Ultra-processed food purchases in Norway: a quantitative study on a representative sample of food retailers

Objective: To identify the use of ultra-processed foods - vectors of salt, sugar and fats - in the Norwegian diet through an assessment of food sales. Design: Sales data from a representative sample of food retailers in Norway, collected in September 2005 (n 150) and September 2013 (n 170), were analysed. Data consisted of barcode scans of individual food item purchases, reporting type of food, price, geographical region and retail concept. Foods were categorized as minimally processed, culinary ingredients, processed products and ultra-processed. Indicators were share of purchases and share of expenditure on food categories. Setting: Six geographical regions in Norway. Subjects: The barcode data included 296 121 observations in 2005 and 501 938 observations in 2013. Results: Ultra-processed products represented 58.8% of purchases and 48.8% of expenditure in 2013. Minimally processed foods accounted for 17.2% of purchases and 33.0% of expenditure. Every third purchase was a sweet ultra-processed product. Food sales changed marginally in favour of minimally processed foods and in disfavour of processed products between 2005 and 2013 (chi(2) (3)= 203 195, P< 0.001, Cramer's V= 0.017, P< 0.001). Conclusions: Ultra-processed products accounted for the majority of food sales in Norway, indicating a high consumption of such products. This could be contributing to rising rates of overweight, obesity and non-communicable diseases in the country, as findings from other countries indicate. Policy measures should aim at decreasing consumption of ultra-processed products and facilitating access (including economic) to minimally processed foods.