Photo of a pizza topped with tomatoes, pepperoni, and red onions on a background of a wooden checkerboard.

Weekend Long Reads: The Kids Are Eating a Lot More Pizza

by Kevin Schofield


This weekend’s “long read” is a report from a 20-year study on the food consumption habits of American youth. The National Health and Nutrition Examination Survey (NAHANES) has been collecting data since 1999, in two-year intervals, on what foods kids are eating, broken out across four categories: unprocessed and minimally processed; processed culinary ingredients such as oils; processed foods like cheeses; and “ultraprocessed” foods such as fast food, sweetened beverages, and store-bought ready-to-heat dishes.

In their most recent cohort, 2017–2018, they found that over two-thirds of the calories consumed by youth are from ultraprocessed food, up from 61.4% in 1999. The ready-to-heat/eat category jumped from 2.2% all the way up to 11.1%; that includes store-bought pizza, hamburgers, and sandwiches, and pizza alone is now over 5% of kids’ total calorie consumption.

The percentage of calories from unprocessed and minimally processed foods dropped over five points and is now less than a quarter. Kids are actually eating more fruit than 20 years ago but less grains and milk. Consumption of meat, fish, and eggs actually increased from 1999 to 2008 but has since dropped twice as much as it went up.

Another bright spot in the data is that the consumption of sugar-sweetened beverages has steadily declined over 20 years and is now half of the 1999 rate. Unfortunately, it seems that (as many researchers feared would happen) many people have substituted other sugary snacks and sweets for their sweetened drinks.

Chart depicting the changes in estimated percentage of energy intake from consumption of subgroups (industrial grain foods, ready-to-heat and -eat mixed dishes, etc.) of ultraprocessed foods among U.S. youth with yellow-orange dots representing the years 1999–2000 and dark-blue dots representing years 2017–2018.
Chart depicting the changes in estimated percentage of energy intake from consumption of subgroups (industrial grain foods, ready-to-heat and -eat mixed dishes, etc.) of ultraprocessed foods among U.S. youth with yellow-orange dots representing the years 1999–2000 and dark-blue dots representing years 2017–2018. Sourced from “Trends in Consumption of Ultraprocessed Foods Among U.S. Youths Aged 2–9 Years, 1999–2018.”

The demographics within this larger trend are very interesting. Consumption of ultraprocessed foods has increased across all age groups, and slightly more for boys than girls. The increase is largest for Black youth and least for Mexican American kids — suggesting that cultures favoring home cooking may have a bit more advantage in resisting the trend. The increase is nearly identical for all income levels, though less pronounced in households where the parents have higher levels of education.

Chart depicting the trends in estimated percentage of energy intake from ultraprocessed foods among the U.S. population categorized by race/ethnicity with a blue line representing Mexican American, a yellow line representing non-Hispanic white, and a green line representing non-Hispanic Black.
Chart depicting the trends in estimated percentage of energy intake from ultraprocessed foods among the U.S. population categorized by race/ethnicity with a blue line representing Mexican American, a yellow line representing non-Hispanic white, and a green line representing non-Hispanic Black. Sourced from “Trends in Consumption of Ultraprocessed Foods Among U.S. Youths Aged 2–9 Years, 1999–2018.”

The research report has an informative discussion of the nutritional differences between ultraprocessed and other foods. Generally, ultraprocessed foods have a much poorer nutrient profile, though FDA regulations (and societal pressures) have created some notable exceptions to that. Ultraprocessed foods these days tend to have less saturated fats and are fortified with iron, folate, and folic acid — important nutrients that tend to be lacking in Western diets (even healthy ones). But that’s no argument to rush out and buy a lot of ultraprocessed foods; they also have a ton of added sugars and salt, which are significant contributors to the epidemics of diabetes and high blood pressure in the United States.

It’s notable that the currently available data stops in 2018 — before the COVID-19 pandemic hit. It will be interesting to see in future years how the shutdown and stay-at-home orders affected kids’ eating habits (and in general trends in home cooking) as well as whether we resume our old habits as the economy returns to pre-pandemic patterns.

Trends in Consumption of Ultraprocessed Foods Among U.S. Youths Aged 2–19 Years, 1999–2018


Kevin Schofield is a freelance writer and the founder of Seattle City Council Insight, a website providing independent news and analysis of the Seattle City Council and City Hall. He also co-hosts the “Seattle News, Views and Brews” podcast with Brian Callanan, and appears from time to time on Converge Media and KUOW’s Week in Review.

📸 Featured image is attributed to russellstreet (under a Creative Commons, CC BY-SA 2.0 license).

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