Validating the usage of household food acquisition surveys to assess the consumption of ultra-processed foods: Evidence from Brazil

Our ability to research dietary changes over time and their effects on health is limited by challenges inaccurately measuring food consumption. In countries where dietary surveys are scarce and rarely nationally representative, household budget surveys may serve as a useful alternative for assessing food consumption. The objective of this study was to evaluate how well household acquisition data reflects the actual intake of ultra-processed foods, using data from the 2008 to 2009 Brazilian Household Budget Survey. The food acquisition module was conducted for all households selected for the survey (n = 55,970) and a subsample corresponding to 25% of the households (n = 13,569) was randomly selected for the individual food intake module, which was conducted for all individuals aged 10 years or older (n = 34,003). Ultra-processed foods were defined as formulations made by the food industry mostly or entirely from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, chips, sugar-sweetened beverages, and ready-to-eat dishes. Our results showed an important agreement between the estimates of ultra-processed food consumption obtained from household acquisition data and individual intake inside-the-home data, particularly for the relative (% of total energy) consumption of these foods. Our study thus indicates that household budget surveys are quite promising for tracking population-level changes in the consumption of ultra-processed foods. The trend toward increased consumption of food away from home in other low- and middle-income countries indicates that future household budget surveys should include the collection of these data.