• Elizabeth K Dunford, Barry M Popkin, and Shu Wen Ng.
• Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia; Department of Nutrition, Gillings Global School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: edunford@georgeinstitute.org.au.
• Am J Prev Med. 2020 Jul 1; 59 (1): 49-58.

IntroductionIn the U.S., there is no consensus of how to define junk food. Strict regulations on what constitutes junk food denoted by front-of-package labels can serve as the basis for statutory actions. Chile was the first country to adopt this approach, and several countries have followed suit. This study examined the proportion of calories and nutrients of concern consumed by U.S. children and adolescents defined as junk food using the Chilean label criteria and the changes between 2003 and 2016.MethodsData were obtained from 4 nationally representative food intake surveys in 13,016 U.S. children and adolescents: National Health and Nutrition Examination Survey 2003-2004, 2005-2006, 2013-2014, and 2015-2016, with analysis performed in 2019. Nutritional content of each consumed food was compared with nutrient thresholds from the Chilean regulation for energy, saturated fat, total sugars, and sodium per 100 g.ResultsBetween 2003 and 2016, there was a 10 percentage point decrease (71.1%-61.3%, p<0.01) in the proportion of foods consumed that were classified as junk food. A significant decrease was seen in mean intake of calories (1,610-1,367 kcal/day, p<0.01), total sugar (88.8-64.2 g/day, p<0.01), saturated fat (22.6-20.5 g/day, p<0.01), and sodium (2,306-2,044 mg/day, p<0.01).ConclusionsAlthough junk food intake has decreased since 2003-2006, diets of U.S. children and adolescents remain dominated by less-healthy foods. These results can help guide policy regulations regarding foods and beverages accessible in schools and marketed to children, adolescents, and their caregivers.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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