted. Such a Code should provide recommendations for prohibiting Ultra-processed food advertising and promotion, particularly to children; prohibiting sponsorship of research, sports and academic activities by Ultra-processed food manufacturers, and developing a system for monitoring and implementation of the code. The code should also prohibit participation of Ultra-processed food manufacturers in national and international policymaking and programme implementation. This study will also be useful for health practitioners, policy makers, researchers and educationists by providing them with relevant information regarding production and consumption of ultra-processed foods. Correspondingly, production and accessibility of wholesome foods need to be increased and improved by adopting specific policies, and regulatory actions designated to make healthy choices the easy choices backed by education programs. It is hoped that if the result of this research is really implemented by the households both at community, wards ,districts  and state levels, it will further help to correct many bad practices associated with  production and consumption of ultra-processed foods and drinks  thereby encouraging many to feed adequately.