Trends in Processed Meat, Unprocessed Red Meat, Poultry, and Fish Consumption in the United States, 1999-2016

Background Accumulating evidence links excessive consumption of processed meat with an increased risk of obesity, diabetes, cardiovascular diseases, and some cancers. Yet, trends in consumption of different types of processed meat in the United States have not been quantified. Objective The aim of the study was to characterize trends in consumption of different types of processed meat among US adults in relation to the consumption of unprocessed red meat, poultry, and fish/shellfish in the past 18 years, and their purchase locations. Design Dietary data collected from US adults aged 20 years and older completing at least one valid 24-hour diet recall from nine cycles of the National Health and Nutrition Examination Survey (NHANES 1999-2016) were used to evaluate the trends in mean consumption of processed meat, unprocessed red meat, poultry, and fish/shellfish. Participants/setting This was a nationally representative sample of 43,995 US adults aged 20 years and older. Main outcome measures We measured survey-weighted, energy-adjusted mean consumption of processed meat, unprocessed red meat, poultry, and fish/shellfish. Statistical analysis Trends in mean intake were assessed by treating the 2-year survey cycle as a continuous variable in survey-weighted linear regression models. Changes in mean intake were computed as the difference in mean intake between the earliest (1999-2000) and latest (2015-2016) cycles. Results The mean consumption of processed meat among US adults remained unchanged in the past 18 years (mean change=4.22 g/wk; P trend=0.95). The top five processed meats consumed by US adults in 2015-2016 were luncheon meat (mean intake=73.3 g/wk), sausage (45.5 g/wk), hot dog (17.5 g/wk), ham (17.5 g/wk), and bacon (8.6 giwk), accounting for 39.3%, 24.4%, 9.4%, 9.4%, and 4.6%, respectively, of the total processed meat consumption in the United States. During the same period, the mean consumption declined for unprocessed red meat (mean change= -56.7 g/wk; P trend<0.001) and increased for poultry (mean change=47.0 g/wk; P trend<0.001). The mean consumption of fish/shellfish did not change (mean change=1.55 g/wk; P trend=0.14). Stores and fast-food restaurants are primary purchase locations for processed meat. Conclusions Despite growing public health concerns about processed meat consumption, there have been no changes in the amount of processed meat consumed by US adults over the last 18 years. Findings of this study can inform public health policy priorities for improving diet and reducing chronic disease burden in United States.