Ultra-processed foods contribute two thirds of energy intake and are associated with poorer nutrient profiles in New Zealand adolescents.

Ultra-processed food (UPF) consumption is rising globally, as is evidence showing its association with poor health outcomes. No studies have assessed UPF intake in New Zealand adolescents. Our cross-sectional study aimed to quantify UPF consumption among New Zealand adolescents and examine associations between UPF consumption and nutrient intake. Dietary intake was assessed using Intake24, an online 24-hour dietary recall, in 631 adolescents (aged 10-19 years) from schools in Auckland, Waikato, and Bay of Plenty, New Zealand. Foods consumed were grouped as either ultra-processed, processed, minimally processed, or processed culinary ingredients, according to the NOVA classification. Participants were stratified into tertiles of UPF consumption (as % of daily energy intake). Nutrient intakes were compared across tertiles using Kruskal-Wallis tests and for linear associations using adjusted linear regression models. On average, UPFs contributed a median 64.8% of daily energy intake. After adjustment for total energy intake and participant sex, UPF consumption had a positive linear association with intakes of saturated fat (P < .001, adjusted R2 = 0.03), sugar (P < .001, adjusted R2 = 0.05), and sodium (P < .001, adjusted R2 = 0.09), and a negative linear association with protein (P < .001, adjusted R2= 0.17), beta-carotene equivalents (P < .001, adjusted R2 = .10), tryptophan (P < .001, adjusted R2 = 0.22), magnesium (P < .001, adjusted R2 = 0.11), potassium (P < .001, adjusted R2 = 0.06), zinc (P < .001, adjusted R2 = 0.10), phosphorous (P < .001, adjusted R2 = 0.10), and vitamin E (P < .001, adjusted R2 = 0.04). The top 3 food groups contributing to UPF intake were bread and bread products, pastries and fried foods, and biscuits and desserts. These findings suggest UPF consumption is associated with poorer nutrient profiles among New Zealand adolescents and may inform future discussion around adolescent nutrition and the food environment.